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Coagulation Assays: Appropriate Workup and Interpretation

Release Date: September 30, 2007

Expiration Date: September 30, 2008

Estimated time to complete this Activity: 1 hours

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Overview

The evaluation of patients with bleeding disorders requires a detailed history and physical examination, leading to a thoughtful differential diagnosis. As the accompanying cases will demonstrate, the value of a carefully taken history cannot be overestimated. Coagulation assays are used to confirm the diagnostic impression, not as part of a searching expedition. The coagulation workup should be narrowly focused. Obtaining blood from young patients is often difficult, painful, and traumatic to both the patient and the parents. A sufficient sample should be collected so that an adequate specimen is available to perform all of the required testing, without the need for another blood sample. Because of advances in technology, most assays require only micro-liter amounts of plasma obtained from a single tube of citrated blood.

Target Audience

The learning activities are primarily intended for residents and fellows in the field of pediatric hematology/oncology. However, practicing physicians and other health care professionals involved in the care and treatment of children with hematologic or oncologic disorders will also significantly benefit from these activities.

Educational Objectives

After completing this continuing medical education (CME) activity, participants should be able to:

• Select appropriate coagulation tests based on the history and physical examination
• List the screening tests relevant to patients with bleeding disorders, and describe the limitations of each test
• Discuss how clotting factor deficiencies may be differentiated from clotting factor inhibitors

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The FCG Institute for Continuing Education and Acumentis. The FCG Institute for Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The FCG Institute for Continuing Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity

How to Get Credit

To receive CME Credit, you should read the newsletter then view and participate in the accompanying web-based case studies by answering the interactive test questions. Your answers for each case will be tallied and a passing score of 70% or higher must be attained to receive credit. You must also complete the online evaluation and credit request form. Then print your certificate online. That's it—no need to wait for the certificate to be mailed to you!

Faculty Disclosure

It is the policy of the FCG Institute for Continuing Education that all faculty participating in continuing medical education activities are expected to disclose to the program audience (1) any real or apparent conflict(s) of interest related to the content of their presentation and (2) discussion of unlabeled or unapproved uses of drugs or medical devices. Faculty disclosure statements can be found with their biographical sketches.

Conflict of Interest Resolution

When individuals in a position to control or influence the development of the content have reported Financial Relationships with one or more commercial interests, The FCG Institute for Continuing Education utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias. The content of this presentation was vetted through The Institute’s process of peer review and content validation and modified as required to meet this standard.

Notice About Investigational or Off-Label Use

This educational activity may include discussion of drugs or devices or uses of drugs and devices, that have not been approved by the FDA or have been approved by the FDA for specific uses only. It is the responsibility of the physician to determine the FDA clearance status of each drug or device he or she wishes to use in clinical practice. The FCG Institute for Continuing Education is committed to the free exchange of medical education. Inclusion of any product or device discussion, including discussion of investigational or off-label uses, does not imply endorsement by The Institute of the uses, products, or techniques presented.

Disclaimer

This CME/CE activity is designed for use by healthcare professionals for educational purposes only. The information and opinions expressed by the faculty are their own and do not necessarily reflect those of The FCG Institute. The FCG Institute for Continuing Education does not define a standard of care, nor does it intend to dictate an exclusive course of management but presents through the educational activities it sponsors recognized methods and techniques of clinical practice for consideration by physicians and other healthcare providers for incorporation into their practices. Participants should use their own clinical judgment before applying information, whether provided here or by others, for any professional use.

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Sponsored by: The FCG Institute for Continuing Education

The FCG Institute for Continuing Education
gratefully acknowledges an educational grant from
Novo Nordisk Inc. in support of this Web Site