Reference no: EM132887711

Scenario/Summary

Jessie was a typical 2-year-old who liked to try and spread his wings. He would run and fall throughout the house. On several occasions, with minor falls, a bruise would develop on his legs or arms. Jessie's parent would often worry about being reported for child abuse because of the easy bruising that Jessie experienced.

At three, Jessie would complain that his ankles hurt. This was especially true after a hectic day of running and playing with other kids at the playground. Jessie's parents wondered if he was simply trying to get attention. Which he usually did being an only child.

When Jessie was four, he accidentally ran into a small tree, hitting his nose. The nose bled excessively. Jessie's mother tried to stop the bleeding, first with paper towels, which Jessie soaked through quickly, and then with a cold washcloth. Nothing seemed to help. Nervous about the amount of blood that Jessie was losing, his parents rushed him to the emergency room.

The emergency doctor ordered some blood work that included a Prothrombin Time (PT)and a Thromboplastin Time (PTT) test for clotting deficiencies. The site of the venipuncture for the blood draw, also took some time to stop bleeding.

An hour after the blood draw, the physician returned to the ER room to discuss the test results. Jessie's PT results were normal but his PTT results were abnormal with an extended clotting time. The PTT clotting time was much longer than normal indicating the Jessie may lack of or decreased levels of a clotting factor.

Discuss which clotting factors the PT and PTT test evaluate and whether each test measures the intrinsic or the extrinsic pathways.

Describe the common coagulation pathway.

Based on Jessie's test, which factor deficiency do you believe he has and why?

Jessie's clotting factor disease is seen more often in males. Please explain why.

If both the PT and the PTT tests were abnormally long, which part of the coagulation pathway would be affected?