Which of the following is an expected finding in DIC? a. ...

[TVarnum]

Which of the following is an expected finding in DIC?
 
  a. Thrombocytosis
  b. Schistocytes on the blood film
  c. Normal hemoglobin and hematocrit
  d. Macrocytic red cells

Question 2

Select the next best test to run given the following PTT results on a patient's plasma:
 
  Initial PTT: 75 seconds
   Immediate 1:1 mix with normal plasma: 38 seconds
   Incubated 1:1 mix with normal plasma: 36 seconds
 
  a. Dilute Russell's viper venom time
  b. Factor assays
  c. Factor V Leiden
  d. Bethesda titer

[dyrone]

Answer to Question 1

ANS: B
Schistocytes are seen in about 50 of DIC cases. Thrombocytopenia is expected, along with anemia because red cells are being destroyed in circulation. Red cells are not macrocytic.

Answer to Question 2

ANS: B
Factor assays should be performed on this plasma to determine the factor deficiency (or deficiencies) present. The PTT corrects on a 1:1 mix. If this were the lupus anticoagulant, then the prolonged PTT should remain prolonged on the 1:1 mix; thus no reason exists to perform the dilute Russell's viper venom time to confirm the presence of the lupus anticoagulant. If it were a factor VIII inhibitor, which can fully correct on the immediate 1:1 mix, then it would prolong after incubation of the 1:1 mix. Then it would be appropriate to perform a Bethesda titer. Factor V Leiden does not result in a prolonged PTT.