Course Outline
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- Introduction to Coagulation Inhibitors and Factor Deficiencies
- Introduction to Coagulation Inhibitors
- Coagulation Inhibitors
- Introduction to Factor Deficiencies
- Coagulation Inhibitors and Their Effects on Testing
- Why is platelet-poor plasma (PPP) important when testing for a lupus anticoagulant?
- Evaluating Prolonged Test Results
- Performing a Mixing Study
- Introduction to Mixing Studies
- When to Perform a Mixing Study
- Mixing studies may help to determine the presence of which of the following?
- Mixing Study Test Principle
- Mixing Study Specimen Requirements
- Performance of a Mixing Study
- Performance of a Mixing Study, continued
- Performance of a Mixing Study, continued
- What is the ratio of patient plasma to pooled normal plasma that is usually used in the performance of a mixing study?
- What is the minimum percentage of each coagulation factor that must be present in a patient's plasma to produce a normal PT and aPTT test result?
- Analyzing and Interpreting Mixing Study Results
- Analyzing the Mixing Study Results
- Interpreting the Mixing Study Results
- Are the patient's mixing study results corrected or not corrected? Would this support the presence of a factor deficiency or a coagulation inhibitor?I...
- Using the Rosner Index to Interpret Mixing Studies
- Using the 70% Correction Method to Interpret Mixing Studies
- Mixing Study Methodology Differences
- Case Study One
- Case Study One
- Case Study One, continued
- After reviewing the mixing study results, what is the most likely determination?
- Which factor level could be deficient?
- Case Study Two
- Case Study Two
- After reviewing the mixing study results, is the aPTT corrected or not corrected? Does this support the presence of a factor deficiency or a coagulati...
- Case Study Three
- Case Study Three
- Has the mixing study corrected the aPTT? Is a factor deficiency or a coagulation inhibitor the likely cause of the patient's prolonged aPTT?
- Determination of Further Coagulation Studies
- Further Analyses for Factor Deficiencies
- Factor Activity Curves
- Treatment for Factor Deficiencies
- Lupus Anticoagulant
- Lupus Anticoagulant, continued
- Further Analyses for Coagulation Inhibitors
- Treatment for Coagulation Inhibitors
- Which of the following tests is used to quantify a coagulation inhibitor?
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical
laboratory technicians, laboratory supervisors, and laboratory managers. This
course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Leah Coppolino, MPH, CLS(NCA), MLS(ASCP), is the Director of the Clinical Laboratory Science Program at St. Christopher’s Hospital for Children in Philadelphia, Pennsylvania. She holds a Master's in Public Health from Thomas Jefferson University.
Reviewer Information:
Donna D. Castellone, MS, MLS(ASCP)SH, has worked as a coagulation specialist in both clinical and commercial settings. Ms. Castellone holds a Master's Degree in Health Science and Administration from State University at Stony Brook, Stony Brook, New York. She has written over 70 articles, was a contributing author for three textbooks, and is a frequent lecturer at laboratory workshops.
Laurie Bjerklie, MA, MLS(ASCP)CM, is
a Lead Education Developer. She earned a B.S. in Medical Laboratory Science
from the University of North Dakota and an M.A. in Curriculum and Instruction
from Saint Xavier University. She has over 20 years of experience in higher
education and has held program director and faculty positions in both MLT and
MLS programs.
Course Description: Prolonged PT and aPTT results are caused by many different conditions. It is important for medical laboratory scientists to be able to distinguish between preanalytic causes, secondary clinical causes, and important and potentially dangerous causes such as coagulation factor deficiencies and circulating coagulation factor inhibitors. Upon completion of this course, you will be able to identify the common causes associated with prolonged PT and/or aPTT results, when it is appropriate to perform a mixing study, how to perform and interpret mixing studies, how to differentiate between factor deficiencies and factor inhibitors, and further testing that can be done to confirm mixing study results.
