Case 6 An outpatient comes to the laboratory for a PT. He had been in the hospit

Question

Case 6

An outpatient comes to the laboratory for a PT. He had been in the hospital 6 weeks earlier for treatment of deep vein thrombosis (DVT).

PT: 14.0 sec

Thromboplastin International Sensitivity Index (ISI): 2

PT reference range: 11-13 sec (for this laboratory)

aPTT: not requested

1. Interpret the coagulation results.

2. What is the patient’s international normalized ratio (INR)?

(do you know this calculation?)

3. Based on all the data provided, what condition is most likely?

4. Is the patient taking enough oral anticoagulant?

5. What is the risk for this patient?

Explanation / Answer

1. PT and ISI is slightly raised. This means the extrinsic and common final pathway of clotting is affected which largely depends upon Factor VII, II, V, X.

2. INR is the ratio of a patients Prothrombin time to a normal sample raised to the power of the ISI value for the analytical system being used.

INR =( PT test/ PT normal)ISI =0.73

3. Patient is on Oral anticoagulant therapy.

4. Yes, patient is taking enough oral anticoagulant.

5. The normal range of INR for people on oral anticoagulant is 2-3. Here INR is below the target range. This increases the risk of developing a CLOT.

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