Vitamin K Kinetics

George received a series of questions about vitamin K kinetics from colleague and friend Catherine N. Otto, MLS, PhD, Rutgers University. Dr. Otto is assisting a Nutrition Science colleague. It seems that vitamin K deficiency (as defined by PT/INR) does not show up until there is serious depletion in the amounts of these activated proteins. Why? […]

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Anticoagulant Therapy

Jul 3 2019

george

FVL and AC Therapy

From friend, colleague, and frequent contributor Dave McGlasson: A friend contacted me about if her should be put on an anticoagulant. He is a 71 year old male who in 2004 suffered a DVT. A subsequent work-up revealed he possessed a heterozygous factor V Leiden mutation. At the time of the clot he had been […]

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Anticoagulant Therapy

Jul 2 2019

george

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 […]

Bleeding Disorders

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

All Posts

Vitamin K Kinetics

FVL and AC Therapy

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

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question