4. (a) A 45-year-old man was scheduled for an elective surgical procedure. Pre-a

Question

4. (a) A 45-year-old man was scheduled for an elective surgical procedure. Pre-admission testing revealed the following results: Hb WBC Platelets 15.6 g/dL 10.3 x 10/L 34 x 10M Normal range: 12.0-13.0 sec.] Normal range: 23.5-33.5 sec.] PT 25.0 sec APTT 30.2 sec The patient reported that he had episodes of nose bleeding and easy bruising. Below is a typical field of the stained blood smear from this patient. What is the abnormality? How can a correct platelet count be obtained? (i) (3 marks) (ii) When the patient's plasma sample was mixed in a ratio of 1:1 with normal plasma and the PT re-tested, the result was 12.9 seconds. What is the most probable cause of the bleeding tendency? Explain (3 marks) (iii) An additional specific test is required to confirm the diagnosis and establish the severity of the disease. What is this test? Explain its principle. 4 marks)

Explanation / Answer

Prothrombin time is increased.To rule out bleeding disorder.

To do repeat PT and INR (international normalised ratio) if not in warfarin.

Vitamin K deficiency

Liver function test

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