A 2-year-old girl is brought to your clinic. Developmentally normal, her parents had noticed her to...

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Medical Sciences

A 2-year-old girl is brought to your clinic.Developmentally normal, her parents had noticed her to be bruisingeasily.

Coagulation tests show:
Test
Patient
Reference Range
PT
13s
11-14s
APTT
105s
23-35s
Fibrinogen (Clauss)
2.7g/L
1.5-4.0g/L
Thrombin Time
13s
10-13s
1. What additional questions might you ask theparents?
2. Briefly outline how you would investigate the clottingabnormalities.
3. What are the possible explanations for theseresults?
The prolonged PT and APTT correct in a mix with normalplasma.
A 10-day-old baby, previously well, breast fed and bornat home is found by his parents unconscious and bleeding from mouthand gums. The only history of note is that the mother had had amajor post-partum haemorrhage and had required emergency admissionto hospital.

A coagulation screen shows:
Test
Patient
Reference Range
PT
102s
11-14s
APTT
>120s
23-35s
Fibrinogen (Clauss)
1.9g/L
1.5-4.0g/L
Thrombin Time
13s
10-13s
1. What is the most likely diagnosis?
â€‹â€‹â€‹â€‹â€‹â€‹â€‹2. How would you confirm this?
3. Why does this occur?

Answer & Explanation Solved by verified expert

3.7 Ratings (329 Votes)

1A 2yrs old girl with chief complains of easy bruising 1st history taking is utmost important since already coagulation study is givenit will further guide us to the probable diagnosis only APTT prolongedothers being normalAll these guide us that it is most probably a clotting disorderHemophiliaA hemophiliaB von willibrand disease Questions that we will ask the parents duration of symptoms Any family history of clotting disorders Any spontaneous See Answer

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Test	Patient	Reference Range
PT	13s	11-14s
APTT	105s	23-35s
Fibrinogen (Clauss)	2.7g/L	1.5-4.0g/L
Thrombin Time	13s	10-13s