Question

a 23-year-old male was seen in the office of an orthopedic surgeon. he injured his left knee while playing basketball. the injury had resulted in severe swelling and discoloration of the knee. the patient had a history of easing bruising and sometimes s spontaneous bleed. several petechiae were noted over his armed and there was some gingival bleeding. surgery was to be performed.

screening lab results:

PT 11 sec

APTT 35sec

PLT 200,000

PFA. abnormal

a. does the patient have an abnormality of primary or secondary hemostasis?

b. in addition to platelet aggregation what additional lab tests would be helpful?

Answer 1

A) Its a primary hemostasis . Primary hemostasis occurs when platelets attach to a damaged or disrupted area of the endothelium. This adhesion allows the platelets to undergo a shape change and then aggregate together. Once adhered to each other a temporary platelet plug is created.

B) Additional tests include :- platelet count, a buccal mucosal bleeding time (BMBT), genetic testing for specific inherited disorders, and measurement of vWf concentrations, TCT ,fibrinogen concentration test .