Welcome back. Case 37 has focused around an abnormal APTT. This is a common finding in the routine coagulation screen. It is important to investigate appropriately to avoid delayed procedures and patient anxiety. The first case had a factor XII deficiency and the second case was contaminated with heparin.

You are reviewing the results of a patient who has been admitted via the emergency department. She has type II diabetes and has been admitted with community acquired pneumonia. Results reveal:

• PT 14s (11-14s)
• APTT 48s (33-40s)
• Fibrinogen (Clauss) 4.9g/L (1.5-4.5g/L)

Questions:

• Based on the previous cases how do you approach this problem?
• Should she receive prophylactic LMWH?

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