Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma)

of your blood to clot. How the Test is Performed The health care provider uses a needle to take blood from one of your veins. The blood collects into an airtight container. You may be given a bandage to stop any bleeding. If you are taking a medicine called heparin, you will be watched for signs of bleeding. The laboratory specialist will add chemicals to the blood sample and see how long it takes for the plasma to clot. How to Prepare for the Test Your doctor may tell you to stop taking certain drugs before the test. For example, blood thinners can affect the results of this test. Do not stop taking any medicine without first talking to your doctor. How the Test Will Feel When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the Test is Performed Your doctor may order this test if you have signs of a blood clotting disorder. When you bleed, the body launches a series of activities that help the blood clot. This is called the coagulation cascade. The PT test looks at special proteins (called coagulation factors) that are involved in this event, and measures their ability to help blood clot.

It measures: Factor I (fibrinogen) Factor II (prothrombin) Factor V Factor VII Factor X

Normal Results The normal range is 11 to 13.5 seconds. The PT result will be longer in persons who take blood thinners. Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. What Abnormal Results Mean When any of the blood clotting factors are lacking or not working properly, the PT is prolonged. Increased PT may be due to: Bile duct obstruction Cirrhosis Disseminated intravascular coagulation Hepatitis Liver disease Malabsorption Vitamin K deficiency Coumadin (warfarin) therapy Factor VII deficiency

Factor X deficiency Factor II (prothrombin) deficiency Factor V deficiency Factor I (fibrinogen) deficiency

Risks This test is often done on people who may have bleeding problems. The risks of bleeding and hematoma in these patients are slightly greater than for people without bleeding problems. In general, risks of any blood test may include: Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) Multiple punctures to locate veins

Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have bleeding or clotting problems. How the Test is Performed The health care provider uses a needle to take blood from one of your veins. The blood collects into an air-tight container. You may be given a bandage to stop any bleeding. If you are taking a medicine called heparin, you will be watched for signs of bleeding. The laboratory specialist will add chemicals to the blood sample and see how many seconds it takes for the blood to clot.

How to Prepare for the Test The health care provider may tell you to stop taking certain drugs before the test. Drugs that can affect the results of a PTT test include antihistamines, vitamin C (ascorbic acid), aspirin, and chlorpromazine (Thorazine). Do not stop taking any medicine without first talking to your doctor. How the Test Will Feel When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the Test is Performed Your doctor may order this test if you have problems with bleeding or blood clotting. When you bleed, the body launches a series of activities that help the blood clot. This is called the coagulation cascade. There are three pathways to this event. The PTT test looks at special proteins, called factors, found in two of these pathways. The test may also be used to monitor patients who are taking heparin, a blood thinner. A PTT test is usually done with other tests, such as the prothrombin test. Normal Results The normal value will vary between laboratories. In general, clotting should occur between 25 to 35 seconds. If the person is taking blood thinners, clotting takes up to two and a half times longer.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. What Abnormal Results Mean An abnormal (too long) PTT result may be due to: Cirrhosis Disseminated intravascular coagulation (DIC) Factor XII deficiency Hemophilia A Hemophilia B Hypofibrinogenemia Lupus anticoagulants Malabsorption Vitamin K deficiency Von Willebrand's disease

Risks This test is often done on people who may have bleeding problems. The risks of bleeding and hematoma in these patients are slightly greater than for people without bleeding problems. In general, risks of any blood test may include: Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken) Multiple punctures to locate veins

INR: International normalized ratio, a system established by the World Health Organization (WHO) and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation (clotting) tests. All results are standardized using the international sensitivity index for the particular thromboplastin reagent and instrument combination utilized to perform the test.

For example, a person taking the anticoagulant ("blood thinner") warfarin (brand name: Coumadin) might optimally maintain a prothrombin time (a "pro time" or PT) of 2 to 3 INR. No matter what laboratory checks the prothrombin time, the result should be the same even if different thromboplastins and instruments are used. This international standardization permits the patient on warfarin to travel and still obtain comparable test results.

Dengue shock syndrome: A syndrome due to the dengue virus that tends to affect children under 10, causing abdominal pain, hemorrhage (bleeding) and circulatory collapse (shock). Known also as dengue hemorrhagic fever (DHF), it starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain. Shock occurs after 2 to 6 days with sudden collapse, cool clammy extremities, weak thready pulse, and blueness around the mouth (circumoral cyanosis). There is bleeding with easy bruising, blood spots in the skin (petechiae), spitting up blood (hematemesis), blood in the stool (melena), bleeding gums and nosebleeds (epistaxis). Pneumonia and heart inflammation (myocarditis) may be present. The mortality is appreciable ranging from 6 to 30%. Most deaths occur in children. Infants under a year of age are especially at risk of death. It is also called Philippine or Southeast Asian hemorrhagic fever.