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Platelet neutralization tests are one of the confirmatory tests that can be used to determine if a patient has a circulating lupus antibody, or lupus anticoagulant. The principle in this test involved the use of a freeze-thawed platelet suspension that, when mixed with the patient plasma, will neutralize the anti-phospholipid antibodies (lupus anticoagulant) present and allow for a corrected aPTT result upon re-testing.
A patient has a history of repeated spontaneous abortion. Coagulation studies reveal an elevated APTT, normal PT, normal platelet function, and normal clotting time. Schistocytes were seen on the peripheral blood smear.
Which test should be performed to determine if the patient has lupus anticoagulant?
Since cimetidine inhibits CYP2D6, less amphetamine will probably need to be given since it will not be able to be metabolized as readily.
Most drug interactions are like this: one drug inhibits or competes with the same CYP450 as another drug. The end result is that higher concentrations of one, or both, drugs are present, leading to potential toxicity.
A patient is taking cimetidine for a stomach ulcer. This drug inhibits CYP2D6. The patient is now prescribed amphetamine for narcolepsy. Amphetamine is metabolized by CYP2D6. What would you predict?
PCT usually rises within 3-6 hours of infection. CRP also increases rapidly following infection, but is not as specific for infection as PCT. A rise in CRP could also occur with SIRS. Lactic acid is usually used to detect and monitor impaired circulation and tissue oxygenation in critically ill patients.
Chemistry
Of the three laboratory tests that are listed, which has proven to be most effective for early differentiation of systemic inflammatory response syndrome (SIRS) from sepsis due to its increase following infection and higher specificity?