Case: VWD? Please Answer

A 16-year-old girl experiences chronic menorrhagia. Her PT is 12.2 s, PTT 37.1 s (H), factor VIII activity 51% (L), VWFag 54%, VWFactivity 45% (L), VWFRCo 43% (L), VWF multimers: normal distribution. CBC results are normal except HGB is 11.8 g/dL (L). What is her presumptive diagnosis, what follow-up testing, if any, is necessary, and […]

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Bleeding Disorders

Jun 29 2019

george

Quick Question: TTP Laboratory Assay

Our June, 2019 Quick Question generated a near-unanimous response from 68 voters: What laboratory assay confirms thrombotic thrombocytopenic purpura (TTP)? Shiga toxin test: 3% (2) Complement C3 level: 7% (5) ADAMTS13 activity: 83% (56) VWF multimers: 7% (5) The Shiga toxin test correlates to Shiga toxin-induced hemolytic-uremic syndrome (ST-HUS), the “classic” HUS detected mainly in […]

Arterial Thrombosis

Lot to Lot Validation

From Maureen (Mo) Tacke, St Luke’s Health System: Hi George, our institution is coming to the joyous time of lot roll over in coagulation, and it’s got me wondering… Is our process a little (or a lot) overkill? Current process: Normal ref range studies (20 normals) for PT, PTT, FIB, AT, TT, PC, PS, DRVVT, […]

Validation

Venous Thoracic Outlet Syndrome

I (Geo) recently learned of an acquaintance who has developed venous thoracic outlet syndrome (VTOS), also termed “effort thrombosis” or more formally, Paget-Schroetter syndrome. This is thrombosis of the axilosubclavian vein where the vein passes by the junction of the clavicle and first rib. VTOS is rare, and is seen in athletes, for example, baseball […]

Thrombophilia

Aspirin Presentation June 26, 2019

Thanks to the American Society for Clinical Laboratory Science for providing George with the opportunity to present “Aspirin, the 1899 Wonder Drug Lives Again,” and thanks to the many participants who came to hear the talk. Click or tap here for an updated copy of the presentation handout. George will present an expanded version on […]

Antiplatelet Therapy

What is the CHA2DS2-VASc Score?

The CHA2DS2-VASc score assigns points to a series of clinical observations in patients with non-valvular atrial fibrillation (AFIB). CHA2DS2-VASc scores are used to predict the risk of ischemic stroke. The score is computed as follows: Congestive heart failure or left ventricular systolic dysfunction: 1 point Hypertension: BP consistently above 140/90 mmHg or treated hypertension on […]

Thrombophilia

Rivaroxaban in CHF

On Wednesday, June 5, The Heart.org posted this entry, “Rivaroxaban Cuts Stroke Risk in Sinus-Rhythm Heart Failure: COMMANDER-HF.” (Click or Tap). This is the first publication that implicates an advantage for DOAC therapy in addition to antiplatelet therapy in preventing ischemic strokes and transient ischemic attacks in patients with congestive heart failure with. The key […]

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Anticoagulant Therapy

May 28 2019

george

Quick Question: FVL Order

Our Quick Question for May, 2019 was “A rheumatologist orders a thrombophilia profile that includes a genotypic factor V Leiden mutation assay. You… A. Proceed with the FVL assay: 40% (14) B. First perform the phenotypic APCR: 51% (18) C. Cancel the order: 9% (3) George posted this because the American Society for Clinical Laboratory […]

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Quick Question Archive

May 18 2019

george

Ticagrelor Antibacterial Property

Click below to see a May 9, 2019 article that links ticagrelor (Brilinta) antiplatelet therapy with its putative anti-gram-positive bacterial property, including Methacillin-resistant Staph aureus and Vancomycin-resistant enterococcus. It appears that platelets are able to sequester the drug in sites of infection. Lancellotti P, Musumeci L, Jacques N, et al. Antibacterial activity of ticagrelor in […]

Antiplatelet Therapy

Wearable Clot Detector

Nephrologist Vinay Narasimha Krishna, M.D, University of Alabama at Birmingham, developed a wearable clot detection device for which he received one of 15 KidneyX Redesign Dialysis prizes from the U.S. Department of Health and Human Services and the American Society of Nephrology. The device is designed to be worn over the dialysis fistula in real […]

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Arterial Thrombosis

All Posts

Case: VWD? Please Answer

Quick Question: TTP Laboratory Assay

Lot to Lot Validation

Venous Thoracic Outlet Syndrome

Aspirin Presentation June 26, 2019

What is the CHA2DS2-VASc Score?

Rivaroxaban in CHF

Quick Question: FVL Order

Ticagrelor Antibacterial Property

Wearable Clot Detector

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question