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Physiology Heart, Circulation, and Blood 861f2b6e

A 9-year-old boy with elevated both PT and aPTT What is the diagnosis?

A
Defect in extrinsic pathway
B
Defect in Intrinsic pathway
C
Platelet function defect
D
Defect in common pathway
High-Yield Explanation
Ans. D. Defect in common pathwaya. The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation.b. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status.c. PT measures factors I, II, V, VII, and X.d. The partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT or APTT) is a performance indicator measuring the efficacy of both the "intrinsic" (now referred to as the contact activation pathway) and the common coagulation pathways.e. It is also used to monitor the treatment effects with heparin, a major anticoagulant. 4f. It is used in conjunction with the prothrombin time (PT) which measures the extrinsic pathway.g. Incase both are increased it indicates defect in common pathway.ConditionProthrombin timePartial thromboplastin timeBleeding timePlatelet countVitamin K deficiency or warfarinprolongedprolongedunaffectedunaffectedDICprolongedprolongedprolongeddecreasedVon Willebrand diseaseunaffectedprolongedprolongedunaffectedHemophiliaunaffectedprolongedunaffectedunaffectedAspirinunaffectedunaffectedprolongedunaffectedThrombocytopeniaunaffectedunaffectedprolongeddecreasedEarly Liver failureprolongedunaffectedunaffectedunaffectedEnd-stage Liver failureprolongedprolongedprolongeddecreasedUremiaunaffectedunaffectedprolongedunaffectedCongenital afibrinogenemiaprolongedprolongedprolongedunaffectedFactor V deficiencyprolongedprolongedunaffectedunaffectedFactor X deficiencyprolongedprolongedunaffectedunaffectedGlanzmann's thrombastheniaunaffectedunaffectedprolongedunaffectedBernard-Soulier syndromeunaffectedunaffectedprolongeddecreased

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