The Thrombin Time (TT) measures the final step of the clotting cascade: the conversion of fibrinogen to fibrin by the enzyme thrombin. A prolonged TT indicates a problem at this stage. The differential includes: 1) Low fibrinogen level (hypofibrinogenemia), 2) Abnormal fibrinogen function (dysfibrinogenemia), or 3) The presence of an inhibitor that interferes with thrombin, such as heparin. The Reptilase Time test is very helpful here. Reptilase is an enzyme from snake venom that also converts fibrinogen to fibrin, but it is NOT inhibited by heparin. Therefore, if the TT is prolonged due to heparin, the Reptilase Time will be normal. If both TT and Reptilase Time are prolonged, the problem is with fibrinogen itself (low level or dysfunction).

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Zambia

• Joseph Soko – 101 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies