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Old 09-24-2011
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Default blood disorder

A 17-year-old male is brought to the ED intubated and sedated 15 minutes following a motor vehicle accident. His mother, who was sitting in the passenger seat, tells you that her son hit his head against the windshield and that he has a bleeding disorder. Neurosurgical evaluation indicates the need for operative intervention, but a STAT set of coagulation labs returns the following results:

Platelet count: 147,000/mm3
Bleeding time: 6 minutes
Prothrombin time: 13 seconds
Partial thromboplastin time (activated): 53 seconds

Which of the following should be administered immediately?
A. Packed red blood cells
B. Activated protein C
C. Factor IX
D. Platelets
E. Factor VII
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Old 09-24-2011
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Answer, possibly C
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Old 09-24-2011
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Quote:
Originally Posted by ricko335 View Post
A 17-year-old male is brought to the ED intubated and sedated 15 minutes following a motor vehicle accident. His mother, who was sitting in the passenger seat, tells you that her son hit his head against the windshield and that he has a bleeding disorder. Neurosurgical evaluation indicates the need for operative intervention, but a STAT set of coagulation labs returns the following results:

Platelet count: 147,000/mm3
Bleeding time: 6 minutes
Prothrombin time: 13 seconds
Partial thromboplastin time (activated): 53 seconds

Which of the following should be administered immediately?
A. Packed red blood cells
B. Activated protein C
C. Factor IX
D. Platelets
E. Factor VII
Hemophilia type b Factor 9 def.
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Old 09-25-2011
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The correct answer is C.
This patient has a known bleeding disorder with anisolated PTT elevation. This suggests hemophilia, which occurs when either factor 8 is deficient (hemophilia A) or factor 9 is deficient (hemophilia B). The clinical presentation of both is very similar, and both are X-linked.
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