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Path questions imperialendo.co.uk > Coagulation > Flashcards

Coagulation Flashcards

1
Q

Choose the most appropriate answer from the list.

  • Abciximab
  • Stop Warfarin for 1-2 days
  • Alteplase
  • Stop Warfarin, give FFP
  • Aspirin
  • Tranexamic acid
  • Clopidogrel
  • Unfractionated Heparin
  • Dabigatran
  • Warfarin
  • Fondaparinux
  • LMW Heparin
  • Stop Warfarin, give 1-5mg Vit K

A 64yo lady is accidentally given an overdose of this drug. It is reversed with protamine sulphate.

A

Unfractionated Heparin

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2
Q

Choose the most appropriate answer from the list.

  • Abciximab
  • Stop Warfarin for 1-2 days
  • Alteplase
  • Stop Warfarin, give FFP
  • Aspirin
  • Tranexamic acid
  • Clopidogrel
  • Unfractionated Heparin
  • Dabigatran
  • Warfarin
  • Fondaparinux
  • LMW Heparin
  • Stop Warfarin, give 1-5mg Vit K

A 54yo man at risk of thromboembolic and atherothrombotic events is prescribed this ADP-receptor antagonist along with Aspirin

A

Clopidogrel

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3
Q

Choose the most appropriate answer from the list.

  • Abciximab
  • Stop Warfarin for 1-2 days
  • Alteplase
  • Stop Warfarin, give FFP
  • Aspirin
  • Tranexamic acid
  • Clopidogrel
  • Unfractionated Heparin
  • Dabigatran
  • Warfarin
  • Fondaparinux
  • LMW Heparin
  • Stop Warfarin, give 1-5mg Vit K

A 74yo man on Warfarin has an INR of 9

A

Stop Warfarin, give 1-5mg Vit K

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4
Q

Choose the most appropriate answer from the list.

  • Abciximab
  • Stop Warfarin for 1-2 days
  • Alteplase
  • Stop Warfarin, give FFP
  • Aspirin
  • Tranexamic acid
  • Clopidogrel
  • Unfractionated Heparin
  • Dabigatran
  • Warfarin
  • Fondaparinux
  • LMW Heparin
  • Stop Warfarin, give 1-5mg Vit K

A 34yo women with menorrhagia is managed with this anti-fibrinolytic agent

A

Tranexamic acid

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5
Q

Choose the most appropriate answer from the list.

  • Abciximab
  • Stop Warfarin for 1-2 days
  • Alteplase
  • Stop Warfarin, give FFP
  • Aspirin
  • Tranexamic acid
  • Clopidogrel
  • Unfractionated Heparin
  • Dabigatran
  • Warfarin
  • Fondaparinux
  • LMW Heparin
  • Stop Warfarin, give 1-5mg Vit K

This GPIIb/IIIa inhibitor can be used in the prevention of ischaemic complications in high risk patients undergoing percutaneous transluminal coronary intervention

A

Abciximab

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6
Q

Choose the most appropriate answer from the list.

  • Activated Partial Thromboplastin Time
  • Fasting Plasma Homocysteine Levels
  • Activated Protein C Resistance tests
  • Heparin Antibodies
  • Fibrinogen Levels
  • Urine Human Chorionic Gonadotrophin
  • Anticardiolipin antibodies
  • Flow Cytometry
  • Plain film X-ray
  • Ultrasound
  • Full Blood Count
  • D-dimer
  • Prothrombin Time

A 32 year old woman has a GP check up. She gave birth to a premature child 10 weeks ago after suffering 3 miscarriages. On close examination she appears to have a purple mottled lace-like rash. What is the most appropriate diagnostic test?

A

Anticardiolipin antibodies

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7
Q

Choose the most appropriate answer from the list.

  • Activated Partial Thromboplastin Time
  • Fasting Plasma Homocysteine Levels
  • Activated Protein C Resistance tests
  • Heparin Antibodies
  • Fibrinogen Levels
  • Urine Human Chorionic Gonadotrophin
  • Anticardiolipin antibodies
  • Flow Cytometry
  • Plain film X-ray
  • Ultrasound
  • Full Blood Count
  • D-dimer
  • Prothrombin Time

A 28 year old woman presents to the emergency department with sudden onset chest pain and shortness of breath. History reveals recent recurrent vomiting, tiredness, frequently low moods and over 30 days since her last menstrual period. What is the most appropriate diagnostic test?

A

Urine Human Chorionic Gonadotrophin

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8
Q

Choose the most appropriate answer from the list.

  • Activated Partial Thromboplastin Time
  • Fasting Plasma Homocysteine Levels
  • Activated Protein C Resistance tests
  • Heparin Antibodies
  • Fibrinogen Levels
  • Urine Human Chorionic Gonadotrophin
  • Anticardiolipin antibodies
  • Flow Cytometry
  • Plain film X-ray
  • Ultrasound
  • Full Blood Count
  • D-dimer
  • Prothrombin Time

A 60 year old man presents with headaches, blurred vision and ringing in his ears. He has flushed cheeks and complains he has been itching after hot baths. What is the most appropriate diagnostic test?

A

Full Blood Count

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9
Q

Choose the most appropriate answer from the list.

  • Activated Partial Thromboplastin Time
  • Fasting Plasma Homocysteine Levels
  • Activated Protein C Resistance tests
  • Heparin Antibodies
  • Fibrinogen Levels
  • Urine Human Chorionic Gonadotrophin
  • Anticardiolipin antibodies
  • Flow Cytometry
  • Plain film X-ray
  • Ultrasound
  • Full Blood Count
  • D-dimer
  • Prothrombin Time

A tall and thin 22 year old man presents with right sided numbness and weakness on his body and difficulty formulating speech. His symptoms resolve whilst in hospital. On examination, he appears to have a downward dislocation of his lens and long limbs relative to his body. What is the most appropriate diagnostic test?

A

Fasting Plasma Homocysteine Levels

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10
Q

Choose the most appropriate answer from the list.

  • Activated Partial Thromboplastin Time
  • Fasting Plasma Homocysteine Levels
  • Activated Protein C Resistance tests
  • Heparin Antibodies
  • Fibrinogen Levels
  • Urine Human Chorionic Gonadotrophin
  • Anticardiolipin antibodies
  • Flow Cytometry
  • Plain film X-ray
  • Ultrasound
  • Full Blood Count
  • D-dimer
  • Prothrombin Time

A 55 year old Caucasian woman arrives in A&E with a red, painful, swollen leg. History reveals she recently travelled to London from Aberdeen via train. She says she has had a previous episode 7 years ago and her 2 of her siblings have also previously experienced similar symptoms. What is the most appropriate diagnostic test?

A

Activated Protein C Resistance tests (Factor V Leiden)

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11
Q

Choose the most appropriate answer from the list.

  • Warfarin
  • Von Willebrand Disease
  • Heparin (unfractionated)
  • INR
  • LMWH
  • Vitamin K
  • APTT
  • Protein S
  • PT
  • Protein C
  • Bleeding time
  • Antithrombin
  • Factor VIII
  • Factor IX

Haemophilia A deficient in…

A

Factor VIII

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12
Q

Choose the most appropriate answer from the list.

  • Warfarin
  • Von Willebrand Disease
  • Heparin (unfractionated)
  • INR
  • LMWH
  • Vitamin K
  • APTT
  • Protein S
  • PT
  • Protein C
  • Bleeding time
  • Antithrombin
  • Factor VIII
  • Factor IX

Can be teratogenic

A

Warfarin

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13
Q

Choose the most appropriate answer from the list.

  • Warfarin
  • Von Willebrand Disease
  • Heparin (unfractionated)
  • INR
  • LMWH
  • Vitamin K
  • APTT
  • Protein S
  • PT
  • Protein C
  • Bleeding time
  • Antithrombin
  • Factor VIII
  • Factor IX

Christmas Disease

A

Factor IX

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14
Q

Choose the most appropriate answer from the list.

  • Warfarin
  • Von Willebrand Disease
  • Heparin (unfractionated)
  • INR
  • LMWH
  • Vitamin K
  • APTT
  • Protein S
  • PT
  • Protein C
  • Bleeding time
  • Antithrombin
  • Factor VIII
  • Factor IX

Increases APTT and bleeding time

A

Von Willebrand Disease

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15
Q

Choose the most appropriate answer from the list.

  • Warfarin
  • Von Willebrand Disease
  • Heparin (unfractionated)
  • INR
  • LMWH
  • Vitamin K
  • APTT
  • Protein S
  • PT
  • Protein C
  • Bleeding time
  • Antithrombin
  • Factor VIII
  • Factor IX

Potentiated by heparin

A

Antithrombin

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16
Q

Choose the most appropriate answer from the list.

  • Capillary abnormality
  • Protein C deficiency
  • Chronic Lymphocytic Leukaemia
  • Prothrombin deficiency
  • Chronic Myeloid Leukaemia
  • Warfarin overdose
  • Disseminated Intravascular Coagulation
  • Vitamin K deficiency
  • Factor IX deficiency
  • Von Willebrand disease
  • Factor VIII deficiency
  • Platelet count 19,000 per microL
  • Platelet count 26,000 per microL

A 12 year old boy had a tooth removed at the dentist, it initially stopped bleeding but once back at home it began to continuously ooze blood.

A

Factor VIII deficiency

17
Q

Choose the most appropriate answer from the list.

  • Capillary abnormality
  • Protein C deficiency
  • Chronic Lymphocytic Leukaemia
  • Prothrombin deficiency
  • Chronic Myeloid Leukaemia
  • Warfarin overdose
  • Disseminated Intravascular Coagulation
  • Vitamin K deficiency
  • Factor IX deficiency
  • Von Willebrand disease
  • Factor VIII deficiency
  • Platelet count 19,000 per microL
  • Platelet count 26,000 per microL

A fit and well 88 year old lady has purple blotches on the palms of both hands. They are not painful.

A

Capillary abnormality

18
Q

Choose the most appropriate answer from the list.

  • Capillary abnormality
  • Protein C deficiency
  • Chronic Lymphocytic Leukaemia
  • Prothrombin deficiency
  • Chronic Myeloid Leukaemia
  • Warfarin overdose
  • Disseminated Intravascular Coagulation
  • Vitamin K deficiency
  • Factor IX deficiency
  • Von Willebrand disease
  • Factor VIII deficiency
  • Platelet count 19,000 per microL
  • Platelet count 26,000 per microL

A 23 year old woman presents to her GP with several bruises over her body. She has no idea where they came from. The GP finds she has been experiencing heavy periods

A

Von Willebrand disease

19
Q

Choose the most appropriate answer from the list.

  • Capillary abnormality
  • Protein C deficiency
  • Chronic Lymphocytic Leukaemia
  • Prothrombin deficiency
  • Chronic Myeloid Leukaemia
  • Warfarin overdose
  • Disseminated Intravascular Coagulation
  • Vitamin K deficiency
  • Factor IX deficiency
  • Von Willebrand disease
  • Factor VIII deficiency
  • Platelet count 19,000 per microL
  • Platelet count 26,000 per microL

A 12 year old boy is admitted to hospital with recent onset wide spread petechiae. Lab investigations reveal an abnormality that reveals the cause of the bleeding.

A

Platelet count 19,000 per microL

20
Q

Choose the most appropriate answer from the list.

  • Capillary abnormality
  • Protein C deficiency
  • Chronic Lymphocytic Leukaemia
  • Prothrombin deficiency
  • Chronic Myeloid Leukaemia
  • Warfarin overdose
  • Disseminated Intravascular Coagulation
  • Vitamin K deficiency
  • Factor IX deficiency
  • Von Willebrand disease
  • Factor VIII deficiency
  • Platelet count 19,000 per microL
  • Platelet count 26,000 per microL

After a very recent heart valve replacement, a 62 year old man is admitted with haematuria and a nose bleed. He is on warfarin and his INR is measured as 4.1

A

Prothrombin deficiency

21
Q

A 1 year old boy who presents with multiple bruises, mucosal bleeding and a swollen painful knee, that occurred spontaneously with no history of trauma. His Hb was 122g/, WCC 7x109/litre and MCV 75fl. aPTT is prolonged, bleeding time and PT are normal. Rank the following treatments given this information, putting the MOST APPROPRIATE treatment first, and the least appropriate treatment last.

A) Clotting Factor VIII concentrate

B) Clotting Factor IX concentrate

C) Desmopressin

D) Fresh frozen plasma and cryoprecipitate

E) IV immunoglobulin

A

Clotting Factor VIII concentrate

Fresh frozen plasma and cryoprecipitate

Desmopressin

Clotting Factor IX concentrate

IV immunoglobulin

22
Q

Choose the most appropriate answer from the list

  • Acute Lymphoblastic Leukaemia
  • Henoch-Schonlein Purpura
  • Beta-Thalassaemia
  • Hereditary Spherocytosis
  • Diamond-Blackfan Syndrome
  • Hodgkin’s Lymphoma
  • Dyskeratosis Congenita
  • Rhesus Haemolytic Disease
  • Fanconi Anaemia
  • Shwachman-Diamond Syndrome
  • G6PD Deficiency
  • Sickle Cell Anaemia
  • Haemophilia A
  • Thrombocytopenia-Absent Radius Syndrome
  • Haemophilia B
  • Von Willebrand Disease

A neonate develops jaundice within a few hours of birth. A blood smear reveals Howell-Jolly bodies. Osmotic fragility test is positive.

A

Hereditary Spherocytosis

23
Q

Choose the most appropriate answer from the list

  • Acute Lymphoblastic Leukaemia
  • Henoch-Schonlein Purpura
  • Beta-Thalassaemia
  • Hereditary Spherocytosis
  • Diamond-Blackfan Syndrome
  • Hodgkin’s Lymphoma
  • Dyskeratosis Congenita
  • Rhesus Haemolytic Disease
  • Fanconi Anaemia
  • Shwachman-Diamond Syndrome
  • G6PD Deficiency
  • Sickle Cell Anaemia
  • Haemophilia A
  • Thrombocytopenia-Absent Radius Syndrome
  • Haemophilia B
  • Von Willebrand Disease

A neonate is found to have a cleft palate and abnormal thumbs. Investigations reveal a macrocytic anaemia.

A

Diamond-Blackfan Syndrome

24
Q

Choose the most appropriate answer from the list

  • Acute Lymphoblastic Leukaemia
  • Henoch-Schonlein Purpura
  • Beta-Thalassaemia
  • Hereditary Spherocytosis
  • Diamond-Blackfan Syndrome
  • Hodgkin’s Lymphoma
  • Dyskeratosis Congenita
  • Rhesus Haemolytic Disease
  • Fanconi Anaemia
  • Shwachman-Diamond Syndrome
  • G6PD Deficiency
  • Sickle Cell Anaemia
  • Haemophilia A
  • Thrombocytopenia-Absent Radius Syndrome
  • Haemophilia B
  • Von Willebrand Disease

A four year old boy comes in with generalised fatigue, bruising and a history of frequent infections. On examination the boy has palpable neck swellings.

A

Acute Lymphoblastic Leukaemia

25
Q

Choose the most appropriate answer from the list

  • Acute Lymphoblastic Leukaemia
  • Henoch-Schonlein Purpura
  • Beta-Thalassaemia
  • Hereditary Spherocytosis
  • Diamond-Blackfan Syndrome
  • Hodgkin’s Lymphoma
  • Dyskeratosis Congenita
  • Rhesus Haemolytic Disease
  • Fanconi Anaemia
  • Shwachman-Diamond Syndrome
  • G6PD Deficiency
  • Sickle Cell Anaemia
  • Haemophilia A
  • Thrombocytopenia-Absent Radius Syndrome
  • Haemophilia B
  • Von Willebrand Disease

A 3 month old infant with absent radii bilaterally but normal thumbs, presents with bruising, petechiae and nosebleeds.

A

Thrombocytopenia-Absent Radius Syndrome

26
Q

Choose the most appropriate answer from the list

  • Acute Lymphoblastic Leukaemia
  • Henoch-Schonlein Purpura
  • Beta-Thalassaemia
  • Hereditary Spherocytosis
  • Diamond-Blackfan Syndrome
  • Hodgkin’s Lymphoma
  • Dyskeratosis Congenita
  • Rhesus Haemolytic Disease
  • Fanconi Anaemia
  • Shwachman-Diamond Syndrome
  • G6PD Deficiency
  • Sickle Cell Anaemia
  • Haemophilia A
  • Thrombocytopenia-Absent Radius Syndrome
  • Haemophilia B
  • Von Willebrand Disease

A 2 year old boy presents with bleeding gums. On further investigation Hb, WBC and platelets are normal. APTT is prolonged, bleeding time is prolonged and PT is normal.

A

Von Willebrand Disease

27
Q

Choose the most appropriate answer from the list

  • Antiphospholipid syndrome
  • Hypertrophic Obstructive Cardiomyopathy
  • Arrythmia
  • Paroxysmal nocturnal haematuria
  • Chronic Kidney Failure
  • Protein C deficiency
  • Diabetes Mellitus
  • Renal cancer
  • Factor V Leiden
  • Scott Syndrome
  • Haemophilia A
  • Uraemia
  • Haemophilia B
  • Wiskott-Aldrich Syndrome
  • Heparin-Induced thrombocytopenia
  • Von Willebrand Disease

A 23 year old student’s mother calls the ambulance as her daughter has suddenly developed difficulty breathing. She has 9/10 central chest pain that began at rest. There have been no previous episodes. She is on OTC vitamins and the oral contraceptive pill. Her mother says she had 2 similar episodes in her youth before she stopped taking the pill. Investigations reveal both mother and daughter have activated protein C resistance.

A

Factor V Leiden

28
Q

Choose the most appropriate answer from the list

  • Antiphospholipid syndrome
  • Hypertrophic Obstructive Cardiomyopathy
  • Arrythmia
  • Paroxysmal nocturnal haematuria
  • Chronic Kidney Failure
  • Protein C deficiency
  • Diabetes Mellitus
  • Renal cancer
  • Factor V Leiden
  • Scott Syndrome
  • Haemophilia A
  • Uraemia
  • Haemophilia B
  • Wiskott-Aldrich Syndrome
  • Heparin-Induced thrombocytopenia
  • Von Willebrand Disease

A 60 year old man with severe abdominal pain is brought into the emergency department. His GP says he has recently reported changes in his waterworks. His urine is darker, especially in the evening. He has been feeling tired recently and had seemed anxious that he had not been able to satisfy his wife in bed.

A

Paroxysmal nocturnal haematuria

29
Q

Choose the most appropriate answer from the list

  • Antiphospholipid syndrome
  • Hypertrophic Obstructive Cardiomyopathy
  • Arrythmia
  • Paroxysmal nocturnal haematuria
  • Chronic Kidney Failure
  • Protein C deficiency
  • Diabetes Mellitus
  • Renal cancer
  • Factor V Leiden
  • Scott Syndrome
  • Haemophilia A
  • Uraemia
  • Haemophilia B
  • Wiskott-Aldrich Syndrome
  • Heparin-Induced thrombocytopenia
  • Von Willebrand Disease

A 35 year old woman complains of a swollen leg. On examination, her left leg is red, warm and larger in diameter than the right. She has had similar episodes in the past and has also had 2 spontaneous miscarriages. An ELISA confirms the presence of anticardiolipin antibodies.

A

Antiphospholipid syndrome

30
Q

Choose the most appropriate answer from the list

  • Antiphospholipid syndrome
  • Hypertrophic Obstructive Cardiomyopathy
  • Arrythmia
  • Paroxysmal nocturnal haematuria
  • Chronic Kidney Failure
  • Protein C deficiency
  • Diabetes Mellitus
  • Renal cancer
  • Factor V Leiden
  • Scott Syndrome
  • Haemophilia A
  • Uraemia
  • Haemophilia B
  • Wiskott-Aldrich Syndrome
  • Heparin-Induced thrombocytopenia
  • Von Willebrand Disease

A man with a history of sudden death in his family collapses in a supermarket. He is unconscious on arrival at the local hospital but is treated with thrombolytic agents. When he regains consciousness a few hours later, the registrar suggests the patient that a pacemaker be placed.

A

Hypertrophic Obstructive Cardiomyopathy

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