Factor VIII Inhibitor Evaluation
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Factor VIII Inhibitor Evaluation | |
| 2. | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test Workstation :
Mayo
Specimen Type:
Na Citrate Plasma
Tube Type:
2.7 ml Na Citrate
Minimum Volume:
5.4 mL - 2 properly filled 2.7 ml tubes
Preferred Volume:
8.1 mL - 3 properly filled 2.7 ml tubes
Cause for Rejection:
Grossly hemolyzed, grossly lipemic, grossly icteric. Patient must not be receiving Coumadin or heparin therapy.
Storage:
Frozen
Special Instructions:
Double-spin specimen and aliquot 1 ml into 3 separate aliquot tubes. (Minimum 1 ml in 2 separate aliquot tubes.)
TAT:
3-5 days
Additional Info:
For more information, see Mayo Medical Laboratories Lab Test Menu, test code 8INHE.
Synonyms:
Factor VIII Inhibitor Profile
