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Interpreting Coagulation Panels

Read a PT/INR, PTT, and reflex coagulation workup and reason through the differential like a clinician working a bleeding or clotting case.

What this track covers

This track covers the intrinsic, extrinsic, and common pathways, how PT/INR and PTT map onto them, and when to add D-dimer, fibrinogen, or mixing studies to separate factor deficiency from an inhibitor. It also touches monitoring considerations for heparin, warfarin, and DOACs, and the basic pattern recognition for hemophilia, von Willebrand disease, and platelet disorders.

What you will practice

  • Map an isolated PT vs isolated PTT vs combined elevation to the likely pathway involved
  • Decide when a mixing study is indicated and interpret a correcting vs non-correcting result
  • Distinguish DIC from isolated hypofibrinogenemia using fibrinogen and D-dimer patterns together
  • Recognize lab patterns suggestive of hemophilia vs von Willebrand disease vs a platelet-function disorder
  • Identify which anticoagulant a panel is likely monitoring based on which values are affected

Simulator scenario

A patient presents with unexpected bruising and an isolated prolonged PTT; the clinician must decide whether to order a mixing study and interpret the result to guide next steps.

Board question topics

  • Interpreting isolated vs combined PT/PTT elevations
  • Mixing study interpretation: correction vs non-correction
  • D-dimer and fibrinogen patterns in DIC
  • Lab differentiation of hemophilia, von Willebrand disease, and platelet disorders

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