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📌 𝙃𝙀𝙈𝘼 𝙇𝘼𝘽 𝙀𝙑𝘼𝙇𝙐𝘼𝙏𝙄𝙊𝙉: 𝖳𝖮 𝖱𝖤𝖬𝖤𝖬𝖡𝖤𝖱 🩸

see thread:

APTT/PTT - 𝙋𝙡𝙖𝙩𝙚𝙡𝙚𝙩-𝙋𝙤𝙤𝙧 𝙋𝙡𝙖𝙨𝙢𝙖
PLATELET FX TESTS - 𝙋𝙡𝙖𝙩𝙚𝙡𝙚𝙩-𝙍𝙞𝙘𝙝 𝙋𝙡𝙖𝙨𝙢𝙖

COMPLETE THROMBOPLASTIN - 𝙏𝙞𝙨𝙨𝙪𝙚 𝙁𝙖𝙘𝙩𝙤𝙧/𝙋𝙋𝙇/𝙇𝙞𝙥𝙤𝙥𝙧𝙤𝙩𝙚𝙞𝙣

APTT/PTT - 𝙋𝙝𝙤𝙨𝙥𝙝𝙤𝙡𝙞𝙥𝙞𝙙

🧪🩸 𝙛𝙤𝙧 𝙚𝙫𝙚𝙧𝙮 𝙗𝙖𝙩𝙘𝙝 𝙤𝙛 𝙥𝙖𝙩𝙞𝙚𝙣𝙩𝙨 𝙩𝙤 𝙧𝙪𝙣 𝙮𝙤𝙪 𝙝𝙖𝙫𝙚:

1. prolonged control
2. normal control

𝑪𝑳𝑶𝑻-𝑩𝑨𝑺𝑬𝑫 𝑨𝑺𝑺𝑨𝒀𝑺

𝐌𝐚𝐧𝐮𝐚𝐥 🫳🏻
1. Tilt Tube
2. Nichrome Wire Technique

𝐀𝐮𝐭𝐨𝐦𝐚𝐭𝐞𝐝 📠
1. Moving Probe
2. Change in optical density

↑ 10 mins incubation = Coagulation factors 𝐝𝐞𝐭𝐞𝐫𝐢𝐨𝐫𝐚𝐭𝐞

𝐀𝐏𝐓𝐓 - Intrinsic, Common Pathway & Inhibitors
𝐏𝐓 - Extrinsic, Common Pathway & Inhibitors

𝐀𝐃𝐒𝐎𝐑𝐁𝐄𝐃 𝐏𝐋𝐀𝐒𝐌𝐀: Factors V, VIII, XI, XII & I (Prothrombin Group is ABSENT)

𝐀𝐆𝐄𝐃 𝐒𝐄𝐑𝐔𝐌 - Factors VII, IX, X, XI & XII (Thrombin Sensitive Group is ABSENT)

Always 𝐑𝐄𝐏𝐎𝐑𝐓 patients' results whether prolonged or normal

If the result is 𝐆𝐑𝐄𝐀𝐓𝐄𝐑 than the prolonged control, the results 𝐖𝐈𝐋𝐋 𝐍𝐎𝐓 𝐁𝐄 𝐑𝐄𝐏𝐎𝐑𝐓𝐄𝐃 as the reagents, machines and procedure should be examined. If all aforementioned are in order, 𝐑𝐄-𝐑𝐔𝐍 !

𝘽𝙀𝙎𝙏 𝙁𝙊𝙍 𝘾𝙊𝙐𝙈𝘼𝙍𝙄𝙉 𝘼𝙉𝙏𝙄𝘾𝙊𝘼𝙂𝙐𝙇𝘼𝙉𝙏 𝙏𝙃𝙀𝙍𝘼𝙋𝙔 🌡️

Before: 𝐎𝐰𝐫𝐞𝐧’𝐬 𝐓𝐡𝐫𝐨𝐦𝐛𝐨𝐭𝐞𝐬𝐭 𝐌𝐞𝐭𝐡𝐨𝐝
Now: 𝐈𝐍𝐑

𝙎𝙩𝙮𝙥𝙫𝙚𝙣 𝙏𝙞𝙢𝙚/𝙍𝙪𝙨𝙚𝙡𝙡'𝙨 𝙑𝙞𝙥𝙚𝙧 𝙑𝙚𝙣𝙤𝙢 𝙏𝙞𝙢𝙚 🐍

— used to distinguish 𝐅𝐀𝐂𝐓𝐎𝐑 𝐗 & 𝐕𝐈𝐈 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐂𝐈𝐄𝐒, Prothrombin, Fibrinogen, FACTORS V, & X

𝐏𝐓 : 𝐅𝐀𝐂𝐓𝐎𝐑 𝐕𝐈𝐈 deficiencies are not detected !

𝐏𝐑𝐎𝐓𝐇𝐑𝐎𝐌𝐁𝐈𝐍 𝐀𝐂𝐓𝐈𝐕𝐈𝐓𝐘 🤲🏻

𝟕𝟎% is already good but 𝟏𝟎𝟎% is the maximum level but can cause thrombosis

PT in secs is 𝙞𝙣𝙫𝙚𝙧𝙨𝙚𝙡𝙮 𝙥𝙧𝙤𝙥𝙤𝙧𝙩𝙞𝙤𝙣𝙖𝙡 to PT ACTIVITY (%)

𝐏𝐑𝐎𝐓𝐇𝐑𝐎𝐌𝐁𝐈𝐍 𝐀𝐂𝐓𝐈𝐕𝐈𝐓𝐘 💃🏻

↓ PT ACTIVITY (%) - 𝐇𝐄𝐌𝐎𝐑𝐑𝐇𝐀𝐆𝐄
↑ PT ACTIVITY (%) - 𝐓𝐇𝐑𝐎𝐌𝐁𝐎𝐒𝐈𝐒

𝙄𝙣𝙩𝙚𝙧𝙣𝙖𝙩𝙞𝙤𝙣𝙖𝙡 𝙉𝙤𝙧𝙢𝙖𝙡𝙞𝙯𝙚𝙙 𝙍𝙖𝙩𝙞𝙤❗️

— used to monitor patients on 𝐎𝐑𝐀𝐋 𝐀𝐍𝐓𝐈𝐂𝐎𝐀𝐆𝐔𝐋𝐀𝐍𝐓 𝐓𝐇𝐄𝐑𝐀𝐏𝐘

𝐈𝐍𝐑 = [PT of patient in secs/PT of normal control]^ISI

𝐈𝐍𝐑 𝐄𝐗𝐀𝐌𝐏𝐋𝐄 𝐂𝐎𝐌𝐏𝐔𝐓𝐀𝐓𝐈𝐎𝐍 ➗

𝘎𝘪𝘷𝘦𝘯:

PT = 20s
Normal = 18s
ISI = 1.2

𝘚𝘰𝘭𝘶𝘵𝘪𝘰𝘯:

(20s/18s)^1.2 = (1.11)^1.2
= 𝟏.𝟏𝟑

𝐈𝐍𝐑 𝐈𝐍𝐓𝐄𝐑𝐏𝐑𝐄𝐓𝐀𝐓𝐈𝐎𝐍 🧐

𝐈𝐟 𝐮𝐧𝐝𝐞𝐫 𝐂𝐨𝐮𝐦𝐚𝐝𝐢𝐧 𝐓𝐡𝐞𝐫𝐚𝐩𝐲, Desired INR:
2-3 or 2.5-3.5 if the patient has 𝐦𝐞𝐜𝐡𝐚𝐧𝐢𝐜𝐚𝐥 𝐡𝐞𝐚𝐫𝐭 𝐯𝐚𝐥𝐯𝐞

↑ 5 = increased risk of hemorrhage

Result: 𝟏.𝟏𝟑 (𝐍𝐎𝐑𝐌𝐀𝐋)

𝑪𝒐𝒖𝒎𝒂𝒅𝒊𝒏 𝑻𝒊𝒕𝒓𝒂𝒕𝒊𝒐𝒏 💊

𝐃𝐄𝐒𝐈𝐑𝐄𝐃 𝐈𝐍𝐑: 2-3

If the patient's INR result is 1.6 the coumadin dosage will be ↑ (2 tablets) 𝒕𝒐 𝒓𝒆𝒂𝒄𝒉 𝒕𝒉𝒆 𝒅𝒆𝒔𝒊𝒓𝒆𝒅 𝒓𝒂𝒕𝒊𝒐 of 2-3

If the INR is ↑, the dosage will be 𝒍𝒐𝒘𝒆𝒓 (1/2 or 1/4 tablet)

𝐂𝐇𝐑𝐎𝐌𝐎𝐆𝐄𝐍𝐈𝐂 𝐅𝐀𝐂𝐓𝐎𝐑 𝐗 𝐀𝐒𝐒𝐀𝐘 ‼️

— used as an alternative to the PT/INR system

𝟐𝟎% - 𝟒𝟎% of the normal factor activity

— useful when LAC inhibitor prolongs the PT

𝐏𝐑𝐎𝐓𝐇𝐑𝐎𝐌𝐁𝐈𝐍 𝐓𝐈𝐌𝐄: 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘚𝘪𝘨𝘯𝘪𝘧𝘪𝘤𝘢𝘯𝘤𝘦 ✅

60% - tendency to bleed
20% spontaneous bleeding
20% - 30% (2-3 INR) - heparin/coumarin therapy

↑ 𝐏𝐓
• Liver Damage
• Vit K Deficiency
• Heparin Therapy
• DIC
• Dysproteinemias

Factor with the shortest half life (6 hours) 🕕

𝐅𝐀𝐂𝐓𝐎𝐑 𝐕𝐈𝐈

To distinguish between Vit K Def and Liver Disease,

Both 𝐅𝐀𝐂𝐓𝐎𝐑𝐒 𝐕 & 𝐕𝐈𝐈 are reduced in 𝐋𝐈𝐕𝐄𝐑 𝐃𝐈𝐒𝐄𝐀𝐒𝐄 but only 𝐅𝐀𝐂𝐓𝐎𝐑 𝐕𝐈𝐈 is reduced in 𝐕𝐈𝐓 𝐊 𝐃𝐄𝐅 ❗️

𝑽𝒊𝒕𝒂𝒎𝒊𝒏 𝑲 𝑫𝒆𝒇𝒊𝒄𝒊𝒆𝒏𝒄𝒚 ❎🥬

Factors II, VII, IX & X (Prothrombin Group) 𝐖𝐈𝐋𝐋 𝐍𝐎𝐓 𝐁𝐄 𝐃𝐄𝐕𝐄𝐋𝐎𝐏𝐄𝐃 since they are 𝐕𝐢𝐭 𝐊 𝐃𝐞𝐩𝐞𝐧𝐝𝐞𝐧𝐭 𝐆𝐫𝐨𝐮𝐩

✍🏻 𝐏𝐓 is not affected by 𝐅𝐀𝐂𝐓𝐎𝐑 𝐕𝐈𝐈𝐈 or 𝐈𝐗 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐂𝐘 since these are under the 𝐈𝐧𝐭𝐫𝐢𝐧𝐬𝐢𝐜 𝐏𝐚𝐭𝐡𝐰𝐚𝐲

𝙎𝙀𝙍𝙐𝙈 𝙋𝙍𝙊𝙏𝙃𝙍𝙊𝙈𝘽𝙄𝙉 𝙏𝙄𝙈𝙀 𝙤𝙧 𝙋𝙍𝙊𝙏𝙃𝙍𝙊𝙈𝘽𝙄𝙉 𝘾𝙊𝙉𝙎𝙐𝙈𝙋𝙏𝙄𝙊𝙉 𝙏𝙀𝙎𝙏 (𝙋𝘾𝙏) 💬

best considered as a test of 𝐏𝐋𝐀𝐓𝐄𝐋𝐄𝐓 𝐏𝐏𝐋 𝐀𝐂𝐓𝐈𝐕𝐈𝐓𝐘

Short PCT = PF3 Deficiency (𝐭𝐡𝐫𝐨𝐦𝐛𝐨𝐜𝐲𝐭𝐨𝐩𝐞𝐧𝐢𝐚 𝐨𝐫 𝐭𝐡𝐫𝐨𝐦𝐛𝐨𝐩𝐚𝐭𝐡𝐢𝐚)

𝐓𝐇𝐑𝐎𝐌𝐁𝐎𝐏𝐋𝐀𝐒𝐓𝐈𝐍 𝐆𝐄𝐍𝐄𝐑𝐀𝐓𝐈𝐎𝐍 𝐓𝐈𝐌𝐄

𝑴𝑰𝑿: + 𝑷𝑷𝑷 = 𝑻𝒉𝒓𝒐𝒎𝒃𝒐𝒑𝒍𝒂𝒔𝒕𝒊𝒏
1. Normal Platelets
2. Aluminium Hydroxide
3. Normal Plasma
4. M/40 CaCl2

Ref Interval = 15 𝐬𝐞𝐜𝐨𝐧𝐝𝐬

𝑴𝑰𝑿𝑰𝑵𝑮 𝑺𝑻𝑼𝑫𝑰𝑬𝑺 🔄
- for ↑ PT and APTT

1. 1 Patient + Aged Plasma (No V & VIII)
2. 1 Patient + Adsorbed Plasma (No Prothrombin Group)
3. 1 Patient + Aged Serum (No F I, II, V & VIII)

𝐑𝐄-𝐑𝐔𝐍 𝐀𝐏𝐓𝐓 𝐀𝐍𝐃 𝐏𝐓 !

NORMAL RESULT = 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐂𝐘

𝑴𝑰𝑿𝑰𝑵𝑮 𝑺𝑻𝑼𝑫𝑰𝑬𝑺 🔄

EXAMPLE:
(+) - Corrected
(-) - Not Corrected

Normal Plasma (+)
Adsorbed Plasma (+)
Aged Serum (-)

= 𝐅𝐀𝐂𝐓𝐎𝐑 I 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐂𝐘

EXAMPLE:

Normal Plasma (+)
Adsorbed Plasma (-)
Aged Serum (-)

= 𝐅𝐀𝐂𝐓𝐎𝐑 II 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐂𝐘
Since factor II is only present in Normal Plasma

THE 𝐅𝐀𝐂𝐓𝐎𝐑 𝐃𝐄𝐅𝐈𝐂𝐈𝐄𝐍𝐓 IS 𝐏𝐑𝐄𝐒𝐄𝐍𝐓 IN A
C̲̲O̲̲R̲̲R̲̲E̲̲C̲̲T̲̲E̲̲D (+) SUBSTITUTION SOLUTION

𝐅𝐚𝐜𝐭𝐨𝐫 𝐕𝐈𝐈 is deficient because it is not present in 𝗔𝗗𝗦𝗢𝗥𝗕𝗘𝗗 𝗣𝗟𝗔𝗦𝗠𝗔 but present in 𝐍𝐨𝐫𝐦𝐚𝐥 𝐏𝐥𝐚𝐬𝐦𝐚 𝐚𝐧𝐝 𝐀𝐠𝐞𝐝 𝐒𝐞𝐫𝐮𝐦

𝐓𝐡𝐫𝐨𝐦𝐛𝐢𝐧 𝐓𝐢𝐦𝐞 (𝐓𝐓) 𝐨𝐫 𝐓𝐡𝐫𝐨𝐦𝐛𝐢𝐧 𝐂𝐥𝐨𝐭𝐭𝐢𝐧𝐠 𝐓𝐢𝐦𝐞 ⌛️

Test for:
1. Hypofibrinogenemia
2. Afibrinogenemia

Ref Interval: 10-20 𝗌𝖾𝖼𝗌

↑ 𝙏𝘾𝙏/𝙏𝙏
1. Therapeutic Heparin
2. ↑ Anti-thrombin/FSPs
3. Hypofibrinogenemia

𝗥𝗘𝗣𝗧𝗜𝗟𝗔𝗦𝗘 𝗧𝗜𝗠𝗘

- TT. Reptilase Rgt is used instead of thrombin to convert fibrinogen to fibrin
𝘼𝙩𝙧𝙤𝙭𝙞𝙣 (𝙧𝙚𝙥𝙩𝙞𝙡𝙖𝙨𝙚 𝙧𝙜𝙩 𝙩𝙧𝙖𝙙𝙚𝙢𝙖𝙧𝙠) + 𝙥𝙩’𝙨 𝙥𝙡𝙖𝙨𝙢𝙖

Ref Interval: 10-15 𝘀𝗲𝗰𝘀

✔️ 𝗧𝗵𝗿𝗼𝗺𝗯𝗶𝗻 𝗧𝗶𝗺𝗲 is affected by Heparin Therapy while 𝗥𝗲𝗽𝘁𝗶𝗹𝗮𝘀𝗲-𝗥 𝗧𝗲𝘀𝘁 is not and functional fibrinogen can be measured

𝗧𝗛𝗥𝗢𝗠𝗕𝗜𝗡 𝗧𝗜𝗠𝗘 𝗔𝗡𝗗 𝗥𝗘𝗣𝗧𝗜𝗟𝗔𝗦𝗘-𝗥 𝗧𝗘𝗦𝗧 ↑ prolonged in:

1. Factor I Deficiency
2. Dysfibrinogenemia
3. Streptokinase Therapy
4. Presence of FDPs/FSPs

𝗙𝗔𝗖𝗧𝗢𝗥 𝗫𝗜𝗜𝗜 𝗦𝗖𝗥𝗘𝗘𝗡𝗜𝗡𝗚 𝗧𝗘𝗦𝗧 ❕

If 𝐅𝐚𝐜𝐭𝐨𝐫 𝐗𝐈𝐈𝐈𝐚 𝐢𝐬 𝐩𝐫𝐞𝐬𝐞𝐧𝐭, the fibrin clot is 𝗜𝗡𝗦𝗢𝗟𝗨𝗕𝗟𝗘 in 5 M Urea and 1% Monochloroacetic Acid for 24 hrs

𝐅𝐀𝐂𝐓𝐎𝐑 𝐈 (𝐅𝐈𝐁𝐑𝐈𝐍𝐎𝐆𝐄𝐍)

Ref Interval: 200-400 𝐦𝐠/𝐝𝐋