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QQ: 5 YO Girl with Systemic Bleeding

On February 24, 2011, George responded privately to a question posted to the American Society for Clinical Laboratory Science Consumer Web Forum from the parent of a 5-YO girl. The girl had experienced epistaxis and easy bruising from birth. Platelet aggregometry, performed on a specimen taken January 23, 2007 (1 YO) reported no aggregation to […]

Bleeding Disorders

December, 2019 Quick Question

Check our December, 2019 Quick Question on the right: “When collecting hemostasis specimens, when do you use a discard tube?” Please provide an answer based on your facility’s specimen management policy. If your answer doesn’t match the answers that are offered, please provide your comment below or send it to George at [email protected] for publication.

Quick Question Archive

November, 2019 Quick Question

Our November, 2019 Quick Question asked, “What may you substitute for the PT when LAC prolongs the PT?” We accumulated 53 votes. A. None, use the PT anyway: 9% (5) B. Chromogenic anti-Xa: 13% (7) C. Chromogenic factor X: 30% (16) D. Activated clotting time: 8% (4) E. Thrombin time: 11% (6) F. There is […]

Anticoagulant Therapy

Platelets and Diet

Colleague and friend Mary Coleman, University of North Dakota referred a student in her Hematology class. The student told Prof. Coleman of a patient whose platelet count was chronically low. The student learned that a nurse told the patient there are foods that increase their platelets, such as pumpkin, kiwi, and pomegranate and wonders if […]

Platelet Function Testing

Choosing Wisely

George presents “Medical Laboratory Scientists Choose Wisely” today, Friday, November 15 at the Clinical Laboratory Managers Association of Georgia and Alabama, hosted by the University of Alabama at Birmingham Clinical Laboratory Management Symposium, UAB School of Health Professions. George’s talk describes the American Board of Internal Medicine Foundation’s Choosing Wisely initiative. Click or tap here […]

Coagulation Factors

Switching from DOAC to UFH

From Maureen Tacke, Program Manager, Lab, Hematology/Coagulation, St. Luke’s Health System: Our institution is working towards a conversion to Anti-Xa monitoring for patients on UFH, however, our pharmacy group has a question. What are other facilities doing if a patient presents, needs UFH, and is already on a DOAC (the baseline anti-Xa or PTT is […]

Anticoagulant Therapy

Quick Question: PT substitute

Our November, 2019 Quick Question asks, “What may you substitute for the PT when LAC prolongs the PT?” This question addresses the unreliability of the PT for monitoring Coumadin therapy when lupus anticoagulant interferes by prolonging the result. It is also relevant to PT prolongation by fibrinogen deficiency or factors II, V, VII, or X […]

Anticoagulant Therapy

Quick Question: Liver Disease or VK Deficiency?

Here are the results to our October, 2019 Quick Question, “What factor assays do you perform to distinguish liver disease from vitamin K deficiency?” a. II and V: 13 (15%) b. V and X: 10 (12%) c. II and X: 8 (9%) d. V and VII: 44 (51%) e. VII and X: 11 (13%) The […]

Bleeding Disorders

CUSUM

From Heather DeVries, Indiana University: I’ll make this one short and sweet…how many samples should be used in a cumulative summation study? Heather, I’ve never used nor taught CUSUM, so I’m posting this in hopes of attracting comments. I did find a helpful reference, Westgard JO,Groth T, Aronsson T, de Verdler C. Combined Shewhart-cusum control […]

AUGUSTUS Trial: Apixaban and Clopidogrel

Click or tap here to learn the results of the AUGUSTUS trial, which shows that the combination of apixaban and a P2Y12 inhibitor such as clopidogrel is safer than Coumadin and clopidogrel, Coumadin and aspirin, or apixaban and aspirin for post-PCI or acute coronary syndrome therapy.

Anticoagulant Therapy

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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.

Cheat Sheets from George

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