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Discussion

Coagulation Panel Question-HELP

So I'm studying for my dreaded upcoming exam, and I am having a hard time understanding the following question/concept. I am confused about the results from a coagulation panel in a patient diagnosed with DVT due to hypercoagulation caused by factor V leiden.

So PT, INR, aPTT values are all normal. D-Dimer is nearly triple the normal value (which is expected).

My question is, why are PT, INR and aPTT not lowered or abnormal? My reasoning is that the hypercoagulation would cause faster rates of clotting, therefore the values should be decreased.

Any help is appreciated. Thank you!

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    Timing might answer your question. First off, was the pt on coumadin and/or heparin at the time when the coagulation studies lab was drawn? Also, know that coagulation studies must be drawn before pt is started on blood thinning therapy to check for abnormalities. So find out when the labs were drawn and when pt was started on this therapy.

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    It is not about timing in this situation. The reason why the PT/aPTT are not abnormal is because the client does not have the lupus anticoagulants. If the client had SLE or other phosholipid abnormalities it would alter these particular lab values. This is a good diagnostic criteria to rule out other differential diagnosis. The hypercoagulable state does not change the way treatment should be considered. The client should be on anticoagulants and further testing should be indicated.

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