MMSC 423 Exam 2 Review - Key Terms and Definitions

A 51 year old man presents with deep vein thrombosis (DVT) of the great saphenous vein, swelling, and pain. For the past 15 years he has worked as a bank teller...

a. Bernard-Soulier

b. DIC

c. Prothrombin G20210A

d. vWD type I

Prothrombin G20210A

A prolonged PT, prolonged ATTP, prolonged TT, undetectable fibrinogen by the Clauss method would be seen in:

a. Afibrigenemia

b. Hemophilia A

c. Hyperfibrinogenemia

d. Hypofibrinogenemia

Afibrigenemia

In this sex-linked recessive disorder, a common clinical finding is hemathroses, normal platelet count, normal RIPA, normal PT, prolonged APTT, and normal bleeding time

a. DIC

b. Factor X deficiency

c. Hemophilia A

d. ITP

hemophilia A

in this type of vWD, the platelet count is normal, PTT is prolonged, cWF antigen (vWFAg) is very low or absent. RIPA is absent. And all vWF multimers are absent.

a. Type 1

b. Type 2a

c. Type 2b

d. Type 3

type 3

Which of the following is recognized as viable treatment for TTP (thrombotic thrombocytopenic Purpura)?

a. All answers are correct

b. Cryoprecipiate

c. Plasma exchange

d. Platelet transfusion

plasma exchange

All of the following may be seen in Hemolytic Uremic Syndrome, except:

a. Decreased reticulocyte count

b. Hematuria

c. Increased serum creatinine

d. Proteinuria

decreased reticulocyte count

All of the following are associated with HELLP syndrome, except:

a. Absence of schistocytes

b. Anemia

c. Increased lactate dehydrogenase

d. Proteinuria

absence of shictocytes

In this rare autosomal recessive disorder, patients are missing the radius bone and present with an elevated white blood cell count and decreased platelet count

a. Bernard-Soulier

b. Gray platelet syndrome

c. Hermansky-pudlak syndrome

d. TAR syndrome

TAR syndrome

In this syndrome, patients platelets are lacking dense granules and present with oculocutaneous albinism with bleeding diathesis often resulting in bleeding gums and epistaxis as well as excessive bleeding following surgery.

a. Bernard-soulier syndrome

b. Glanzmann's thrombasthenia

c. Gray platelet syndrome

d. Hermansky-pudlak syndrome

Hermansky Pudlak syndrome

Which TEG (thromboelastography) parameter would let the clinician know a platelet transfusion is indicated?

a. Decreased K time

b. Decreased MA

c. Decreased R time

d. Increased LY30

decreased MA

In this autosomal recessive disorder, clot retraction is abnormal, there is a deficiency of platelet membrane glycoprotein IIb/IIIa which leads to absence of aggregation with natural platelet agonists, like ADP

a. Bernard-Soulier

b. Glanzmanns Thrombasthenia

c. Gray Platelet Syndrome

d. TAR syndrome

Glanzmanns Thrombasthenia

Which of the following disorders is characterized by lack of alpha granules in platelets?

a. Bernard soulier

b. Factor V Leiden

c. Gray platelet syndrome

d. Hemophilia A

gray platelet syndrome

What is considered a normal range in the bleeding time (BT) test?

a. 2-9 minutes

b. 4-6 minutes

c. 5-10 minutes

d. 10-15 minutes

2-9 minutes

This test measures the time required for the platelet plug to occlude the aperture using standard platelet agonists, like ADP and collagen.

a. PFA-100

b. Prothrombin time

c. Reptilase time

d. Thrombin time

PFA 100

When using TEG, what reagent would be employed in the test system for a patient on unfractionated heparin?

a. Aspirin

b. Heparinase

c. Vitamin K

d. Warfarin

heparinase

All of the following coagulation factors are measured in the Prothrombin Time test, except:

a. XIII

b. I

c. VII

d. X

XIII

When calculating the INR, what does ISI stand for?

a. International Sensitivity Index

b. International Solubility Index

c. International Specificity Index

d. International Surveillance Index

international sensitivity index

All of the following coagulation factors are measured by the APTT, except:

a. FVII

b. FX

c. FXI

d. FXII

FVII

The screening test for Factor V Leiden involves adding a standard amount of activated protein C for both patient plasma and normal plasma. This test is based upon the:

a. APPT

b. PT

APTT

Which test is elevated in uncompensated DIC (disseminated intravascular coagulation)?

a. D dimer

b. Fibrinogen

c. Protein C

d. Protein S

D dimer

Light transmittance is increased in platelet aggregation studies where the platelet agonist employed is ADP

a. True

b. False

true

Patients who have a deficiency of GPIb have a disorder of adhesion

a. True

b. False

true

Oral anticoagulation, eg. Warfarin, is associated with:

a. Vitamin A

b. Vitamin C

c. Vitamin D

d. Vitamin K

vitamin K

Which of the following is decreased in uncompensated DIC (disseminated intravascular coagulation)?

a. D-dimer

b. Fibrinogen

c. PT

d. PTT

fibrinogen

1. Bethesda titers are used for

a. Ascertain both agglutinating ability..

b. Identifying vitamin K deficiency

c. Quantitate the number of units of...

d. Quantitating inhibitors to coagulation factors

quantifying inhibitors to coagulation factors

1. DDAVP is an effective treatment for

a. dysfibrinogenemia

b. heparin overdose

c. vWD type 1

d. vWD Type 2b

vWD type 1

what would mixing studies reveal in a patient with an inhibitor to Factor VIII?

a. APTT would not correct with absorbed plasma or normal plasma protein

b. APPT would not correct with normal ...

c. APTT would not correct with normal...

d. APTT would not correct with both normal..

APTT would not correct with absorbed plasma or normal plasma protein

Which of the following tests is increased in a patient with severe hemophilia A?

a. Factor VIII assay

b. PT

c. PTT

d. Thrombin Time

PTT

A patient presents with a PT of 17 seconds, PTT of 31 seconds, and TT of 16 seconds. What factor deficiency is most likely?

a. Factor I

b. Factor VII

c. FVIII

d. FX

factor VII

What subtype of vWD gives a positive response (increased aggregation) to low dose ristocetin-induced platelet aggregation (concentration of ristocetin is 0.6 U/mL)?

a. 1

b. 2a

c. 2b

d. 3

2b

What molecule does unfractionated heparin bind to in precipitating its anticoagulation effect?

a. Antithrombin

b. fibrinogen

c. Thrombomodulin

d. vWF

antithrombin

What efficacy would IVIG serve in treatment of ITP (idiopathic thrombocytopenia purpura)?

a. Binds to CD22 inhibiting product

b. Binds to Rh positive red blood cells

c. Depresses antibody formation

d. Keep IgG coated platelets in circulation...

keep IgG coated platelets in circulation

Which of the following is characterized as a disorder of aggregation?

a. Bernard-soulier syndrome

b. Glansmann's Thrombasthenia

c. Gray platelet syndrome

d. Von willebrands disease

glansmann's thrombasthenia

A female patient, 45 years old, comes into the emergency room complaining of bruises on their forearm and epistaxis. Lab results showed a PT of 16 seconds, APTT off 30 seconds, platelet count of 140,000/uL, and hemoglobin of 14.4 g/dL. A mixing study was done to try and correct the PT with both normal plasma and absorbed plasma. With normal plasma mixed with patient plasma, the PT was 11 seconds; however with absorbed plasma and patient plasma the PT was 16 seconds. What could be the factor deficiency?

a. FV

b. FVII

c. FVIII

d. FX

FVII

The abnormal red cell can be found in a patient with DIC (disseminated intravascular coagulation)

a. Schistocyte

b. Sickle cell

c. stomatocyte

d. Target cell

schistocyte

Which of the following is a vitamin K antagonist?

a. DDAVP

b. Heparin

c. Transemic acid

d. Warfarin

warfarin

What is the target of the anticoagulant mechanism of unfractionated heparin?

a. Plasmin inhibition

b. Plasmin synthesis

c. Thrombin inhibition

d. Thrombin synthesis

thrombin inhibition

The LMWHs are more efficient in binding factor --------- than binding FIIa

a. FVa

b. FVIIa

c. FXa

d. FXIIa

FXa

Which immunoglobulin is implicated in HIT (heparin induced thrombocytopenia)?

a. IgA

b. IgD

c. IgG

d. IgM

IgG

Which coagulation factor level is the first to decrease, having the shortest half life, when a patient is placed on oral anticoagulant therapy (eg, warfarin)?

a. II

b. IX

c. VII

d. X

VII

Which of the following can reverse the effects of warfarin?

a. Coumadin

b. Heparin

c. Protamine sulfate

d. Vitamin K

vitamin K

What is the blood to anticoagulant ration in coagulation samples?

a. 9:1

b. 1:9

c. 1:5

d. 5:1

9:1

What test is usually employed in detecting the presence of Lupus Anticoagulant where an IgG or IgM immunoglobulin targets phospholipids?

a. Activated protein C resistance

b. Dilute Russels Viper Venom Test

c. Lumiaggregeometry

d. Thrombin time

dilute russels viper venom test

Which of the following tests would be unaffected by the presence of heparin in patient plasma?

a. APTT

b. Reptilase time

c. TEG

d. Thrombin time

reptilase time

The extrinsic pathway of coagulation is monitored by the:

a. Activated partial thromboplastin

b. Prothrombin time

c. Reptilase time

d. Thrombin time

prothrombin time

What anticoagulant is used to collect patient blood specimans in coagulation/hemostasis testing, like the PT and APTT?

a. EDTA

b. Sodium citrate

c. Sodium fluoride

d. Sodium heparin

sodium citrate

What course of action should be followed in the event of platelet satelitosis (platelets surround segmented neutrophils) on the peripheral blood smear.

a. Have patient redrawn using EDTA

b. Have patient redrawn using lithium

c. Have patient redrawn using sodium citrate

d. Nothing, report out initial platelet

have patient redrawn using sodium citrate

What is employed to reverse the effects of unfractionated heparin?

a. Cryoprecipitate

b. Protamine sulfate

c. Transemic acid

d. Vitamin K

protamine sulfate

What enzyme is suppressed by Warfarin preventing gamma carboxylation of the vitamin K dependent factors?

a. Cyclooxygenase

b. Prostacyclin synthetase

c. Thromboxane synthetase

d. Vitamin K epoxide reductase

vitamin K epoxide reductase