A consult is requested by the pediatric cardiac surgeon caring for a 5-year old child for a pre-operative evaluation because of a prolonged prothrombin time of 18.1 sec (normal 12.1-14.7), and an aPTT of 51 sec (normal 24.5-34.5). The child’s mother reports that the child has had some bruising and a nosebleed within the past several weeks; there was no evidence of abnormal coagulation studies or bleeding during the patient’s past 3 cardiac procedures, and there is no family history of a bleeding disorder. Your evaluation shows that the thrombin time is also slightly prolonged at 29 sec (normal 14.6-24.5). Mixing studies 1:1 with normal plasma show incomplete correction in both the prothrombin time and aPTT. The platelet count is normal. What studies should be ordered next?
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DIC evaluation including d-Dimer level
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Evaluation for a dysfibrinogen
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Factor V level
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Lupus anticoagulant assay
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Heparin level
Answer
Category:
Hematology MCQs
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