Hema 2 Lec - MIDTERM REVIEW QUESTIONS

Endothelial cell

Endothelial cell

CH. 35 REVIEW QUESTIONS:

What intimal cell synthesizes and stores von Willebrand factor (VWF)?

Tissue factor

CH. 35 REVIEW QUESTIONS:

What subendothelial structural protein triggers coagulation through activation of factor VII?

Fibrinogen

CH. 35 REVIEW QUESTIONS:

What coagulation plasma protein should be assayed when platelets fail to aggregate properly?

Carboxylates the factors to allow calcium binding

CH. 35 REVIEW QUESTIONS:

What is the primary role of vitamin K for the prothrombin group factors?

Thrombin proteolysis of fibrinogen

CH. 35 REVIEW QUESTIONS:

What is the source of prothrombin fragment F1.2?

Factor IXa, factor X

CH. 35 REVIEW QUESTIONS:

What serine protease forms a complex with factor VIIIa, and what is the substrate of this complex?

TPA

CH. 35 REVIEW QUESTIONS:

What protein secreted by endothelial cells activates fibrinolysis?

APC and protein S

CH. 35 REVIEW QUESTIONS:

What two regulatory proteins form a complex that digests activated factors V and VIII?

Mediate platelet adhesion and serve as a carrier molecule for factor VIII

CH. 35 REVIEW QUESTIONS:

What are the primary roles of VWF?

The liver

CH. 35 REVIEW QUESTIONS:

Most coagulation factors are synthesized in:

Lead to the formation of a stable fibrin clot

CH. 35 REVIEW QUESTIONS:

The events involved in secondary hemostasis:

Factor XIII

CH. 35 REVIEW QUESTIONS:

Which of the following coagulation factors is activated by thrombin and mediates the stabilization of the fibrin clot?

AT, TFPI

CH. 35 REVIEW QUESTIONS:

Which of the following endogenous plasma inhibitors is (are) important for the control of excessive thrombin generation?

Trauma-induced coagulopathy

CH. 36 REVIEW QUESTION

What is the most common acquired bleeding disorder?

Central nervous system bleed

CH. 36 REVIEW QUESTION

Which is a typical form of anatomic bleeding?

Factor VII deficiency, the PT

CH. 36 REVIEW QUESTION

What factor becomes deficient early in liver disease, and what assay does its deficiency prolong?

Hypofibrinogenemia

CH. 36 REVIEW QUESTION

Which of the following conditions causes a prolonged thrombin time?

Subtype 2B

CH. 36 REVIEW QUESTION

In what type or subtype of VWD is the RIPA test result positive when ristocetin is used at a concentration of less than 0.5 mg/mL?

Vitamin K and four-factor PCC

CH. 36 REVIEW QUESTION

What is the typical treatment for vitamin K deficiency when the patient is bleeding?

Factor XIII

CH. 36 REVIEW QUESTION

If a patient has anatomic soft tissue bleeding and poor wound healing, but the PT, PTT, TT, platelet count, and platelet functional assay results are normal, what factor deficiency is possible?

rFVIIa

CH. 36 REVIEW QUESTION

What therapy may be used for a hemophilic boy who is bleeding and who has a high FVIII inhibitor titer?

Type 1

CH. 36 REVIEW QUESTION

What is the most prevalent form of VWD?

Factor V assay

CH. 36 REVIEW QUESTION

Which of the following assays is used to distinguish vitamin K deficiency from liver disease?

Defects in primary hemostasis

CH. 36 REVIEW QUESTION

Mucocutaneous hemorrhage is typical of:

Bleeding into the joints (hemarthroses)

CH. 37 REVIEW QUESTION

The clinical presentation of platelet-related bleeding may include all of the following except:

Glanzmann thrombasthenia

CH. 37 REVIEW QUESTION

A defect in GP IIb/IIIa causes:

Abnormal platelet response to ristocetin

CH. 37 REVIEW QUESTION

Patients with Bernard-Soulier syndrome have which of the following laboratory test findings?

Storage pool defects

CH. 37 REVIEW QUESTION

Which of the following is the most common of the hereditary platelet function defects?

Altered expression of phospholipids on the platelet membrane

CH. 37 REVIEW QUESTION

A reduction in thrombin generation in patients with Scott syndrome results from:

Decreased numbers of a granules and dense granules

CH. 37 REVIEW QUESTION

The impaired platelet function in myeloproliferative neoplasms results from:

Impaired membrane activation, owing to protein coating

CH. 37 REVIEW QUESTION

The platelet defect associated with increased paraproteins is:

NO

CH. 37 REVIEW QUESTION

In uremia, platelet function is impaired by higher than normal levels of:

Anti-GP IIb/IIIa antibodies

CH. 37 REVIEW QUESTION

Thrombocytopenia associated with the use of cardiopulmonary bypass is not caused by:

Thromboxane A2

CH. 37 REVIEW QUESTION

Aspirin ingestion blocks the synthesis of:

Direct binding to GP IIb/IIIa

CH. 37 REVIEW QUESTION

A mechanism of antiplatelet drugs targeting GP IIb/IIIa function is:

Ehlers-Danlos syndrome

CH. 37 REVIEW QUESTION

Which is a congenital qualitative platelet disorder?

May-Hegglin anomaly

CH. 38 Review Question:

The Autosomal Dominant Disorder associated with decreased platelet production is

Large Overactive Platelets

CH. 38 Review Question:

Which of the following is not a hallmark of ITP?

HPA-1a

CH. 38 Review Question:

The specific antigen most commonly responsible for the development of NAIT is

Acute ITP

CH. 38 Review Question:

A 2-year-old child with an unexpected platelet count of 15,000/mL and a recent history of a viral infection most likely has?

Anagrelide

CH. 38 Review Question:

Which drug causes a reduction in platelet count by inhibiting megakaryocyte maturation?

Mucosal bleeding

CH. 38 Review Question:

A defect in primary hemostasis (platelet response to an injury) often results in?

The combination of the drug and the platelet membrane protein to which it is bound

CH. 38 Review Question:

When a drug acts as a hapten to induce thrombocytopenia, an antibody forms against which of the following?

Abnormal bone formation, including hypoplasia of the forearms

CH. 38 Review Question:

TAR refers to

The mother has an autoimmune antibody to her own platelets, which crosses the placenta and reacts with the infant’s platelets.

CH. 38 Review Question:

Neonatal autoimmune thrombocytopenia occurs when

Diarrhea caused by Shigella species

CH. 38 Review Question:

HUS in children is associated with

Atypical HUS

CH. 38 Review Question:

Treatment with an anticomplement agent such as eculizumab is first-line therapy for

Thrombocytosis is self-correcting

CH. 38 Review Question:

Which of the following statements regarding thrombocytosis is not true?

1 in 1000

CH. 39 REVIEW QUESTION:

What is the prevalence of venous thrombosis in the United States?

Predisposition to thrombosis secondary to a congenital or acquired disorder

CH. 39 REVIEW QUESTION:

What is thrombophilia?

Lupus anticoagulant

CH. 39 REVIEW QUESTION:

What acquired thrombosis risk factor is assessed in the hemostasis laboratory?

Adenocarcinoma

CH. 39 REVIEW QUESTION:

Trousseau syndrome, a low-grade chronic DIC, is often associated with what type of disorder?

APC resistance (factor V Leiden mutation)

CH. 39 REVIEW QUESTION:

What is the most common heritable thrombosis risk factor in Caucasians?

DRVVT

CH. 39 REVIEW QUESTION:

In most LAC profiles, what test is primary (performed first) because it detects LAC with the least interference?

• It is considered the more specific of the LAC assays

Type I

CH. 39 REVIEW QUESTION:

A patient with venous thrombosis is tested for protein S deficiency. The protein S activity, antigen, and free antigen are all less than 65%, and the C4bBP level is normal. What type of deficiency is likely?

PAI-1

CH. 39 REVIEW QUESTION:

An elevated level of what fibrinolytic system assay is associated with arterial thrombotic risk?

It substitutes for plasminogen or TPA in the forming clot

CH. 39 REVIEW QUESTION:

How does lipoprotein (a) cause thrombosis?

DRVVT using high-phospholipid reagent

CH. 39 REVIEW QUESTION:

What test may be used to confirm the presence of LAC?

MTHFR 677

CH. 39 REVIEW QUESTION:

What molecular test may be used to confirm APC resistance?

Activated prothrombin complex concentrate

CH. 39 REVIEW QUESTION:

What therapeutic agent may occasionally cause DIC?

D-dimer

CH. 39 REVIEW QUESTION:

Which is not a fibrinolysis control protein?

Rule out deep venous thrombosis

CH. 39 REVIEW QUESTION:

What is the most important application of the quantitative D-dimer test?

Platelet count

CH. 39 REVIEW QUESTION:

What is the first laboratory assay necessary to detect heparin-induced thrombocytopenia?

2.5 to 3.5

CH. 40 REVIEW QUESTION:

What is the PT/INR therapeutic range for Coumadin therapy when a patient has a mechanical heart valve?

Acceptable for a patient with stable anticoagulation results after 6 months

CH. 40 REVIEW QUESTION:

Monitoring of a patient taking Coumadin showed that her anticoagulation results remained stable over a period of about 7 months. The frequency of her visits to the laboratory began to decrease, so the period between testing averaged 6 weeks. This new testing interval is:

It is convenient

CH. 40 REVIEW QUESTION:

What is the greatest advantage of point-of-care PT testing?

1 hour

CH. 40 REVIEW QUESTION:

You collect a citrated whole-blood specimen to monitor UFH therapy. What is the longest it may stand before the plasma must be separated from the cells?

ACT

CH. 40 REVIEW QUESTION:

What test is used to monitor high-dose UFH therapy during an interventional cardiology procedure?

PTT

CH. 40 REVIEW QUESTION:

What test is used most often to monitor UFH therapy in the central laboratory?

Chromogenic anti-factor Xa heparin assay

CH. 40 REVIEW QUESTION:

What test is used most often to monitor LMWH therapy in the central laboratory?

It has a predictable dose response

CH. 40 REVIEW QUESTION:

What is an advantage of LMWH therapy over UFH therapy?

HIT

CH. 40 REVIEW QUESTION:

In what situation is an intravenous DTI used?

ECT

CH. 40 REVIEW QUESTION:

What laboratory test may be used to monitor intravenous DTI therapy when PTT results are unreliable?

Platelet aggregometry

CH. 40 REVIEW QUESTION:

What is the reference method for detecting aspirin or clopidogrel resistance?

11-dehydrothromboxane B2

CH. 40 REVIEW QUESTION:

What is the name of the measurable platelet activation metabolite used in the AspirinWorks assay to monitor aspirin resistance?

Abciximab

CH. 40 REVIEW QUESTION:

Which is an intravenous antiplatelet drug used during an interventional cardiology procedure?

Rivaroxaban

CH. 40 REVIEW QUESTION:

Which of the following is a DOAC?

Clot-based test results are falsely prolonged

CH. 41 REVIEW QUESTION:

What happens if a coagulation specimen collection tube is underfilled?

First, or after a nonadditive tube

CH. 41 REVIEW QUESTION:

If you collect blood into a series of tubes, when in the sequence should the hemostasis (blue stopper) tube be filled?

In vitro platelet and coagulation activation

CH. 41 REVIEW QUESTION:

What is the effect of hemolysis on a hemostasis specimen?

10,000/uL

CH. 41 REVIEW QUESTION:

Except for platelet aggregometry, most coagulation testing must be performed on PPP, which is plasma with a platelet count less than:

0.32 mL

CH. 41 REVIEW QUESTION:

You wish to obtain a 5-mL specimen of whole-blood/ anticoagulant mixture. The patient’s hematocrit is 65%. What volume of anticoagulant should you use?

Glanzmann thrombasthenia

CH. 41 REVIEW QUESTION:

You perform whole-blood lumiaggregometry on a specimen from a patient who complains of easy bruising. Aggregation and secretion are diminished when the agonists thrombin, ADP, arachidonic acid, and collagen are used. What is the most likely platelet abnormality?

Serotonin release assay

CH. 41 REVIEW QUESTION:

What is the reference assay for HIT?

Ristocetin

CH. 41 REVIEW QUESTION:

What agonist is used in platelet aggregometry to detect VWD?

Prothrombin

CH. 41 REVIEW QUESTION:

Deficiency of which congenital single factor is likely when the PT result is prolonged and the PTT result is normal?

Vitamin K deficiency

CH. 41 REVIEW QUESTION:

A prolonged PT, a low factor VII level, but a normal factor V level are characteristic of an acquired coagulopathy associated with which of the following?

Lupus anticoagulant

CH. 41 REVIEW QUESTION:

The patient has deep vein thrombosis. The PTT is prolonged and is not corrected in an immediate mix of patient PPP with an equal part of PNP. What is the presumed condition?

DIC

CH. 41 REVIEW QUESTION:

What condition causes the most pronounced elevation in the result of the quantitative D-dimer assay?

Chromogenic substrate assay

CH. 41 REVIEW QUESTION:

What is the name given to the type of assay that uses a synthetic polypeptide substrate that releases a chromophore on digestion by its serine protease?

a2-antiplasmin

CH. 41 REVIEW QUESTION:

What component of the fibrinolytic process binds and neutralizes free plasmin?

Whole-genome sequencing

CH. 41 REVIEW QUESTION:

What type of high-throughput genomic sequencing is likely to become a standard clinical assay?

All of the above

CH. 42 REVIEW QUESTION:

Which of the following includes the advances made in technology in the coagulation lab?

It is not affected by lipemia in the test specimen

CH. 42 REVIEW QUESTION:

Which of the following is considered to be an advantage of the mechanical end-point detection methodology?

Viscoelastic

CH. 42 REVIEW QUESTION:

What method of detection is used in both the TEG and ROTEM?

Reagents and specimens usually are added manually by the operator

CH. 42 REVIEW QUESTION:

Which of the following is a feature of semiautomated coagulation testing analyzers?

Photo-optical clot detection

CH. 42 REVIEW QUESTION:

When a specimen has been flagged as being icteric by an automated coagulation analyzer, which method would be most susceptible to erroneous results because of the interfering substance?

Flow cytometry

CH. 42 REVIEW QUESTION:

Which of the following newer techniques can be used for the measurement of platelet function testing in patients with thrombocytopenia and in pediatrics?

Location of the manufacturer’s home office

CH. 42 REVIEW QUESTION:

All of the following are performance characteristics to consider in the selection of a coagulation analyzer except:

Detecting the time it takes for a clot to form as blood flows through a small aperture in a tube coated with platelet activators

CH. 42 REVIEW QUESTION:

Platelet function is measured by the PFA-100 using which of the following methods?