A patient has an elevated thrombin time and normal reptilase time. Which of the following situations is most likely?
a. Heparin therapy
b. Low fibrinogen
c. Elevated fibrin split products
d. Dysfibrinogenemia
ANS: A
Heparin prolongs the thrombin time but does not prolong the reptilase time. A low fibrinogen, elevated fibrin split products, and dysfibrinogenemia prolong both, although differences exist in sensitivity to some of these between the two tests.
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