Quick Question: Extrinsic Pathway

Our September, 2018 Quick Question was a quiz with one correct answer addressing our knowledge of the coagulation cascade: Which coagulation factor is the first activated in the extrinsic pathway? With 144 responding, the answers were: Factor XII: 16 (11%) Factor IX: 9 (6%) Factor VII: 105 (73%) Prothrombin: 14 (10%) Congratulations to the overwhelming […]

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Coagulation Factors

Sep 21 2018

george

Brillinta and Shortness of Breath

I (Geo) just had a chat with a friend who recently had a stent installed and is now on a regular regimen of aspirin, 81 mg/day, and Brillinta, 90 mg/twice a day. He reports no minor bleeds, but he does have shortness of breath episodes. Shortness of breath is recorded as a possible side effect […]

Antiplatelet Therapy

East Texas Bleeding Disorder

Here is a fascinating response to our September 2 solution to the August 10 Minimally Prolonged PT discussion, from Dimitrios Liapis MSc, Vascular Research Private Medical Center, Athens, Greece. From Mr. Liapis: A very interesting case! Did the patient or members of the immediate family report any bleeding history? Other coagulation tests besides PT? It […]

Bleeding Disorders

Platelet Neutralization Procedure

Geoffrey Wool, MD, PhD, Associate Director of Coagulation at the University of Chicago Medical Center Laboratory, provided an excellent Webinar, “Lupus Anticoagulant Testing: Managing Interferences and Optimizing Quality” on the Labroots provider site. Dr. Wool addresses among other issues the time-honored platelet neutralization procedure (PNP), in which concentrated phospholipid extracted from platelets is used to […]

Mixing Studies

R-T Estimation of the INR

Despite the onslaught of direct oral anticoagulants, Coumadin still occupies an important place in anticoagulation. Most facilities employ POC instruments that rapidly generate the PT/INR, and most choose to confirm all INRs that exceed 4.0 by collecting venous blood and performing a plasma-based PT/INR. A 2016 report describes the R-T estimation formula designed to correlate […]

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Anticoagulant Therapy

Sep 2 2018

george

Minimally Prolonged PT: Solution

Referring to our post of August 10, 2018 entitled Minimally Prolonged PT, Dr. Laposata reviewed the patient’s consistently, though slightly prolonged, PT results, and considered a factor VII deficiency. It turns out the patient’s factor VII level was 40%, found also in some first-degree relatives. It may not be that a factor VII level of […]

Bleeding Disorders

Quick Question: Extrinsic Pathway

For our September, 2018 Quick Question, here is a simple quiz question with one correct answer. This is your opportunity to check your “coagulation casecade” knowledge. Feel free to check your undergraduate coag course notes or check with your coagulation consultant!

Coagulation Factors

August, 2018 Quick Question

Here are the results of our August, 2018 Quick Question, answered by 93 participants:. Stem: What is the FDA-approved assay for anti-Xa DOACs? a. Thrombin time: 12% (11) b. Prothrombin time: 8% (7) c. Partial thromboplastin time: 8% (7) d. Chromogenic anti-Xa using DOAC calibrators: 72% (68) This was perhaps a “trick” question. The US […]

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Anticoagulant Therapy

Aug 31 2018

george

Reference Intervals

I recently became reacquainted with colleague Madeline Ducate, PhD, who supports pharmaceutical houses with the laboratory needs for international clinical trials. Madeline is occasionally confronted with a lack of laboratory reference intervals in under-resourced countries, where cultural norms or the lack of funding limit specimen collection and processing from healthy subjects. In vitro diagnostics companies […]

Bleeding Disorders

HGB Variations During the Day

George, periodically we see patients that have a gram or so difference in their hemoglobin levels which causes some duress with the clinicians. Recently we had a nursing home patient (s/p hip fracture repair) who had a venous draw early in the morning that was sent to our in house hospital laboratory and resulted in […]

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Bleeding Disorders

All Posts

Quick Question: Extrinsic Pathway

Brillinta and Shortness of Breath

East Texas Bleeding Disorder

Platelet Neutralization Procedure

R-T Estimation of the INR

Minimally Prolonged PT: Solution

Quick Question: Extrinsic Pathway

August, 2018 Quick Question

Reference Intervals

HGB Variations During the Day

George Fritsma MS MLS

Cheat Sheets from George

Questions or Comments?

Quick Question