PBL Sessions: Reproductive Organ System


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Page 9

History of Present Illness:

The laboratory test findings are as follows:

  • Prothrombin time: 13 seconds (normal 12 - 15.5)

  • Partial thromboplastin time: 52 seconds (normal 30 - 44)

  • The PTT does not correct upon a 1:1 dilution with normal serum

  • dRVVT = dilute Russell viper venom test is 61 seconds (normal 33 - 46)

  • dRVVT 1:1 Mix (done if dRVVT > 46 sec): 60 seconds

  • Serologic test for syphilis is positive

Anticardiolipin antibody: (Note: APL = For Cardiolipin Antibodies, IgA phospholipid units)

  • < 12 APL: Negative

  • 12-15 APL: Inconclusive

  • >15 APL: Positive

Patient is 35 APL

Phosphatidylserine Antibodies, IgG, IgM, and IgA:

For Phosphatidylserine Antibodies, IgG: (Note: GPS = IgG anti-phosphatidylserine units)

  • <16 GPS: Absent or none detected

  • 16-30 GPS: Low Positive

  • 31-50 GPS: Moderate Positive

  • >50 GPS: High Positive

The patient is 55 GPS

For Phosphatidylserine Antibodies, IgM: (Note: MPS = IgM anti-phosphatidylserine units)

  • <22 MPS: Absent or none detected

  • 22-35 MPS: Low Positive

  • 36-50 MPS: Moderate Positive

  • >50 MPS: High Positive

The patient is 41 MPS

For Phosphatidylserine Antibodies, IgA: (Note: APS = IgA anti-phosphatidylserine units)

  • <20 APS: Absent or none detected

  • >20 APS: Positive

The patient is >20 APS

For Beta-2 Glycoprotein 1 Antibody, IgA: (Note: SAU = Standard IgA Units)

  • < 18 SAU: None detected

  • 18-22 SAU: Inconclusive

  • > 22 SAU: Positive

Patient is 28 SAU

Beta-2 Glycoprotein 1 Antibody, IgG: (Note: SGU = Standard IgG Units)

  • < 18 SGU: None detected

  • 18-22 SGU: Inconclusive

  • > 22 SGU: Positive

Patient is 22 SGU

Beta-2 Glycoprotein 1 Antibody, IgM: (Note: SMU = Standard IgM Units)

  • < 18 SMU: None detected

  • 18-22 SMU: Inconclusive

  • > 22 SMU: Positive

Patient is 24 SMU

After another venogram, a therapeutic procedure is performed.

Figure 14: Venogram via IVC into portal vein. Figure 14 early image.

Figure 15: Venogram via IVC into portal vein. Figure 15 is the later image.

Tasks

  • Explain the significance of the laboratory findings.

  • Explain the contrast media findings in the two venograms

  • Do the images provide evidence of the patient's current problems?

  • What are some of the treatment methods that could help this patient?

  • Are there liability issues in this case?

Stop !! Complete discussions and tasks before moving to the next page.