Chp. 35,37,38 REVIEW QUESTIONS Flashcards by JASMINE IRAH DIOQUINO

What intimal cell synthesizes and stores von willebrand factor (vwf)?
a. Smooth msucle cell
b. Endothelial cells
c. Fibroblast
d. Platelet

Endothelial cells

How well did you know this?

Not at all

Perfectly

What subendothelial structural protein triggers coagulation through activation of factor VII?
a. Thrombomodulin
b. Nitric oxide
c. Tissue factor
d. Thrombin

Tissue factor

How well did you know this?

Not at all

Perfectly

What coagulation plasma protein should be assayed when platelets fail to aggregate properly.
a. Factor VIII
b. Fibrinogen
c. Thrombin
d. Factor X

Fibrinogen

How well did you know this?

Not at all

Perfectly

What is the primary role of vitamin K for the prothrombin group factors?
a. Provides a surface on which the proteolytic reactions of the factors occurs
b. Protects them from inappropriate activation by compounds such as thrombin
c. Accelerates the binding of the serine proteases and their cofactors
d. Carboxylates the factor to allow calcium binding

Carboxylates the factor to allow calcium binding

How well did you know this?

Not at all

Perfectly

What is the source of prothrombin fragment F1.2?
a. Plasmin proteolysis of fibrin polymer
b. Thrombin proteolysis of fibrinogen
c. Proteolysis of prothrombin by factor Xa
d. Plasmin proteolysis of cross-linked fibrin

Thrombin proteolysis of fibrinogen

How well did you know this?

Not at all

Perfectly

What serine protease forms a complex with factor VIIIa and what is the substrate of this complex?
a. Factor VIIa, factor X
b. Factor Va, prothrombin
c. Factor Xa, prothrombin
d. Factor IXa, factor X

Factor IXa, factor X

How well did you know this?

Not at all

Perfectly

What protein secreted by endothelial cells activates fibrinolysis?
a. Plasminogen
b. TPA
c. PAI-1
d. TAFI

TPA

How well did you know this?

Not at all

Perfectly

What two regulatory proteins form a complex that digests activated factors V and VIII?
a. TFPI and Xa
b. Antithrombin and protein C
c. APC and protein S
d. Thrombomodulin and plasmin

APC and Protein S

How well did you know this?

Not at all

Perfectly

What are the primary roles of VWF?
a. Inhibit excess coagulation and activate protein C
b. Activate plasmin and promote lysis of fibrinogen
c. Mediate platelet adhesion and serve as a carrier molecule for factor VIII
d. Mediate platelet aggregation via the GP IIb/IIIa

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

How well did you know this?

Not at all

Perfectly

Most coagulation factors are synthesized by what organ?
a. Liver
b. Monocytes
c. Endothelial cells
d. Megakaryocytes

Liver

How well did you know this?

Not at all

Perfectly

The events involved in secondary hemostasis:
a. Lead to the formation of a stable fibrin clot
b. Usually occur independently of primary hemostasis
c. Occur in a random fashion
d. Are the first line of defense against blood loss

Lead to the formation of a stable fibrin clot

How well did you know this?

Not at all

Perfectly

Which of the following coagulation factors is activated by thrombin and mediates the stabilization of the fibrin clot?
a. Tissue factor
b. Factor VII
c. Factor IX
d. Factor XIII

Factor XIII

How well did you know this?

Not at all

Perfectly

Which of the following endogenous plasma inhibitors are important for the control of excessive thrombin generation?
a. AT, TFPI
b. Platelet factor 4
c. TAT, F1.2
d. A and B

AT, TFPI

How well did you know this?

Not at all

Perfectly

Normal hemostasis depends on all of the following except:
a. An intact vascular system
b. Inadequate numbers of platelets
c. Appropriate coagulation fcators
d. Fibrinolysis

Inadequate numbers of platelets

How well did you know this?

Not at all

Perfectly

The sequence of events following injury to a small blood vessel is _________ to ________ to ________ to __________ to __________

blood vessel spasm
formation of a platelet plug
contact between damaged blood vessel, blood platelets, and coagulation proteins
development of a blood clot around the injury
fibrinolysis and reestablishment of vascular integrity

How well did you know this?

Not at all

Perfectly

Which blood vessels have the thickest walls?
a. Veins
b. Arteries
c. Capilliaries
d. Arterioles

Arteries

How well did you know this?

Not at all

Perfectly

All blood and lymphatic vessels are lined with
a. Endothelium
b. Nerve endings
c. Stratified epithelial cells
d. Simple squamous epithelium

Endothelium

How well did you know this?

Not at all

Perfectly

Blood passes from the arterial to the venous system via:
a. Arterioles
b. Capilliaries
c. Veins
d. Arteries

Capilliaries

How well did you know this?

Not at all

Perfectly

The initiating stimulus to blood coagulation following injury to a blood vessel is:
a.contact activation with collagen
b. Vasoconstriction
c. Stenosis
d. Release of serotonin

Contact activation with collagen

How well did you know this?

Not at all

Perfectly

Endothelium is involved in the metabolism and clearance of molecules such as:
a. Serotonin
b. Angiotensin
Bradykinin
d. All of the above

All of the above

How well did you know this?

Not at all

Perfectly

Which of the following is not correct?
a. Vasoconstriction reduces blood flow and promotes contact activation of platelets and coagulation factors
b. Platelets adhere to exposed endothelial connective tissues
c. Aggregation of platelets releases thromboxane A2 and vasoactive amines (serotonin and epinephrine)
d. None of the above

None of the above

How well did you know this?

Not at all

Perfectly

Which of the following is (are) true of endoreduplication?
a. Duplicates DNA without cell division
b. Results in cells with ploidy values of 4n, 8n, 16n, and 32n
c. Is unique to the megakaryocytuc type of blood cell
d. All of the above

All of the above

How well did you know this?

Not at all

Perfectly

Which of the following is (are) true of thrombopoietin?
a. Thought stimulate the production and maturation of megakaryocytes
b. Is influenecd by various cytokines, which increase megakaryocyte size
c. Is influenced by various cytokines, which impart maturational stage and ploidy
d. All of the above

All of the above

How well did you know this?

Not at all

Perfectly

Which of the following is not a characteristic of platelets?
a. The presence of a nucleus
b. Life span of 9-12 dats
c. Cytoplasm is light blue with fine red purple granules
d. A discoid shape as an inactive cell

The presence of a nucleus

How well did you know this?

Not at all

Perfectly

The cellular ultrastructural component unique to the platelet is the a. Cytoplasmic membrane b. Glycocalyx c. Mitochondrion d. Microtubule

Glycocalyx

Choose the incorrect statement regarding storage granules related to hemostasis in the mature platelet. a. Alpha-granules containplatelet factor 4, beta-thromboglobulin, and platelet-derived growth factor b. Alpha-grabules contain platelet fibrinogen and VWF. c. Dense bodies contain serotonin and ADP d. Lysosomes contain actomyosin, myosin, and filamin

Lysosomes contain actomyosin, myosin, and filamin

At all time, approximately _________ of the total number pf platelets are in the systemic circulation. a. 1/4 b. 1/3 c. 1/2 d. 2/3

2/3

The reference range of platelets in the systemic circulation is a. 50 - 150 x 10^9/L b. 100 - 200 x 10^9/L c. 150 -350 x 10^9/L d. 150 - 400 x 10^9/L

150 - 400 x 10^9/L

The function of platelets in response to vascular damage include a. Maintenance of vascular integrity by sealing minor defects of the endothelium b. Formation of a platelet plug c. Promotion of fibrinolysis d. All of the above

Formation of a platelet plug

If vascular injury exposes the endothelial surface and underlying collagen, platelets __________ to the collagen fibers and ______

Adhere, Aggregate

The end production of ________ occurs with platelet aggregation. a. Thromboxane A2 b. Cyclooxygenase c. Prostacyclin d. Arachidonic acid

Cyclooxygenase

Agents that are capable of aggregating platelets include a. Collagen b. Thrombin c. Serotonin d. All of the above

All of the above

Examination of a Wright-stained peripheral blood smear provides anestimate of platelet numbers. Using 100x (oil) immersion in the areas of erythrocytes just touching each other, the upper limit of the number of platelets seen per field should not exceed a. 10 b. 15 c. 20 d. 25

If 10 platelets are seen per oil immersion field, what is the approximate platelet count? a. 50 x 10^9/L b. 100 x 10^9/L c. 150 x 10^9/L d. 200 x 10^9/L

200 x 10^9/L

Aspirin ingestion has the following hemostatic effect in a normal person: a. Prolongs the bleeding time b. Prolongs the clotting time c. Inhibits factor VIII D. Has no effect

Prolongs the bleeding time

The bleeding time test measures a. The ability of platelets to stick together b. Platelet adhesion and aggregation on locally injured vascular subendothelium c. The quantity and quality of platelets d. Antibodies against platelets

Platelet adhesion and aggregation on locally injured vascular subendothelium

The clot retraction test is: a. A visible reaction to the activation of platelet actomyosin b. A reflection of the quantity and quality of platelets and other factors c. A measurement of the ability of platelets to stick to glass d. A measurement of the cloudiness of blood

A reflection of the quantity and quality of platelets and other factors

What is the most common acquired bleeding disorder? A. Trauma-induced coagulopathy B. Vitamin K deficiency C. Liver disease D. VWD

Trauma-induced coagulopathy

Which is a typical form of anatomic bleeding? A Epistaxis B Menorrhagia C Hematemesis D Central Nervous system bleed

Central nervous system bleed

What factor become deficient early in liver disease, and what assay does its deficiency prolong? A Prothrombin deficiency, the PT B Factor VII deficiency, the PT C Factor VIII deficiency, the PTT D Factor IX deficiency, the PTT

Factor VII deficiency, the PT

In what subtype of VWD is the RIPA test result positive when ristocetin is used at a concentration of less than 0.5 mg.mL? A Subtype 2A B Subtype 2B C Subtype 2N D Type 3

Subtype 2B

Which of the following conditions causes a prolonged thrombin time? A Antithrombin Deficiency B Prothrombin deficiency C hypofibrinogenemia D Warfarin therapy

hypofibrinogenemia

What is the typical treatment for vitamin K deficiency when the patient is bleeding? A Vitamin K and 4 factor PCC B Vitamin K and plasma C Vitamin K and platelet concentrate D Vitamin K and factor VIII concentrate

Vitamin K and 4 factor PCC

If a patient has anatomic soft tissue bleeding and poor wound healing, but the PT, PTT, thrombin time, platelet count, and platelet functional assay results are normal, what factor deficiency is indicated? A Fibrinogen B Prothrombin C Factor XII D Factor XIII

Factor XIII

What therapy may be used for a hemophilic boy who is bleeding and who has a high titer of factor VIII inhibitor? A rFVIIa B Plasma C Cryoprecipitate D Factor VIII concentrate

rFVIIa

What is the most prevalent form of VWD? A Type 1 B Type 2A C Type 2B D Type 3

Type 1

Which of the following assays is used to distinguish vitamin K deficiency from liver disease? A PT B Protein C assay C Factor V assay D Factor VII assay

Factor V assay

Mucocutaneous hemorrhage is typical of: A Acquired hemorrhagic disorders B Localized hemorrhagic disorders C Defects in primary hemostasis D Defects in fibrnolysis

Defects in primary hemostasis

The clinical presentation of platelet-related bleeding may include all of the following except: a. Bruising b. Nosebleeds c. Gastrointestinal bleeding d. Bleeding into the joints (hemarthroses)

Bleeding into the joints (hemarthroses)

A defect in GP IIb/IIIa causes: a. Glanzmann thrombasthenia b. Bernard-Soulier syndrome c. Gray platelet syndrome d. Storage pool disease

Glanzmann thrombasthenia

Aspirin ingestion blocks the synthesis of: a. Thromboxane A2 b. Ionized calcium c. Collagen d. ADP

Thromboxane a2

Patients with Bernard-Soulier syndrome have which of the following laboratory test findings? a. Abnormal platelet response to arachidonic acid b. Abnormal platelet response to ristocetin c. Abnormal platelet response to collagen d. Thrombocytosis

Abnormal platelet response to ristocetin

Which of the following is the most common of the hereditary platelet function defects? a. Glanzmann thrombasthenia b. Bernard-Soulier syndrome c. Storage pool defects d. Multiple myeloma

Storage pool defects

A mechanism of antiplatelet drugs targeting GP IIb/IIIa function is: a. Interference with platelet adhesion to the subendothelium by blocking of the collagen binding site b. Inhibition of transcription of the GP IIb/IIIa gene c. Direct binding to GP IIb/IIIa d. Interference with platelet secretion

Direct bidnding to GP IIb/IIIa

The impaired platelet function in myeloproliferative neoplasms results from: a. Abnormally shaped platelets b. Extended platelet life span c. Increased procoagulant activity d. Decreased numbers of alpha- and dense granules

Decreased numbers of alpha and dense granules

Which is a congenital qualitative platelet disorder? a. Senile purpura b. Ehlers-Danlos syndrome c. Henoch-Schönlein purpura d. Waldenström macroglobulinemia

b. Ehlers-Danlos syndrome

In uremia, platelet function is impaired by higher than normal levels of: a. Urea b. Uric acid c. Creatinine d. NO

The platelet defect associated with increased paraproteins is: a. Impaired membrane activation owing to protein coating b. Hypercoagulability owing to antibody binding and membrane activation c. Impaired aggregation because the hyperviscous plasma prevents platelet-endothelium interaction d. Hypercoagulability because the increased proteins bring platelets closer together, which leads to inappropriate aggregation

Impaired membrane activation owing to protein coating

A reduction in thrombin generation in patients with Scott syndrome results from? A. Defectie granule secretion B. Altered platelet aggregation C. Altered expression of phospholipids on the platelet membrane D. Deficiency of vitamin K dependent clotting factors

Altered expression of phospholipids on the platelet membrane

Thrombocytopenia associated with the use of cardiopulmonary bypass is not caused by? A. Anti-GP IIb/IIIa antibodies B. Hemodilution C. Platelet binding to bypass circuitry D. Platelet consumption associated with normal postsurgical hemostatic activity

Anti-GP IIb/IIIa

The autosomal dominant disorder associated with decreased platelet production is: a. Fanconi anemia b. TAR syndrome c. May-Hegglin anomaly d. Wiskott-Aldrich anomaly

May-Hegglin anomaly

Which of the following is not a hallmark of ITP? a. Petechiae b. Thrombocytopenia c. Large overactive platelets d. Megakaryocyte hypoplasia

Large overactive platelets

The specific antigen most commonly responsible for the development of NAIT is: a. Bak b. HPA-1a c. GP Ib d. Lewis antigen a

HPA-1a

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: a. HIT b. NAIT c. Acute ITP d. Chronic ITP

Acute ITP

Which drug causes a reduction in platelet count by inhibiting megakaryocyte maturation? A. Gold salts B. Abciximab C. Anagrelide D. Quinidine

Anagrelide

A defect in primary hemostasis (platelet response to an injury) often results in: a. Musculoskeletal bleeding b. Mucosal bleeding c. Hemarthroses d. None of the above

Mucosal bleeding

When a drug acts as a hapten to induce thrombocytopenia, an antibody forms against which of the following? a. Typically unexposed, new platelet antigens b. The combination of the drug and the platelet membrane protein to which it is bound c. The drug alone in the plasma, but the immune complex then binds to the platelet membrane d. The drug alone, but only when it is bound to the platelet membrane

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

TAR refers to: a. Abnormal platelet morphology in which the radial striations of the platelets are missing b. Abnormal appearance of the iris of the eye in which radial striations are absent c. Abnormal bone formation, including hypoplasia of the forearms d. Neurologic defects affecting the root (radix) of the spinal nerves

Abnormal bone formation, including hypoplasia of the forearms

Neonatal autoimmune thrombocytopenia occurs when: a. The mother lacks a platelet antigen that the infant possesses, and she builds antibodies to that antigen, which cross the placenta b. The infant develops an autoimmune process such as ITP secondary to in utero infection c. The infant develops an autoimmune disease such as lupus erythematosus before birth d. The mother has an autoimmune antibody to her own platelets, which crosses the placenta and reacts with the infant's platelets

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

HUS in children is associated with: a. Diarrhea caused by Shigella species b. Meningitis caused by Haemophilus species c. Pneumonia caused by Mycoplasma species d. Pneumonia caused by respiratory viruses

Diarrhea caused by Shigella species

Treatment with an anticomplement agent such as eculuzumab is first line therapy for: A. Hereditary TTP B. Hemolytic uremic syndrome (HUS) C. ITP D. Atypical HUS

Atypical HUS

Which of the following statements regarding thrombocytosis is not true? A. Thrombocytosis can be associated with hemorrhage and thrombosis B. Affected patients have platelet counts in excess of 450,000/mL C. Thrombocytosis is self correcting D. Thrombocytosis can be congenital or acquired

Thrombocytosis is self correcting