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Black and Blue with Love

A Case Study in Blood Clotting

Co Authors:

Kendra S. Mell
University Medical Center
Texas Tech University

Breanna N. Harris
Biological Sciences
Texas Tech University


In this directed case study students follow a nurse practitioner and work with a diagnostics team to determine what is wrong with Tristan, an infant who comes to the clinic with multiple bruises. Students are given background and patient history, and are then given results of various blood tests ordered by the diagnostics team. The exercise emphasizes the physiological process of coagulation and the importance of various clotting factors, especially factor VIII. Students will be introduced to results from several blood tests, including: complete blood count, partial thromboplastin time, prothrombin time, metabolic panel, and factor VIII assay. The patient is ultimately diagnosed with severe hemophilia A and the case then introduces students to this disorder, the genetic determinants, the incidence, and ways to manage the disease. The data in this case are real and the story represents the medical history of an actual patient. Originally developed for pre-nursing students, this activity would also be suitable for majors in physiology or pre-medical students; it could also be used in an introductory genetics or biology course.

  • Explain the underlying cause of hemophilia A and describe how the clotting process is altered in someone with this disorder.
  • Draw the clotting cascade and list the various factors involved in clot formation.
  • Diagram the genetic inheritance of hemophilia A.
  • Explain various lab tests (complete blood count, metabolic panel, partial thromboplastin time, prothrombin time, and factor VIII assay).
Keywords: clotting; hemophilia; haemophilia; hemophiliac; factor VIII; FVIII; clot; hemostasis; thrombus; prothrombin; blood; inheritance; coagulation
Topical Area: N/A
Educational Level: Undergraduate lower division, Undergraduate upper division, Clinical education
Formats: PDF
Type/Method: Analysis (Issues), Directed, Interrupted
Language: English
Subject Headings: Physiology   Epidemiology   Genetics / Heredity   Medicine (General)   Nursing   Anatomy  
Date Posted: 8/18/2016
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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