MCQ Hematology 17

A 66-year old male is referred because he has noted recent onset intermittent moderate epistaxis requiring medical attention and a prolonged aPTT of 48 sec. He has no past history of bleeding, and his family history is negative for a bleeding disorder. The patient’s family physician recently performed a CBC which showed a hemoglobin of 11.1 gm/dl, a white blood cell count of 11,900/l, and a platelet count of 140,000/l. Your further evaluation shows that there are 61% lymphocytes on the white cell differential and that the hemoglobin and platelet counts are similar to those previously reported. A diagnosis of chronic lymphocytic leukemia (CLL) is made with further testing. A repeat aPTT is 45 seconds, and a 1:1 mixing study is 39 seconds (normal 26-34 sec).

What tests should be ordered next?

1. Lupus anticoagulant

2. Factor IX level

3. Factor XI level

4. Factor XII level

5. Factor VIII level

Answer

Category: Hematology MCQs