DVT+raised PTT...how will you CONFIRM the dx? - USMLE Forums
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Old 06-14-2012
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Blood DVT+raised PTT...how will you CONFIRM the dx?

A 26-year-old woman presents to the local emergency room with
the sudden onset of shortness of breath. She occasionally
smokes cigarettes. She has a respiratory rate of 28/min and a
pulse of 110/min and a normal temperature. Initial laboratory
tests show: WBC 9,000/mm3
; hematocrit 39%; platelets
330,000/mm3
; prothrombin time (PT) 12 seconds; partial
thromboplastin time (PTT) 85 seconds.

The chest x-ray is normal, and the ventilation-perfusion (V/Q)
scan reveals a high probability for pulmonary embolus. She is
started on full-dose intravenous heparin. When anticoagulation
is stopped, and a full evaluation can occur, which of the
following is the most specific test to confirm her diagnosis?

(A) Antithrombin III level
(B) Mixing study
(C) VDRL and FTA
(D) Factor VIII inhibitor assay
(E) Russell's viper venom time
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  #2  
Old 06-14-2012
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-(c)=antiphospholipid sy
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  #3  
Old 06-14-2012
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young female + only PTT abnormal + clotting === antiphoshplipid syndrome

best inital test == mixing study

most specific and accurate test === russel viper venom

so the answer is E
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  #4  
Old 06-14-2012
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Quote:
Originally Posted by um aala View Post
-(c)=antiphospholipid sy
soory it's (e).
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tyagee (06-15-2012)



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