Greetings Gang 😈😜 PT. aPTT. TT. Reptilase. Mixing study. DRVVT. Coag questions throw 6 tests at you and expect you to stay calm. Here's the secret: they're all asking the same 5 questions, in the same order. Every time. 1. Read the story: bleeding or clotting? Bleeding → factor deficiency, platelets, vWD or an anticoagulant. Clotting (DVT, PE, recurrent miscarriages) → think lupus anticoagulant. 2. Which screening test is long? PT only → Factor VII (early warfarin, vitamin K deficiency) aPTT only → XII, XI, IX, VIII, vWD, heparin, lupus anticoagulant BOTH → common pathway (X, V, II, I), liver disease, DIC Both normal but bleeding → platelets, mild vWD or Factor XIII 3. Mixing study: is something missing or blocked? Corrects → something's MISSING (factor deficiency) Doesn't correct → something's BLOCKING (inhibitor) Corrects, then prolongs after 1–2 hours at 37°C → Factor VIII inhibitor 4. Pair the thrombin time with the reptilase time TT long + reptilase NORMAL → heparin (reptilase ignores heparin 🐍) TT long + reptilase LONG → the fibrinogen itself is the problem 5. Confirm with ONE test Heparin → anti-Xa Direct thrombin inhibitor → ecarin clotting time Lupus anticoagulant → DRVVT that corrects with excess phospholipid Factor VIII inhibitor → Bethesda assay 🧐 Try it (answer in the comments): A hospitalized patient has a prolonged aPTT. The mix does NOT correct. TT is prolonged, reptilase is normal. What's the cause, and how do you confirm it? I attached my Ultimate Coagulation Cascade Breakdown to this post. It covers every pathway, every factor, every snake-venom test, and a self-quiz at the end. Want to walk through coag questions live? There are still 5 sessions left in 7 Days of Study Sessions, and today's starts at 5PM EST. 👉🏽 Join here: https://www.skool.com/microscopeviews See you there! — Marilyn

Greetings Gang 😈😜 Real talk: it’s been quiet in here, and that’s on me. There are 2,100 of you, all working toward the same goal: passing the ASCP. That’s way too many smart people to be studying alone. So starting today, I’m showing up in here every weekday with something to help you study, like helpful hint/tips, mini-quizzes, and exam traps. All you have to do is show up too. Your first job (it takes 10 seconds) is to comment below with: 1. Your exam date (if you have one, if not, just put the tentative month) 2. The subject you dread most I’ll reply to every single one. The subject that gets the most votes will be the topic of my next post. If you want to go all in, my paid community kicks off 7 days of live study sessions on November 1st, one subject per day. Members also get my ultimate mycology chart, thalassemias and anemias quick guide and the bacteriology buzzwords cheat sheet. 👉🏽 Join here: https://www.skool.com/microscopeviews Let’s get it poppin in here, Gang! — Marilyn

Greetings Gang 😈😜 I gotta be honest... biochemicals are the WORST. Even now after 10 years of being in the field and over a year of teaching them... Catalase, coagulase, oxidase, bile esculin, PYR, CAMP, novobiocin... it starts to feel like a lost cause. The problem isn’t your memory. It’s how most of us study them: as long lists. Your brain doesn’t store lists well. It stores stories, pictures and decisions. Here’s how to switch. 1. Every biochemical answers ONE question. Stop memorizing “S. aureus: catalase +, coagulase +, DNase +, mannitol +...” Instead, ask: “𝗪𝗵𝗮𝘁 𝗶𝘀 𝘁𝗵𝗶𝘀 𝘁𝗲𝘀𝘁 𝘀𝗲𝗽𝗮𝗿𝗮𝘁𝗶𝗻𝗴?” - Catalase: Staph (+) vs. Strep/Enterococcus (−) - Coagulase: S. aureus (+) vs. all other Staph (−) - Novobiocin: S. epidermidis (sensitive) vs. S. saprophyticus (resistant) - Bacitracin / PYR: Group A Strep, S. pyogenes (sensitive / +) - CAMP / hippurate: Group B Strep, S. agalactiae (+) - Optochin / bile solubility: S. pneumoniae (sensitive / soluble) vs. viridans strep - Bile esculin + 6.5% NaCl: Enterococcus (+ / +) vs. group D strep (+ / −) - Oxidase: Pseudomonas, Neisseria, Vibrio, Campylobacter, Helicobacter (+) vs. Enterobacterales (−) If you know what each test splits, you can work out the answer even when you blank on the details. 2. Learn flowcharts, not facts. The exam gives you clues one step at a time, like a flowchart: Gram stain → morphology → arrangement → first test → second test. Study the same way. Example: Gram-positive cocci in clusters → catalase + → coagulase − → novobiocin resistant → UTI in a young woman = S. saprophyticus. Action step: Draw the gram-positive cocci flowchart from memory on a blank page every day this week. Day 1 will be hella messy, but by Day 5 you’ll be doing it in 2 minutes. 3. Give every organism a “personality card," and a gender LOL. Make one card per organism with: - Gram stain + shape: what it looks like under the scope - Plate: what the colony looks like (color, hemolysis, smell) - 1–2 key biochemicals: only the ones that separate it from look-alikes - The disease: the clinical story

“Guys, I took my exam yesterday and I didn’t pass. I believe Blood Bank was my weak point because there were a lot of Blood Bank questions. I only had one question on parasitology. I found the exam pretty straightforward, with simple questions, not much text, and very few images. What strategy did you use after failing the first time?” Thank youuuu

Guys can you help me to understand this question??? If the test don’t give me the percentage what I do????