Risk vs. Uncertainty in Decision Making
Q: Distinguish among state, effect, and response uncertainty.
Did You Know?
This statement is false. The reptilase time is a valuable test specifically because it is NOT affected by heparin. Reptilase is an enzyme derived from snake venom (Bothrops atrox) that, like thrombin, converts fibrinogen to fibrin. However, unlike thrombin, it is not inhibited by heparin or direct thrombin inhibitors. Therefore, if a patient has a prolonged thrombin time (TT) due to heparin contamination or therapy, the reptilase time will be normal. This pattern (prolonged TT, normal reptilase time) is diagnostic of heparin effect. If both the TT and reptilase time are prolonged, it indicates a problem with fibrinogen itself—either a low level (hypofibrinogenemia) or a dysfunctional molecule (dysfibrinogenemia).
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