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MLAB 1227- Coagulation Keri Brophy-Martinez

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MLAB 1227- Coagulation Keri Brophy-Martinez

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    1. Chapter 40: Laboratory Testing in Coagulation MLAB 1227- Coagulation Keri Brophy-Martinez

    2. Lab Testing For Primary Hemostasis Disorders Purpose Evaluate platelet concentration and function Tests Bleeding time: discussed in lab PFA-100 Platelet aggregometry

    3. PFA-100: Platelet Function Assay In-vitro system that stimulates the in-vivo function of platelets in primary hemostasis: adhesion, activation and aggregation Aids in detection of platelet dysfunction Whole blood is passed through an aperture in a membrane coated with agonists Closure of aperture with platelet plug results in “closure time” Replacing the BT in many labs due to variability

    4. Platelet Aggregation Studies Foundation of platelet function testing Disadvantages: Time consuming Requires attention to detail Tests the platelets ability to respond and aggregate In the presence of in-vitro platelet aggregating agents, normal platelets will aggregate producing characteristic patterns of aggregation. (Refer to pg. 895 in text or Coag Automation ppt. from lab) Agonists include epinephrine, collagen, ADP, ristocetin, and arachidonic acid

    5. Lab Testing For Secondary Hemostasis Disorders Purpose Evaluates coagulation factors Detects inhibitors Screening Tests PT APTT Discussed in lab Fibrinogen Thrombin Time Qualitative Useful to detect parameters not detected by PT and aPTT; such as heparin, presence of FDPs, presence of dys/hypofibrinogenemia Measures conversion of fibrinogen to fibrin Thrombin cleaves fibrinogen in undiluted plasma Normal reference range 10-16 seconds

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