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monoloco
yeah, iโve never heard of antiphospholipids increasing PT time ...
+26
goldenwakosu
Not sure if that little detail was to throw us off. I think the point of the question was to ID antiphospholipid syndrome based on the clinical criteria (spontaneous abortion + thrombosis)
+5
johnthurtjr
I actually went down a rabbit hole with this one recently - essentially in vitro findings =/= in vivo findings, clot-wise with anti-phospholipid antibodies.
+4
link981
No mention of lupus anticoagulant, anticardiolipin, or anti Beta 2 antibodies. FA mentios prolonged PTT but nothing on PT. What a piece of shit question. But thanks to the dudes above who explained it
+9
yb_26
UWorld mentioned "prolong aPTT (and sometimes PT)" in APS
+5
oslerweberrendu
@yb_26 Can u please tell the QID because the one I have seen it says, "Although patients often have prolonged ptt (because the antiphospholipid interferes with ptt test), pt is normal."
QID: 1298
+1
kevin
just to clarify, lupus anticoag is in antiphospholipid and presents with paradoxical increased ptt +/- pt despite increase risk thrombosis
+2
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suckitnbme
You should be able to rule it out by the normal Thrombin time. Abnormal fibrinogen would have increased PT/PTT but also increased Thrombin time because the entire pathway is compromised by the inability of fibrinogen to be cleaved to functioning fibrin.
+9
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sd22
PT, PRT, and TT normal in antithrombin deficiency. FA โ20 pg. 428
+
sd22
PTT* lol autocorrect clearly hasnโt been studying
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suckitnbme
@rainlad Protein C deficiency doesn't cause elevated PT and aPTT. I believe they're both normal and assays for the disease measure protein C activity.
+6
drzed
Protein C is an anti-coagulant, so if you lack factor C, then you have MORE clotting factors. This means that the PT and PTT would not be prolonged.
+6
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submitted by โhayayah(1212)
Pregnancy + Hx of thrombosis --> think antiphospholipid syndrome
The PT and PTT are prolonged d/t interference from the antibodies to phospholipids. Thrombin time normal.
Had to find research articles about it so take it from here and don't waste your time...