Coagulation Instrumentation Flashcards

1
Q

Clot formation was determined by visual inspection of the plasma as the tube was tilted, and a stopwatch was used to determine the time to clot formation. This was referred to as the

A

Tilt-tube technique

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2
Q

The 1950s witnessed the dawn of the modern era of instru- mentation in coagulation testing with the development of the first coagulometer

A

BBL Fibrometer.

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3
Q

Subsequent 20th century developments in clot detectors in- cluded a

A

rolling steel ball and photo-optical measurements

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4
Q

Coagulation instruments apply clot detection principles that either

A

observe” the clot formation (optical and nephelometric devices)
detect the clot by “feel” (mechanical and viscosity- based devices).

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5
Q

detect a change in plasma optical density (OD; light transmittance) during the clotting process.

A

Photo-optical (turbidometric) coagulometers

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6
Q

Principle of photo optical

A

LIGHT TRANSMITTANCE

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7
Q

used to detect clot formation in the past is still used today in particular instruments for whole blood clotting.

A

viscoelastic technique

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8
Q

vital for assesing hemostasis

A

viscoelastic technique

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9
Q

Chromogenic (synthetic substrate, amidolytic) methodology uses a synthetic small peptide substrate conjugated to a chromo- phore, usually

A

para-nitroaniline (pNA).

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10
Q

means for measuring the activity of a specific coagulation fac- tor because it exploits the factor’s enzymatic (protease) proper- ties.

A

Chromogenic analysis

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11
Q

The activity of coagulation enzymes is measured by

A

direct or indirect chromogenic methods

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12
Q

a modification of photo-optical end-point detection in which 90-degree or forward-angle light scatter, rather than OD, is measured.

A

Nephelometry

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13
Q

and a photodetector detects variations in

A

light scatter at 90 degrees (side scatter)
180 degrees (forward-angle scatter)

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14
Q

be adapted to measure the dynamics or kinetics of clot formation.

A

Nephelometry

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15
Q

are the newest assays available for routine coagulation testing.

A

Immunologic assays

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16
Q

ASSAY END-POINT DETECTION PRINCIPLES

A

Mechanical Clot End-Point Detection
Photo-Optical Clot End-Point Detection
Viscoelastic Clot Detection
Nephelometric End-Point Detection
Immunologic Light Absorbance End-Point Detection
Chromogenic End-Point Detection

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17
Q

Tradi- tionally, PT assays required. (Reagent and specimen volume)

A

100 ul of patient plasma and 200 uL of thromboplastin/calcium chloride reagent

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18
Q

flexibility of selecting reagents that best suit their needs, and prefer not to be restricted in their choicesby the analyzer being used.

A

Open Reagent Systems

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19
Q

has improved the safety and efficiency of coagulation testing.

A

Closed-tube sampling of specimens

20
Q

premature activation of coagulation factors and platelets
that generate FVIIa and thrombin.

A

Clotted

21
Q

OD-sensing instruments because of interference with light
transmittance.

A

Lipemia
Hemolysis

22
Q

Causes falsely shortened

A

Clotted
Hemolysis

23
Q

Falsely prolonged

A

Icterus
Lipemia

24
Q

Falsely elevated

A

Abnormal clot formation

25
Q

A second common POC test is the

A

prothrombin time/ international normalized ratio (PT/INR) f

26
Q

technique uses the viscoelastic property of blood clotting

A

Thromboelastography

27
Q

The assay pro- vides information on the entire kinetic process of whole blood clot formation.

A

Thromboelastography

28
Q

Clot initiation or clotting time

A

TEG- R
ROTEM- CT
Comment- Time of initial fibrin formation

29
Q

Clot kinetics

A

TEG- K
ROTEM- CFT (clot formation time)
COMMENT- measure of the speed to reach a specific level of clot strength

30
Q

📐

A

TEG- a
ROTEM- a
COMMENT- Measure of the rate of clot formation, reflects the rate of fibrin formation and cross linking

31
Q

Clot strength

A

TEG- MA (maximum amplitutde)
ROTEM- MCF (maximum clot firmness
COMMENT- Measure of the strength of the clot

32
Q

Clot stability

A

TEG- Ly30 (lysis at 30 minutes as a ratio of MA)
ROTEM- CLI (clot lysis index)
COMMENT- Measure of the rate of amplitude reduction

33
Q

Platelet Aggregometers principle

A

Light transmittance

34
Q

This test system measures the increase in light transmission that occurs in direct propor- tion to platelet aggregation

A

Platelet Aggregometers

35
Q

mea- suring the platelet secretion response using the luciferase reagent

A

Chrono-Log has a Whole Blood/Optical Lumi-Aggregation

36
Q

Chronolog principle

A

Electrical impedance

37
Q

used to detect aggregation, and optical density to detect luminescence identifies platelet secretion.

A

Electrical impedance

38
Q

monitors platelet function by impedance, is the latest development.2

A

Multiplate Analyzer from Diapharma, also called the Whole-Blood Multiple Electrode Platelet Aggregometer (MEA)

39
Q

modular system for platelet aggregation and ristocetin cofactor testing.

A

AggRAM from Helena

40
Q

Test cartridges contain membranes coated with

A

collagen/epinephrine or collagen/ADP

41
Q

The Siemens PFA-100 Platelet Function Analyzer is an auto- mated instrument that provides rapid results on quantitative and qualitative platelet abnormalities. Test cartridges contain membranes coated with collagen/epinephrine or collagen/ADP to stimulate platelet aggregation.

A
42
Q

successful at detecting von Willebrand disease and the efficacy of aspirin therapy.

A

PFA-100 system

43
Q

measures platelet aggregation by microbead agglutination.

A

Verify Now from Accriva Diagnostics

44
Q

Test agent in verify now

A

aspirin assay using arachidonic acid

45
Q

can measure multiple cellular activation-dependent changes related to platelet surface receptor upregulation and activation, generation of platelet microparticles, and binding of platelets to leukocytes, in addition to the traditional platelet secretion and aggregation markers

A

Flow cytometry

46
Q

Molecular testing is now readily available for gene mutations of

A

factor V (FV Leiden)
prothrombin (prothrombin G20210A)

47
Q

accurate for the detection of both point mutations and single-nucleotide polymorphisms.

A

PCR