Unique Plan Description: Thrombophilia Workup
Plan Selection Display: Thrombophilia Workup
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-01-11 18:03:51
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2023-05-25 12:33:02
Available at all facilities: Yes

Thrombophilia Workup
Laboratory
		For initial workup, consider for all persons with thrombosis prior to congenital/limited workup to assess for precipitating factors.(NOTE)*
	CBC with Diff
		T;N, Routine, spec type = Blood
	INR - MH/WH/JE
		T;N, Routine, spec type = Blood
	PTT - MH/WH/JE
		T;N, Routine, spec type = Blood
			Comment: obtain only if PTT is inappropriately prolonged.
	Comprehensive Metabolic Panel
		T;N, Routine, spec type = Blood
			Comment: obtain only if PTT is inappropriately prolonged
	Urinalysis
		T;N, Routine, Routine, spec type = Urine
	PSA
		T;N, Routine, spec type = Blood
	Peripheral Smear Consult
		T;N, Routine, Blood, Routine
	Pregnancy Test Urine
		T;N, Routine, Routine, spec type = Urine
		Congenital/inherited workup - consider in patients with initial thrombosis prior to 50 years of age. Not recommended for hereditary prothromotic disorders.(NOTE)*
	APC Resistance Profile
		T;N, Routine, spec type = Blood
	APC Resistance Profile with Reflex to Factor V Leiden PCR (PreAuth Req)
		T;N, Routine, spec type = Blood
	Factor V Leiden Mutation  (PreAuth Req)
		Routine, spec type = Blood
	Prothrombin (F2) G20210A Pathogenic Variant (PreAuth Req)
		Routine, spec type = Blood
	Homocysteine Total
		T;N, Routine, spec type = Blood
		Protein C & S cannot be measured reliably if on Warfarin(NOTE)*
	Protein C Functional
		T;N, Routine, spec type = Blood
	Protein S Functional
		T;N, Routine, spec type = Blood
		Antithrombin & Lupus anticoagulant cannot be measured reliably if on Heparin.(NOTE)*
	Anti-Thrombin III Enzymatic (Activity)
		T;N, Routine, spec type = Blood
	Lupus Anticoagulant Panel
		T;N, Routine, spec type = Blood
	Cardiolipin Antibodies IgG and IgM
		T;N, Routine, spec type = Blood
	Factor VIII
		T;N, Routine, spec type = Blood
		Arterial Thrombosis(NOTE)*
	Cardiolipin Antibodies IgG and IgM
		T;N, Routine, spec type = Blood
	Homocysteine Total
		T;N, Routine, spec type = Blood
Consults/Follow-up
	Consult Hematologist/Oncologist
		Reason for Referral: Thrombophilia

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase