Daily Quiz Questions

The Thymus is responsible for the initial development of

T cells

Apoptosis is defined as

Programmed cell death

The spleen sequesters (holds in reserve) what percentage of total available PLT mass

33%

The Breakdown products of heme go through several biochemical degradations to form

Bilirubin

Intravascular hemolysis refers to the process of

Fragmentation or destruction of RBCs within the blood vessels

Simply define 1* Hemostasis step Adhesion

PLT stick to site of injury

Simply define 1* Hemostasis step Aggregation

PLT stick to each other

Simply define 1* Hemostasis step Activation/Secretion

PLT release granular contents

List the three important PLT agonists

Thrombin, ADP, TXA2

What molecule is necessary for PLT activation and is exposed as part of the endothelial cell matrix during injury?

Collagen

What will stain blue on a wrigh-giemsa stain?

DNA and RNA

What color will most proteins end up staining in Wrigh-giemsa stain

Pink

Which term is best defined as progression from an early stage cell without specialized function to a later stage cell with a limited and specialized function

Maturation

What is the growth factor that is important for PLT

TPO (Thrombopoietin)

List all sites likely to have active red marrow in an adult

Proximal ends of long bones, Torso bones, and Skull

List the Factors in the Intrinsic Pathway of 2* Hemostasis (PTT)

XII, XI, IX, VIII

List the Factors in the Extrinsic Pathway of 2* Hemostasis (PT)

III & VII

List the Factors in the Common Pathway of 2* Hemostasis

X, V, II (Pro/Thrombin), I (Fibrinogen/Fibrin), XIII

What does thrombin activate

• Fibrinogen to Fibrin

• Continues PLT activation

• F XIII, V, VIII, Thrombomodulin, and TAFI

List the Factors and Proteins that are Vitamin K Dependent

Factors: II, VII, IX, and X

Proteins: S, C, and Z

List top 3 criteria for COAG specimen rejection

1. Clot

2. Under filled

3. Over filled

oral anticoagulation, Warfarin therapy, is based on

Vitamin K antagonism

Most Coagulation testing uses the formation of what to determine the test end poit

Fibrin

Warfarin therapy is most commonly monitored by which test

PT/INR

Aspirin therapy results in decreased production of TXA2 due to inhibition of what enzyme

Cyclo-oxygenase (COX)

What is the purpose of INR test

to standardize the interpretation of PT results across different labs, platforms, and reagent lots

The deficiency of _____ would most likely result in a thrombotic disorder

Plasminogen

What are the three regulatory pathways/molecules that atop clotting

• Protein C pathway

• TFPI

• Antithrombin

Why does a deficiency of plasminogen result in a thrombotic disorder

it is responsible for breaking down clots, so without it clots can not be removed. This causes clots to hang out longer then they should causing inappropriate clot retention.

A 28 year old women bleed more than expected during birth of first child.

Hx: always bruised somewhat easily, moderate heavy periods throughout life

testing showed:

• PT/INR: normal

• PTT: increased

• PLT and fibrinogen: normal

What disorder is consistent with symptoms?

Von Willebrand disease

Petechiae, purpura, ecchymoses are all described as

Varying sizes of hemorrhages into the skin

Ca as a reagent is necessary for clot based coagulation testing because

it is required as a cofactor, activates multiple secondary hemostasis complexes

Which coag regulatory mechanism is Vit K dependent

Protein C Pathway (II, V, VII, IX, XI, Pro. S, C, Z)

A patient with Hemophilia A is most likely to experience which bleeding symptoms

Hemarthroses

What assay would be performed in combination with FVII assay to differentiate moderate to severe liver disease from vitamin K deficiency?

FV assay

Type 2 VWD, a near complete quantitative absence of VWF, is typically characterized by all factors including

• Prolonged PTT

• Decreased FVIII levels

• Normal PLT count

Type 2 VWD, a near complete quantitative absence of VWF, is typically characterized by all factors Except

• Normal VWF antigen levels

A 27 year old woman with no previous Hx of bleeding or inappropriate bruising presents to the ED complaining of recent increase in menorrhagia and recurrent epistaxis over the past 4-6 months. Her pLT count is 36,000/uL and her RBC morphology was normal. What is the most likely explanation of her symptoms

Chronic immune thrombocytopenic purpura

A 27 year old woman with no previous Hx of bleeding or inappropriate bruising presents to the ED complaining of recent increase in menorrhagia and recurrent epistaxis over the past 4-6 months. Her pLT count is 36,000/uL and her RBC morphology was normal. What is the most likely explanation of her symptoms

The patients disorder could be described as

Generalized, acquired, systemic

All of the following are characteristics of Hemophilia A Including

• Sex-linked inheritance patterns

• Acute and chronic hemarthroses

• Decreased FVIII activity

All of the following are characteristics of Hemophilia A Except

• Decreased WVF antigen/activity

what symptoms would you expect in a patient with a quantitative FXIII deficiency

Delayed bleeding after injury and poor would healing