EXPERIMENT 11

1. What are the sources of error for the prothrombin time test?

o
o Overfilled or underfilled tubes
o The specimen is mixed aggressively
o Heparin contamination
o turbid plasma (e.g., hyperlipidemia and hyperbilirubinemia) which may affect
automated methods of measurement of PT
2. What are the uses of the prothrombin time test?
o A prothrombin time (PT) is a test used to help detect and diagnose a bleeding
disorder or excessive clotting disorder; the international normalized ratio (INR) is
calculated from a PT result and is used to monitor how well the blood-thinning
medication (anticoagulant) warfarin (Coumadin®) is working to prevent blood
clots.
o The PT is performed diagnostically when any coagulopathy is suspected. Acquired
multiple deficiencies such as disseminated intravascular coagulation (DIC), liver disease,
and vitamin K deficiency all affect factor VII activity and are detected through prolonged
PT results. The PT is particularly sensitive to liver disease, which causes factor VII levels
to become rapidly diminished (
3. Differentiate one-stage prothrombin time from two-stage prothrombin time
o In the first method, now known as the one-stage test, an excess of a standardized tissue
extract and a calculated amount of calcium chloride are added to oxalated plasma and
the prothrombin directly estimated from the resulting clotting time. In the two-stage
test, the oxalated plasma is first diluted and then an extract of tissue extract and
 calcium chloride added to generate thrombin which is measured by the clotting time
obtained when added to a standardized solution of fibrinogen.
4. Give disease/conditions associated with prolonged Prothrombin time
Prothromin time is prolonged in the following conditions;
 inherited single factor deficiencies of factors X, VII, V, II, I
 Liver disease
 Vitamin K deficiency
 Disseminated intravascular coagulation
 Individuals taking oral anticoagulants
 PT is slightly prolonged in newborns due to lower coagulation factor levels
 Inhibitors of coagulation such as lupus anticoagulant

Keohane

Lab Tests Online. (n.d.). Prothrombin Time and International Normalized Ratio (PT/INR).
https://labtestsonline.org/tests/prothrombin-time-and-international-normalized-ratio-ptinr#:~:text=A
%20prothrombin%20time%20(PT)%20is,is%20working%20to%20prevent%20blood

Nguyen, Andy (2013). Accurate Results in the Clinical Laboratory || Sources of Errors in

Hematology and Coagulation Testing. , (), 305–314. doi:10.1016/B978-0-12-415783-5.00019-0
Quick, Armand J. (1961). The One-stage Prothrombin Time Determination its History and
Interpretation. Chemotherapy, 3(4), 313–320. doi:10.1159/000219548 

Roshal, M. (2019). Prothorombin Time. Transusion Medicine and Hemostasis (Third Edition).
https://www.sciencedirect.com/topics/medicine-and-dentistry/prothrombin-time

EXPERIMENT 12

1. How do you prepare a platelet-poor plasma?

a. Sodium citrate-anticoagulated whole blood is centrifuged at 1500 xg for 15 minutes in a
swinging bucket centrifuge to produce supernatant PPP
2. What is the significance of the phospholipid emulsion (platelet substitute)?
a. The platelet substitute platelet
substitute is added to the patient's
blood to initiate the coagulation process via the intrinsic
pathway.  by providing phospholipids on which enzymatic reactions in the
coagulation cascade can occur
3. Give conditions wherein there is a falsely prolonged PTT.
 4. Give the significance of activating agents for this test.
a. The activator provides a surface that mediates a conformational change in plasma factor
XII that results in its activation (Figure 42-9). Factor XIIa forms a complex with two other
plasma components: high-molecular-weight kininogen (Fitzgerald factor) and
prekallikrein (Fletcher factor). These three plasma glycoproteins, termed the contact
activation factors, initiate in vitro clot formation through the intrinsic pathway but are
not part of in vivo coagulation.

KEOHANE

LabCE. (2014). Preanalytical Variables That Can Cause Falsely Elevated

PT or aPTT Results.
https://www.labce.com/spg296325_preanalytical_variables_that
_can_cause_falsely_ele.aspx