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Physiology

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Blood

Question
2 out of 42
 

A 9 year old boy with elevated both PT and aPTT. What is the diagnosis? (AIIMS NOV 2010)


A Defect in extrinsic pathway

B Defect in Intrinsic pathway
C Platelet function defect

D Defect in common pathway

Ans. D Defect in common pathway

I. The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalised ratio (INR) are measures of the extrinsic pathway of coagulation.

II. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status.

III. PT measures factors I, II, V, VII, and X.

IV. 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.

V. It is also used to monitor the treatment effects with heparin, a major anticoagulant. 4

VI. It is used in conjunction with the prothrombin time (PT) which measures the extrinsic pathway.

VII. Incase both are increased it indicates defect in common pathway.

Condition

Prothrombin time

Partial thromboplastin time

Bleeding time

Platelet count

Vitamin K deficiency or warfarin

prolonged

prolonged

unaffected

unaffected

DIC

prolonged

prolonged

prolonged

decreased

Von Willebrand disease

unaffected

prolonged

prolonged

unaffected

Haemophilia

unaffected

prolonged

unaffected

unaffected

Aspirin

unaffected

unaffected

prolonged

unaffected

Thrombocytopenia

unaffected

unaffected

prolonged

decreased

Early Liver failure

prolonged

unaffected

unaffected

unaffected

End-stage Liver failure

prolonged

prolonged

prolonged

decreased

Uremia

unaffected

unaffected

prolonged

unaffected

Congenital afibrinogenemia

prolonged

prolonged

prolonged

unaffected

Factor V deficiency

prolonged

prolonged

unaffected

unaffected

Factor X deficiency

prolonged

prolonged

unaffected

unaffected

Glanzmann's thrombasthenia

unaffected

unaffected

prolonged

unaffected

Bernard-Soulier syndrome

unaffected

unaffected

prolonged

decreased

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