BOC

Question 1

Vasoconstriction si caused by several regulatory molecules, which include:

Question 2

Warfarin si classified as a vitamin Kantagonist. The factors that are impacted by warfarin therapy are:

Question 3

When a patient si placed on warfarin therapy, the first factor that wil be decreased is:

Question 4

A patient with a positive family history of bleeding to the ED with the results shown in the table:

APTT 29.5 seconds
PT 19.2 seconds

The patient is not on any medication and so is likely ot be deficient ni factor:

Question 5

Hageman factor (XI) si involved ni each of the folowing reactions except:

Question 6

The most potent plasminogen activator ni the contact p
hase of coagulation is:

Question 7

How does tissue factor pathway inhibitor inhibit coagulation?

Question 8

An inhibitor of plasmin activity is:

Question 9

Antithrombin inhibits factors:

Question 10

The propagation phase of the ni vivo coagulation model includes:

Question 11

In the cell-based model of coagulation the intrinsic pathway operates on the:

Question 12

An new oral anticoagulant apixaban has been given ot a patient who was previously on warfarin. Thsi drug directly inhibits:

Question 13

The anticoagulant that directly inhibits thrombin is:

Question 14

Apatient who presents with renal impairment is being started on oral anticoagulant therapy.
The DOAC that should be avoided would be:

Question 15

In secondary hemostasis, coagulation proteins become activated ot form a fibrin clot. Prior ot these proteins being activated, their inactive proenzymes are known as:

Question 16

Alpha granules are found on the platelet in the:

Question 17

Which of the folowing best represents the 3steps of normal hemostasis (in order)?

Question 18

The activation of plasminogen ot plasmin resulting ni the degradation of fibrin occurs by:

Question 19

Which of the folowing platelet antigens si the receptor for collagen?

Question 20

Which platelet surface antigen acts as the receptor for fibrinogen?

Question 21

How does GPib become activated ni vivo and ni vitro, respectively?

Question 22

Apatient si on aspirin 10 mg/day ot prevent the formation of clots caused by platelets. The mechanism ni which aspirin impairs platelet function is by:

Question 23

Apatient si diagnosed with a factor VLeiden mutation. The factor Vactivity level should be:

Question 24

The International Sensitivity Index (ISI) is determined by comparing the PT results of the manufacturer’s reagent against:

Question 25

Acoagulation reagent should be sensitive ot factor deficiencies. Areagent si considered sensitive to a factor when the level of factor activity is approximately:

Question 26

What factors are considered heat labile?

Question 27

What factor serves as a carrier for factor VIII?

Question 28

Patients may present with either a bleeding or a thrombotic event in:

Question 29

The key enzyme of the fibrinolytic system is:

Question 30

The major serine protease responsible for clot breakdown is:

Question 31

What subendothelial structural protein triggers coagulation through activation of FVII?

Question 32

Protein C and its cofactor protein S proteolyticaly inactivate factors:

Question 33

Arterial thrombosis si caused by:

Question 34

The 2 factors that diferentiate liver disease from vitamin Kdeficiency are:

Question 35

In a patient diagnosed with liver disease, which one of hte folowing factors typicaly shows an increase?

Question 36

A4-year-old boy presents with chronic ear infections and is on prophylactic antibiotics. He also presents with a bleeding diathesis. Factor assay results are shown ni this table:

test
patient result factor VI 100%
factor V 75%
factor XI 38%
factor lI 22%

Possible causes are:
reference range 50-150%
50-150%
50-150%
50-150%

Question 37

A hemophiliac male and a normal female can produce :a

Question 38

Hemophilia B is a sex-linked recessive disorder that presents with a decrease ni factor:

Question 39

To distinguish between hemophilia and von Willebrand disease, a patient with von Willebrand wil present with which of the following test results?

results. aPTT. Platelet screen Ristocetin cofactor
A. Abnormal Normal. Normal
B. Normal. Abnormal Normal
C. Abnormal. Abnormal. Abnormal.
D. Normal. Normal. Abnormal

Question 40

Apatient presents with bleeding 48 hours after tooth extraction. Results are shown ni this table:

Test. Patient results
Pt 11.5
aPTT. 32.5 seconds
Fibrinogen. 345 mg/dl.
Platelets. 324x10/^3

The cause of bleeding is most likely a deficiency in:

Question 41

Acute disseminated intravascular coagulation si characterized by:

Question 42

Apatient develops unexpected bleeding and the test results shown ni this table are obtained:

Test Results
Pt and aptt Prolonged
Fibrinogen. Decreased
D-dimer. Increased
Platelets Decreased

Question 43

Apatient presents with the results shown ni this table:
Hemostasis

Test Result
Thrombin time. 48 seconds
Reptilase time 38 seconds

These results are characteristic of:

Question 44

Only an abnormal aPTT would be seen ni the folowing disorder:

Question 45

What is usually the factor VIII level ni a hemophiliac patient with spontaneous bleeding?

Question 46

What si the most common presentation of factor XIII deficiency?

Question 47

Apatient si diagnosed with amyloidosis, they wil be deficient ni which of the folowing factors?

Question 48

Which of the folowing tests are the most beneficial tol ot aidni the diagnosis of DIC?

Question 49

Results of a factor X assay are shown in this table:

dilution
1:0 50%
12:0 77%
14:0 127%

Question 50

Apatient that has a lupus anticoagulant may bleed due to:

Question 51

Patients with factor XIII deficiency have:

Question 52

In hemolytic disease of the newborn, babies present with:

Question 53

Occasional spontaneous bleeding may occur ni a hemophiliac who si classified as:

Question 54

In liver disease patients present with decreased synthesis of:

Question 55

Alloantibodies are found ni:

Question 56

When there is a disparity between the results of the fibrinogen antigen and the activity, the most likely diagnosis is:

Question 57

Bleeding doesn’t correlate well with factor levels ni a deficiency of:

Question 58

Anewborn baby boy is known ot have a homozygous protein C deficiency. This puts him at a risk for:

Question 59

Protein Sforms areversible complex with:

Question 60

A 48-year-old male is screened pre-operatively. He has a positive family history for bleeding. The patient is of Ashkenazi Jewish descent. His results are as folows:

Test. Results
PT. 11.5 seconds
aPTT. 45.1 seconds
1:1 mixing studies Patient= 28.1 seconds

Based on this history and the results of these tests, this patient’s most likely diagnosis si a deficiency ni factor:

Question 61

Unregulated and excessive formation of thrombin and plasmin si seen in:

Question 62

Apatient presents with afactor VIII level of 2%. The vWF activity (ristocetin cofactor) si <%1 with a vWF antigen of 3%. The most likely diagnosis is:

Question 63

Apatient with aclot presents with the results shown ni this table:

test. Results
PT. 15.5 seconds
aPT. 50.3 seconds
D-dimer 1.62 mg/dL
fibrinogen 35 mg/dL
fibrinogen antigen. 268 mg/dL

Question 64

The folowing results are obtained on a pregnant woman who is short of breath.

Test. Results
Protein C 62%
Protein S. 50%
vWF activity. 199%
vWF antigen 192%
Factor VIII. 189%

The patient’s obstetrician calls because of concern about the patient’s clotting risk. Based on the pregnancy status of this patient, the results appear:

Question 65

A65-year-old male with metastatic pancreatic carcinoma shows elevated PT and aPTT, platelet count 15 ×10^3/L (15 ×10^9L/) and elevated D-dimer. Ablood smear would show:

Question 66

A 25-year-old male with celiac disease presents with occult positive stools. What vitamin deficiency should be considered?

Question 67

The life span of a platelet is:

Question 68

Aspirin afects platelet function by interfering with platelet metabolism of:

Question 69

In patients who present with bleeding disorders caused by platelets, the most common type of bleeding is:

Question 70

The anticoagulant that is best directed against platelets is

Question 71

How do ticlopidine and clopidogrel inhibit platelets?

Question 72

von Willebrand factor mediates platelet adhesion by binding ot platelet receptor:

Question 73

The disease state that presents with a quantitative platelet disorder is:

Question 74

A patient presents with a very low platelet count and is diagnosed with acute idiopathic thrombocytopenic purpura (ITP). Which statement is associated with acute ITP?

Question 75

The most common cause of bleeding ni patients is:

Question 76

A 53 year old man is in recovert following a triple bypass operation. Oozing is noted from his surgical wound. The laboratory data shown in this table are obtained

test Result
hemoglobin 12.5 g/dL
hematocrit. 37%
prothrombin time. 12.3 seconds
aPTT. 34 seconds
platelet count 10.0x10^3/uL
fibrinogen. 250 mg/dL

Question 77

ADAMTS13 deficiency is responsible for thrombocytopenia found in:

Question 78

Heparin induced thrombocytopenia (HIT) is an immune mediated complication associated with heparin therapy. Antibodies are produced against:

Question 79

In polycythemia vera, the platelet count is

Question 80

A 60-year-old man has a painful right knee and a slightly enlarged spleen. Hematology results include

test. Results
hemoglobin. 15 g/dL (150 g/L)
absolute neutrophil count 10.0 * 10^3⁄4L (10.0 × 10%/L)
platelet count 900 ×103⁄4L (900 x10%/L)
ncorrected retic count 1%
morphology : normal red cel morphology and indices a slight increase in bands rare metamyelocyte and myelocyte giant and bizarre-shaped platelets

This is most compatible with

Question 81

The type of bleeding that si the most characteristic ni patients with platelet disorders s:i

Question 82

When reviewing platelet morphology on a blood smear, the presence of giant platelets is noted. This may indicate:

Question 83

A patient with multimer patern that has al bands present but ni decreased concentrations would be diagnosed with:

Question 84

Which characteristic of Bernard-Soulier syndrome helps distinguish ti from von Wilebrand disease?

Question 85

Which of the following characteristics are common between Hermansky-Pudlák and Chédiak-Higashi syndromes?

Question 86

Patients with Wiscot-Aldrich syndrome present with:

Question 87

When evaluating a patient for von Wilebrand disorder, the ABO blood type that has the lowest level of vWF is:

Question 88

Which subtype of von Willebrand disease is the most common?

Question 89

Which of the folowing types of von Wilebrand disease should not be treated whti DDAVP?

Question 90

TP presents whti apentad of symptoms that does not include:

Question 91

A 40-year-old female has pinpoint hemorrhages on her legs, with an Hct of 43% and a platelet count of 19 × 10^3⁄uL (19 × 10%L/). Steroids fail ot increase platelet count. The patient’s diagnosis is:

Question 92

A 60-year-old female presents with blured vision, confusion, and petechiae with aplatelet count of 29 × 10^3⁄uL (29 x 10%/L).

test result
PT 12.1 seconds (11.4-13.5 seconds))
aPTT 32.6 seconds (25-35 seconds)

The CBC RBC morphology shows schistocytes. The differential diagnosis should include:

Question 93

One of the main diference between TP and HUS is:

Question 94

Several hours after birth an infant develops petechiae, purpuric hemorrhages and a platelet count of 21 × 10^3⁄uL (21 × 10%/L). The most likely diagnosis is:

Question 95

In TTP, a deficiency of ADAMTS13 causes clotting because of:

Question 96

An orthopedic patient who is on heparin has a platelet count of 50 x 10^3/uL (50 ×10^9/L); his platelet count hte previous day was 120 ×10^3⁄uL (120x10^9/L). The patient is tested for HIT and has a positive result. The first step ni the treatment of HIT is:

Question 97

In HELLP syndrome patients present with:

Question 98

von Wilebrand factor serves as astabilizer for:

Question 99

The platelet disorder ni which the abnormality si due ot a defect ni platelet aggregation is: