A 35 yr old lady with normal PT and increased a PIT. 2 year back, she was operated for cholecystectomy & did not have any bleeding episoe. What is next investigation for clinical diagnosis aEUR’
**Core Concept**
The patient presents with a normal Prothrombin Time (PT) and an increased Activated Partial Thromboplastin Time (aPTT), suggesting a problem with the intrinsic coagulation pathway. This discrepancy is crucial for diagnosing coagulopathies.
**Why the Correct Answer is Right**
Given the increased aPTT and normal PT, the next step involves investigating the intrinsic pathway, which could involve factors such as factor VIII, IX, XI, or XII. Since the patient had a major surgery without bleeding episodes, conditions like hemophilia A or B (factor VIII and IX deficiencies) are less likely.
**Why Each Wrong Option is Incorrect**
**Option A:** This choice is not provided, so we cannot assess its accuracy.
**Option B:** Similarly, this choice is missing.
**Option C:** Without the specific option text, it's challenging to determine why it's incorrect.
**Option D:** This option is also not provided for evaluation.
**Clinical Pearl / High-Yield Fact**
A key point in coagulation disorders is that patients with mild factor deficiencies might not exhibit bleeding symptoms until they undergo significant trauma or surgery. However, the absence of bleeding during major surgery like cholecystectomy makes severe intrinsic pathway factor deficiencies less likely.
**Correct Answer:** D. Mixing study to correct aPTT