COAGULATION / ROTEM / TEG Flashcards

1
Q
Which disorder is associated with a deficiency in the binding of GPIb and wWF?
A. Glanzman thromboastemia
B. Bernard Soulier disease
C. HIT
D. vWD
A

B. Bernard Soulier disease

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2
Q
Which disorder is associated with a deficiency in the binding of GPIIb/IIIa and fibrinogen?
A. Glanzman thromboastemia
B. Bernard Soulier disease
C. HIT
D. vWD
A

A. Glanzman thromboastemia

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3
Q
Which of the ff will generally show an increase in PTT results?
A. Presence of lupus anticoagulant
B. Vit K deficiency
C. DIC
D. multi deficiency due to liver damage
E. Hemophilia A or B
A

A. Presence of lupus anticoagulant
E. Hemophilia A or B

PTT = will asses the intrisic pathway, usually FVIII associated

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4
Q
Which of the ff will generally show an increase in PT results? NEED TO UPDATE THIS SLIDE
A. Presence of lupus anticoagulant
B. Vit K deficiency
C. DIC
D. multi deficiency due to liver damage
E. Hemophilia A or B
A

B. Vit K deficiency

II(prothrombin), VII, IX, X, proteins C and S (antifibrinolytic)

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5
Q
Which of the ff will generally show an increase in both PT and PTT results?
A. Presence of lupus anticoagulant
B. Vit K deficiency
C. DIC
D. multi deficiency due to liver damage
E. Hemophilia A or B
A

C. DIC

D. multi deficiency due to liver damage

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6
Q
In coagulation studies, which of the ff is used to monitor the activity of direct thrombin inhibitors?
A. Thrombin time
B. PTT
C. Anti-Xa
D. D-Dimers
A

B. PTT

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7
Q
Which of the ff does not result in an elevated thrombin time?
A. DIC
B. Low or dysfunctional fibrinogen 
C. Plasminogen inhibitors
D. Heparin
A

C. Plasminogen inhibitors

Plasminogen is the inactive form of plasmin (these lyse clots)

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8
Q
Which of the ff assays is appropriate to use to measure the time for fibrin clot formation in the presence of heparin?
A. Reptilase time
B. Thrombin time
C. Mixing studies
D. Rotem Intem parameter values
A

A. Reptilase time

Insensitive to heparin

Choices B - D are sensitive to heparin

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9
Q
Which of the ff is the most appropriate treatment for a patient with Haemophilia A?
A. Novo 7
B. Recombinant factor
C. FFP
D. Cryo
A

B. Recombinant factor

Choice A- used only in the presence of high titer inhibitor
Choices C and D - these are no longer used

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10
Q

The ff coagulation results suggests which coagulopathy?

  • platelet count, PFA100, RIPA, PT, vWF:Ag = normal
  • APTT = increased
  • Factor VIII = decreased

A. vWD
B. Haemophilia
C. Lupus
D. Bernard Soulier Disease

A

B. Haemophilia

Factor VIII deficiency

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11
Q

The ff coagulation results suggests which coagulopathy?

  • platelet count, PT, APTT = normal
  • PFA100 , RIPA = abnormal
  • vWF:Ag = decreased

A. vWD
B. Haemophilia
C. Lupus
D. Bernard Soulier Disease

A

A. vWD

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12
Q
Which of the ff is NOT affected in the presence of warfarin (levels are normal)?
A. FVII
B. Protein C
C. Prothrombin
D. FIX
A

D. FIX

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13
Q

A mixing study is performed to asses a patient’s coagulation activity. The ff results were obtained at 0 mins and 90 mins:
Correction at 0 mins and 90 mins. What do these results suggest?
A. Suggests a factor deficiency
B. Suggests the presence of heparin or Lupus ag
C. Suggests time / temperature dependent inhibitor
D. No deficiency / normal results

A

A. Suggests a factor deficiency

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14
Q

A mixing study is performed to asses a patient’s coagulation activity. The ff results were obtained at 0 mins and 90 mins:
Correction at 0 mins but NOT at 90 mins. What do these results suggest?
A. Suggests a factor deficiency
B. Suggests the presence of heparin or Lupus ag
C. Suggests time / temperature dependent inhibitor
D. No deficiency / normal results

A

C. Suggests time / temperature dependent inhibitor

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15
Q

A mixing study is performed to asses a patient’s coagulation activity. The ff results were obtained at 0 mins and 90 mins:
No correction at 0 mins or at 90 mins. What do these results suggest?
A. Suggests a factor deficiency
B. Suggests the presence of heparin or Lupus ag
C. Suggests time / temperature dependent inhibitor
D. No deficiency / normal results

A

B. Suggests the presence of heparin or Lupus ag

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16
Q
A ROTEM test parameter shows an A10 on extem = 20mm and an A10 on fibtem = 20mm. Which blood components would you expect the provider to order to correct the coaguopathy?
A. Plasma
B. Platelets
C. Cryo
D. TXA
A

B. Platelets

If A10(extem) <45mm (below range), and A10(fibtem) > 10 mm (normal) = give platelets
If A10(extem) <45mm (below range), and A10(fibtem)  <10 mm (below range) = give cryo
17
Q
A ROTEM test parameter shows an A10 on extem = 20mm and an A10 on fibtem = 5mm. Which blood components would you expect the provider to order to correct the coaguopathy?
A. Plasma
B. Platelets
C. Cryo
D. TXA
A

C. Cryo

If A10(extem) <45mm (below range), and A10(fibtem) > 10 mm (normal) = give platelets
If A10(extem) <45mm (below range), and A10(fibtem)  <10 mm (below range) = give cryo
18
Q
A ROTEM test parameter shows an LY30 (TEG) / LI30 (ROTEM) that is too high. Which blood components would you expect the provider to order to correct the coaguopathy?
A. Plasma
B. Platelets
C. Cryo
D. TXA
A

D. TXA

If the parameters are corrected when run in APTEM, this suggests hyperfibrinolysis

19
Q
A test parameter shows a prolonged CT (ROTEM) / R value (TEG). Which blood components would you expect the provider to order to correct the coaguopathy?
A. Plasma
B. Platelets
C. Cryo
D. TXA
A

A. Plasma

Or PCC if avoiding volume overload

CT / R show how fast a clot begins to form

20
Q
Which ROTEM (or TEG) parameter assesses clot strength or deficiency?
A. CT / R
B. CFT / K
C. MCF / MA
D. A10 / A
A

C. MCF / MA

This is the highest amplitude of the graph

21
Q
Which ROTEM (or TEG) parameter assesses fibrinogen activity or detects hyperfibrinolysis?
A. MCF / MA
B. A10 / A
C. Alpha angle
D. LI30 / LY30 or LY60
A

D. LI30 / LY30 or LY60

Graph will show a spindle or fishtail