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Coagulation > Clinical Study Guide > Flashcards

Clinical Study Guide Flashcards

1
Q

What are the normal values for the Duke bleeding time?

A

1-3 minutes

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2
Q

What are the normal values for the Ivy bleeding time?

A

1-6 minutes

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3
Q

What are the normal values for the simplate bleeding time?

A

2.3-9.5 minutes

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4
Q

What effect does aspirin have on bleeding time, and why?

A

prolongs bleeding time due to its effect on platelet coagulation

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5
Q

How would you interpret agglutination in the 1:5 sample but not the 1:20 sample in the FSP test?

A

> 10 mcg/mL but

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6
Q

How would you interpret agglutination in both the 1:5 sample and the 1:20 sample in the FSP test?

A

> 40 mcg/mL

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7
Q

How would you interpret no agglutination in either the 1:5 or 1:20 samples?

A
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8
Q

Fibrinolysis depends on the conversion of plasminogen to what?

A

plasmin (active form)

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9
Q

Which test for fibronolysis is faster: clot lysis or euglobulin lysis?

A

euglobulin lysis - only takes 2 hours, while clot lysis takes 72 hours

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10
Q

Why is primary fibrinolysis difficult to distinguish from the secondary form (DIC)?

A

Factors I, V, and VIII are decreased in both conditions, giving increased PT, PTT, and TT, along with low Factor V and VIII assays and fibrinogen levels

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11
Q

What can differentiate primary and secondary fibronlysis?

A

platelet count; in primary, the platelet count is somewhat decreased but still in the normal range; in secondary (DIC), the platelet count is greatly decreased (outside normal range)

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12
Q

What does the peripheral blood smear show in DIC?

A

schistocytes due to the effect of clots on the red cells

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13
Q

What are the normal values for the Ivy bleeding time?

A

1-6 minutes

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14
Q

What are the normal values for the simplate bleeding time?

A

2.3-9.5 minutes

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15
Q

What effect does aspirin have on bleeding time, and why?

A

prolongs bleeding time due to its effect on platelet coagulation

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16
Q

How would you interpret agglutination in the 1:5 sample but not the 1:20 sample in the FSP test?

A

> 10 mcg/mL but

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17
Q

How would you interpret agglutination in both the 1:5 sample and the 1:20 sample in the FSP test?

A

> 40 mcg/mL

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18
Q

How would you interpret no agglutination in either the 1:5 or 1:20 samples?

A
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19
Q

Fibrinolysis depends on the conversion of plasminogen to what?

A

plasmin (active form)

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20
Q

Which test for fibronolysis is faster: clot lysis or euglobulin lysis?

A

euglobulin lysis - only takes 2 hours, while clot lysis takes 72 hours

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21
Q

Why is primary fibrinolysis difficult to distinguish from the secondary form (DIC)?

A

Factors I, V, and VIII are decreased in both conditions, giving increased PT, PTT, and TT, along with low Factor V and VIII assays and fibrinogen levels

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22
Q

What can differentiate primary and secondary fibronlysis?

A

platelet count; in primary, the platelet count is somewhat decreased but still in the normal range; in secondary (DIC), the platelet count is greatly decreased (outside normal range)

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23
Q

What does the peripheral blood smear show in DIC?

A

schistocytes due to the effect of clots on the red cells

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24
Q

What is Stage I of coagulation?

A

formation of plasma thromboplastin

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25
Q

What is Stage II of coagulation?

A

conversion of prothrombin to thrombin

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26
Q

What is Stage III of coagulation?

A

conversion of fibrinogen to fibrin

27
Q

What is Stage IV of coagulation?

A

fibrinolysis

28
Q

What is the role of plasma thromboplastin in Stage II?

A

acts like an enzyme to convert prothrombin to thrombin

29
Q

What is the role of thrombin in Stage III?

A

acts like an enzyme to convert fibrinogen to fibrin

30
Q

What are the two best tests to perform as a means of screening for coagulation disorders, and why?

A

PT and PTT; they test for all of the factors in the intrinsic and extrinsic system (except for Ca, platelets, and tissue factor III), and they can both be performed on the same sample

31
Q

What is the test best suited to check platelet function?

A

bleeding time

32
Q

Why is the clotting time test inconvenient as a means of screening?

A

sample must be drawn with a syringe, and the test must be performed immediately

33
Q

What are the platelet count and function in thrombasthenia?

A

normal count, abnormal function

34
Q

What are the platelet count and function in thrombocytopenia?

A

decreased number, normal function

35
Q

What are the platelet count and function in thrombocythemia?

A

increased number, abnormal function

36
Q

What is telangiectasia?

A

hereditary vascular abnormality that causes dilation of the capillaries, causing them to appear as red clusters or have a “spidery” appearance, either on the skin or on the surface of organs

37
Q

What are the platelet count and function in thrombocytosis?

A

increased number, normal function

38
Q

What are the liver factors?

A

I, II, V, VII, IX, X, XI, XII, XIII

39
Q

Which factors can give an increased PT?

A

VII, X, V, II, I

40
Q

What are the adsorbed plasma factors?

A

I, V, VIII, XI, XII

41
Q

What are the aged serum factors?

A

II, VII, IX, X, XI, XII

42
Q

What is the treatment for factor deficiencies involving the labile factors (V, VIII)?

A

fresh blood or FFP transfusion

43
Q

What test differentiates Hemophilia A from von Willebrand’s disease?

A

bleeding time

44
Q

How does the bleeding time differentiate Hemophilia A from von WIllebrand’s disease?

A

both involve a Factor VIII deficiency, but von Willebrand’s will have a platelet abnormality where Hemophilia A will not

45
Q

Which factor is required for the intrinsic system of coagulation, and what is it a source of?

A

platelet factor 3; source of phospholipid

46
Q

What abnormal platelet count is usually associated with bleeding, and in what form does this bleeding occur?

A
47
Q

What is the ratio of blood to anticoagulant when using sodium citrate?

A

9:1

48
Q

How is the level of sodium citrate adjusted for specimens with a low hematocrit?

A

small amount is removed

49
Q

When is the level of sodium citrate increased for a specimen?

A

when hematocrit levels are very high (55% or more)

50
Q

What are the liver factors?

A

I, II, V, VII, IX, XIII

51
Q

What are the vitamin K dependent factors?

A

II, VII, IX, X

52
Q

What are the adsorbed plasma factors?

A

V, VIII, XI, XII

53
Q

What are the aged serum factors?

A

VII, IX, X, XI, XII

54
Q

Which pathway and anticoagulant is the PTT used to monitor?

A

intrinsic pathway, heparin

55
Q

Which pathway and anticoagulant is the PT used to monitor?

A

extrinsic pathway, coumadin

56
Q

What other two tests, besides the PT, can be used to monitor heparin therapy?

A

Lee-White clotting time, and thrombin time

57
Q

What is the only test for Factor XIII?

A

5M urea solubility test

58
Q

What factor initiates the extrinsic system?

A

tissue factor III

59
Q

What three things can initiate the intrinsic system?

A

exposed collagen, activation of the contact factor (XII), or platelet factor 3

60
Q

What is the action of coumadin and what is its antidote?

A

interferes with the synthesis of vitamin K dependent factors; antidote is vitamin K

61
Q

What is the action of heparin and what is its antidote?

A

works with antithrombin III to neutralize thrombin; antidote is protamine sulfate

62
Q

Which factors have an enzymatically active form?

A

XII, XI, IX

63
Q

What tests are required to check for overall competence of the coagulation system?

A

PT, PTT, bleeding time, clot solubility, and fibrinogen level

Coagulation (2 decks)

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