Clinical haematology · UKMLA & AKT

Patient on anti-platelet therapy

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise patient on anti-platelet therapy — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Antiphospholipid antibodies cause a paradoxically hypercoagulable state despite prolonging in-vitro clotting tests - raised APTT is a lab artefact, NOT a bleeding tendency
  • Key lab pattern: raised APTT + normal PT + thrombocytopenia (NOT thrombocytosis) + APTT does not correct on mixing with normal plasma
  • Clinical features: arterial thrombosis, venous thrombosis, recurrent miscarriage (≥3 consecutive or ≥1 second-trimester loss), livedo reticularis

APS causes thrombocytopenia - never thrombocytosis. Raised APTT with normal PT + recurrent miscarriage = APS until proven otherwise.

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