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Fitzgerald and Fletcher Factor Deficiencies

Another brain teaser from Kim Kinney at Clarian in Indianapolis: Hi George, I am working on a case study for American Society for Clinical Laboratory Science (ASCLS). We had a patient who came in for a right hip replacement and ended up being < 1% high molecular weight kininogen (HMWK, Fitzgerald factor) and 58% prekallikrein […]

Quick Question: PT Delta Check

The PT delta-check question was… Please select the 24-hour PT delta-check range closest to the one you use. The answers… a. 0.5: 8 (42%) b. 0.1: 5 (26%) c. 1.5: 2 (11%) d. 2.0: 4 (21%) In interpreting these results, a number of people reported earlier they used no delta check on the PT result. […]

Hemophilia A Carrier Status

Here is a message from Col. More at Elmendorf in Alaska: Hi, we have a pregnant mom, having a boy, who says her dad has hemophilia. I’m waiting for more history on that. In the meantime I looked for ways to test the mom. I found that if you run factor VIII and IX antigen […]

Interpreting a prolonged PT and PTT

Hi George, I am a MLT and I am currently working on my MT. I have a few questions about mixing studies. I have listened to several of your modules on your website but I am still having trouble with understanding factor deficiencies in certain scenarios. If a patient has a prolonged PT and PTT […]

Determining Reference Intervals

I’ve enjoyed an interesting exchange with an engineer who contacted the American Society for Clinical Laboratory Science Consumer Forum. She was concerned that her blood specimen, which had been sent to two laboratories for complete blood counts, had generated the same hemoglobin result from each, however one reported the value as normal and the other as elevated. […]

Quick Reference

George, I was wondering if you could recommend a “quick” reference guide that provides a comprehensive yet easily understandable overview of hemostasis (I know this may be an oxymoron). Our off shifts are sometimes questioned by clinicians (mainly residents) about interpretations of “special” coagulation tests (lupus anticoagulant, APC testing, proteins C and S, etc). While […]

HELLP Syndrome

Here is a question about HELLP from a colleague with heterozygous factor V Leiden mutation. George: If you have not heard I had my baby, a healthy boy. I had HELLP syndrome/preeclampsia. Do you know of any studies that may link factor V Leiden to HELLP? Just curious. A quick PubMed search turned up approximately […]

Platelet Clumping in Sodium Citrate and Plateletpheresis

An interesting question from Mary Coleman at the University of North Dakota: A female student reported to student health with a severe headache. She had a complete blood count performed using a standard EDTA tube and she had a low platelet and elevated lymphocyte count. The laboratory scientist also prepared a direct blood film from […]

Rivaroxaban Vote

The US Food and Drug Administration’s (FDA) Cardiovascular and Renal Drugs Advisory Committee recommended approval of Rivaroxaban (Xarelto) oral anti-Xa antithrombotic for prophylaxis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing hip replacement or knee replacement surgery. The FDA has until May 28 to vote full approval. See Medical News Today for more […]

Adsorbed plasma and aged serum

Dear George, I am finding reference to the use of aged serum or adsorbed plasma in mixing study board review questions, yet no information in the current texts. Are those out of date procedures? Thank you, Tania Puro Hi, Ms. Puro. You are correct, the substitution assays are no longer used and are not likely […]

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George Fritsma is a medical laboratory scientist, educator, and author. George is a member of the International Society on Thrombosis and Hemostasis, the International Society for Laboratory Hematology, and the American Society for Clinical Laboratory Science.

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