Chrono-Log 490 4+4 - Page 16

Document # 49044IM1
Revision 7.5 15
Dated February 16, 2017
Reporting Format:
PLATELET AGGREGATION STUDIES:
DATE __________________________________
PHYSICIAN _________________________________ TIME BLOOD DRAWN: ___________
INSTITUTION: ______________________________ DEPARTMENT: ____________________
PATIENT ___________________ I.D. _______________ DATE OF BIRTH: ______________
AGE: ________ SEX: (M) (F) HCT ___________ PLT CT _________ BT _________
CLINICAL HISTORY: ______________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
OPTICAL AGGREGATION TEST RESULTS
AGONIST
NORMAL RANGES
(Mean ±
±±
±1 SD)
CONTROL
VALUE
PATIENT
VALUE
TEST
RESULTS
(Normal, Reduced,
Increased)
ADP, 5 µ
µµ
µM
69 - 88%
ADP, 10 µ
µµ
µM
71 - 88%
COLLAGEN, 2 µ
µµ
µg/mL
70 - 94%
COLLAGEN, 5µ
µµ
µg/mL
ARACHIDONIC ACID,
0.5 mM
74 - 99%
*
EPINEPHRINE, 5 µ
µµ
µM
78 - 88%
RISTOCETIN, 1.25 mg/mL 87 - 102%
RISTOCETIN, 0.5 mg/mL 0%
* ±
±±
±2SD
INTERPRETATION:
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
TEST PERFORMED BY: ___________________________________ INTERPRETED BY: _______________________________________________