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A 2-year-old boy, weighing 8 kg, was brought to the emergency department by his mother due to oozing blood from his mouth following a fall nearly 6 hours ago. His mother mentioned that he tends to bleed for prolonged periods from immunization sites, but there is no history of bruising or hematomas.

Laboratory Tests:
- Hemoglobin (Hb) = 26%
- Bleeding time = 5 minutes
- Prothrombin Time (PT) = 12 seconds
- Activated Partial Thromboplastin Time (aPTT) = 60 seconds
- Thrombin Time = 13 seconds

Compute the number of units required for a replacement to raise the level of a factor in the blood to 40%, assuming that the intrinsic activity is 2%.

Answer :

The numbers of units required for a replacement to raise the level of clotting factor in the blood to 40% with an intrinsic activity of 2% is 7 units.

To calculate the number of units required for replacement, let's first identify the specific clotting factor being referred to in this case. Given that the intrinsic activity is mentioned as 2%, this likely pertains to a clotting factor involved in the intrinsic pathway of coagulation. One such factor is factor VIII.

The initial factor level is 26%, and the desired target is 40%. The increase needed is 40% - 26% = 14%.

Given that the factor's intrinsic activity is 2%, we need to calculate how many times the factor needs to be replaced to achieve the desired increase.

Number of factor units required = (Desired increase in percentage) / (Intrinsic activity of factor)

Number of factor units required = 14% / 2% = 7.

Hence, 7 units of the clotting factor would be needed to raise its level to 40% in this 2-year-old boy.

It's important to note that this calculation assumes a linear response to the increase in factor levels, and in clinical practice, other factors like half-life, clearance rates, and potential for factor inhibition would also need to be considered for accurate dosing.

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