• The problem is one of two things:
• Quantity of the clotting agent or
• Quality of the agent
• How long is the history?
• All their life or recent? In other words:
  • Inherited or
  • Acquired (aspirin is very common)

• Type of bleeding tells you a lot about the possible defect:
• Petechiae and bruises suggest platelet problems (numbers or function).
• Deep muscle and joint hemorrhage suggest clotting protein problems.
• Multiple factor deficiencies suggest liver disease, vitamin deficiency or malabsorption.
• Remember the basic starting place is always history and physical.
• After the H & P, the basic screening labs would be:
• PT
• aPTT
• CBC, look for platelet count and presence of anemia
• Platelet aggregation studies.

So, how do I make sense of the tests?                                                           Back