CASE 4

 

CLINICAL HISTORY

A 21 year-old male seen in the emergency room with a swollen, tender right knee. Patient is an electrician who had fallen to the ground an hour ago while working on a power line.

 

Patient had a history of easy bruising that occasionally occurred with minor injuries.  He also had a history of prolonged bleeding after dental extractions. The patient had not previously been hospitalized or received blood transfusions.

 

There was no family history of bleeding problems.

 

The patient was taking no medication at the time of the accident.

 

PHYSICAL EXAMINATION

Physical examination showed a swollen, tender right knee.

 

SCREENING COAGULATION LABORATORY RESULTS

PT= 10 sec (Normal 8-11.5)

aPTT= 57 sec (Normal 24-37.5)

Plt= 450,000 /μL (Normal 150,000-350,000)