Professional Documents
Culture Documents
Pathologist-in-chief
Vanderbilt University Hospital
:DIAGNOSIS
O~F
CHILD ABUSE
",
v~.J1Willebr~dlddis~ase
Hemophilia A and B
Thrombocytopenia with lymphoblastic leukemia
..... taminK deficiency
Purpura fulminans
. Meningifiswith.disseminafedlntravascular coagulatioJ1
Hemorrhagic disease of the newborn
..
,".
Uenoch-Schonlein purpura
Ruptured subarachnoid vascular formation
Bluesp~ts malform~tion
COMPARI 0
LIDES
OF CHILD ABUSE
VS.
COAGULOPATHY Which case is abuse and
which case is a child with
a bleeding disorder who
experienced a minor injury?
General
H~ospital
~P-rofessor_Har'laJ"dMedical
/
Scho(ll-
COAGULATION TESTS
o
a
o
o
o
o
o
o
o
o
a
o
o
o
o
o
a
o
o
o
o
a
LMWH(602)
o
o
o
o
o
o
Q
Q
a
o
Plasminogen
o AclMty (400)
0 Antigen (408)
Platelet Neutralization Procedure (805)
Platelet Antibody
Q Direct (523)
o Screen
(520)
AnUcardlollplnAntlbody
Q Antiphosphatldylserine
(153)
Antithrombin
Q
Q APn(040)
Q beta-Thromboglobulln (085)
Q Cryofibnnogen (203)
O.otmer
QuantitatNe(405)
Semiquantitative (404)
Q Ollute Russefl's Viper Venom Test (057)
Euglobulin Lysis Time (401)
a
o
Factor Activities
o
o
o
o
o
o
F 1/ (100)
F V (101)
0 F X (105)
F VII (102)
Q F XI (106)
F Vila- (activated Factor VII) (111)
F VIII (103)
F XII (107)
FIX (104)
F ')(1fI* (t08)
Factor AnUgens
a
a
a
a
F VII- (112)
0 F IX (205)
FX(206)
Factor V Mutation (Lelden) (719)
Factor VIII Concentrate Quantitation (056}
Factor InaCHvators
Q Inhibitorlfnaclivalor Screen (lOO)
F V (Bethesda) (706)
t
PTT mixing study (1: 1 mix of
PTT NOralizes
Factor deficiencymeasure factors VIII, IX,
XI, and XII
~
Inhibitor, most commonly Lupus
coagulant; may be a Factor VIII inhilU' . . . .~J,
if PTT mixing study first normalizesang'
then becofes prolonged
..
..
c<'f.'iorl.'KT"
90
t/)
CI)
t/)
80
70
CI)
0:::
60
(ij
0
....
50
f-
'+-
40
a.
t/)
CI)
Ol
....
30
co
c
20
"-
10
CI)
(J
CI)
a..
0
Saved Physician
Time
Impacted Differential
Diagnosis
Reduced Time to
Diagnosis