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The Doctors Lounge - Primary Care Answers

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Forum Name: Studying Clinical Sciences

Question: Case Study


SavLake - Thu Jan 25, 2007 12:11 am

So, I am a first year medical student and I'm getting these case studies every week in my courses. I am stuck in determining what my patient has and I cannot narrow down the disease/symtoms this patient is having.

Here's the case:
60 year old male with a nose bleed and post operative bleeing. His Thrombin test is 11 and bleeding time is 4 minutes. Normal pool and Asborbed pool corrected his PT and APTT values, which were high in the beginning.

I could only narrow down to the patient is taking a drug that is causing his clots not to form within his body. There's no history of a Heart attack but surgery indicates he could just had Heart attack.

Any help would be greatly appreciated.


Savanna
Dr. Chan Lowe - Fri Mar 16, 2007 7:15 am

Sorry for the delay. You've probably already figured this out by now.

As this is an assignment, I don't generally give answers but I'll give you some help that may put you in the right direction.

First, considering that the PT and aPTT were both abnormal, this excludes anything that would cause an isolated elevation of one or the other, essentially moving the issue down to the common pathway (with a few exceptions).

The normal pool and absorbed pool blood refer to mixing studies where the patient's blood and the control blood are mixed together. Then the clotting times are tested. If there is something in the blood that is preventing clotting then this compound would not be removed by doing the mixing study and the clotting times will not correct. If there is something lacking in the blood that is needed to clot, the normal blood will have it and will allow the clotting time to normalize.

Does this give you some ideas about how to proceed?

Best of luck in medical school. Medicine is a wonderful career.

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