Haematology Flashcards
1
Q
The most important cell in the initiation of normal haemostasis. A. Protein C B. Antithrombin III C. Thromboxane A2 D. Tissue plasminogen-activator (t-PA) E. Cycloxygenase F. a2 macroglobulin G. Fibrin H. Platelet I. Endothelial cell J. Erythrocyte K. Fibrinogen L. Plasmin M. Megakaryocyte
A
I. Endothelial cell
2
Q
The main component involved in stabilising the primary haemostatic plug. A. Protein C B. Antithrombin III C. Thromboxane A2 D. Tissue plasminogen-activator (t-PA) E. Cycloxygenase F. a2 macroglobulin G. Fibrin H. Platelet I. Endothelial cell J. Erythrocyte K. Fibrinogen L. Plasmin M. Megakaryocyte
A
G. Fibrin
3
Q
A serine protease which assists in the break down of blood clots by binding to the clot and localising agents which break it down. A. Protein C B. Antithrombin III C. Thromboxane A2 D. Tissue plasminogen-activator (t-PA) E. Cycloxygenase F. a2 macroglobulin G. Fibrin H. Platelet I. Endothelial cell J. Erythrocyte K. Fibrinogen L. Plasmin M. Megakaryocyte
A
D. Tissue plasminogen-activator (t-PA)
4
Q
A potent inhibitor of plasmin in the blood. A. Protein C B. Antithrombin III C. Thromboxane A2 D. Tissue plasminogen-activator (t-PA) E. Cycloxygenase F. a2 macroglobulin G. Fibrin H. Platelet I. Endothelial cell J. Erythrocyte K. Fibrinogen L. Plasmin M. Megakaryocyte
A
F. a2 macroglobulin
5
Q
A single chain glycoprotein, synthesised by the liver and endothelium, which has strongly anticoagulant action and is important in the mode of action of heparin. A. Protein C B. Antithrombin III C. Thromboxane A2 D. Tissue plasminogen-activator (t-PA) E. Cycloxygenase F. a2 macroglobulin G. Fibrin H. Platelet I. Endothelial cell J. Erythrocyte K. Fibrinogen L. Plasmin M. Megakaryocyte
A
B. Antithrombin III
6
Q
This product of the cyclic endoperoxides induces platelet aggregation A. Ehlers-Danlos syndrome B. Megakaryocyte C. Marfan syndrome D. Thromboxane A2 E. von Willebrand deficiency F. Factor VIII deficiency G. Vitamin K deficiency H. Haemophilia I. Sensitised platelet J. Autoimmune thrombocytopenic purpura K. Christmas disease L. Prostacyclin PGI2 M. Factor XII deficiency
A
D. Thromboxane A2
7
Q
A 6 foot 7 inch rower presents to his GP complaining of easy skin bruising. On further examination he is found to have pectus excavatum, lax joints and a high-arched palate. A. Ehlers-Danlos syndrome B. Megakaryocyte C. Marfan syndrome D. Thromboxane A2 E. von Willebrand deficiency F. Factor VIII deficiency G. Vitamin K deficiency H. Haemophilia I. Sensitised platelet J. Autoimmune thrombocytopenic purpura K. Christmas disease L. Prostacyclin PGI2 M. Factor XII deficiency
A
A. Ehlers-Danlos syndrome
8
Q
A 62 year old overweight woman presents to the Emergency Department following a Road Traffic Accident. A full set of investigations is carried out – which shows an increased Activated Partial Thromboplastin Time (APTT) and Prothrombin Time (PT) A. Ehlers-Danlos syndrome B. Megakaryocyte C. Marfan syndrome D. Thromboxane A2 E. von Willebrand deficiency F. Factor VIII deficiency G. Vitamin K deficiency H. Haemophilia I. Sensitised platelet J. Autoimmune thrombocytopenic purpura K. Christmas disease L. Prostacyclin PGI2 M. Factor XII deficiency
A
G. Vitamin K deficiency
9
Q
A 25 year old man presents to the Emergency Department a day after attending his dentist for a routine check-up. After treatment at the dentists the previous day, his gums had not stopped bleeding. On investigation, his APTT and bleeding time are prolonged but a normal PT. A. Ehlers-Danlos syndrome B. Megakaryocyte C. Marfan syndrome D. Thromboxane A2 E. von Willebrand deficiency F. Factor VIII deficiency G. Vitamin K deficiency H. Haemophilia I. Sensitised platelet J. Autoimmune thrombocytopenic purpura K. Christmas disease L. Prostacyclin PGI2 M. Factor XII deficiency
A
E. von Willebrand deficiency
10
Q
A 16 year old girl presents to the Haematology Outpatients clinic describing a fluctuating history of easy bruising, epistaxis and menorrhagia. On investigation there is a thrombocytopaenia with increased megakaryocytes on BM examination. A. Ehlers-Danlos syndrome B. Megakaryocyte C. Marfan syndrome D. Thromboxane A2 E. von Willebrand deficiency F. Factor VIII deficiency G. Vitamin K deficiency H. Haemophilia I. Sensitised platelet J. Autoimmune thrombocytopenic purpura K. Christmas disease L. Prostacyclin PGI2 M. Factor XII deficiency
A
J. Autoimmune thrombocytopenic purpura
11
Q
Which protein, important in haemostasis, is vitamin K dependent but is not a serine protease? A. Protein C B. Arichidonic acid C. Protein S D. Activated factor X E. Thrombin F. Factor VII G. Cyclooxygenase H. Tissue factor I. Vascular subendothelium J. Platelets K. Tissue factor pathway inhibitor L. Vascular endothelium
A
C. Protein S
12
Q
Which option is required as a cofactor for protein C activity? A. Protein C B. Arichidonic acid C. Protein S D. Activated factor X E. Thrombin F. Factor VII G. Cyclooxygenase H. Tissue factor I. Vascular subendothelium J. Platelets K. Tissue factor pathway inhibitor L. Vascular endothelium
A
C. Protein S
13
Q
Which option synthesises tissue factor, vWF, prostacyclin, plasminogen activator, antithrombin III and thrombomodulin? A. Protein C B. Arichidonic acid C. Protein S D. Activated factor X E. Thrombin F. Factor VII G. Cyclooxygenase H. Tissue factor I. Vascular subendothelium J. Platelets K. Tissue factor pathway inhibitor L. Vascular endothelium
A
L. Vascular endothelium
14
Q
Which enzyme, important for platelet aggregation, is irreversibly inhibited by aspirin? A. Protein C B. Arichidonic acid C. Protein S D. Activated factor X E. Thrombin F. Factor VII G. Cyclooxygenase H. Tissue factor I. Vascular subendothelium J. Platelets K. Tissue factor pathway inhibitor L. Vascular endothelium
A
G. Cyclooxygenase
15
Q
Which key clotting factor activates both factors V and VIII, and also activates protein C? A. Protein C B. Arichidonic acid C. Protein S D. Activated factor X E. Thrombin F. Factor VII G. Cyclooxygenase H. Tissue factor I. Vascular subendothelium J. Platelets K. Tissue factor pathway inhibitor L. Vascular endothelium
A
E. Thrombin
16
Q
A 37 year old mother of 4 children, presents to her GP because of recurrent nose bleeds and feeling tired all the time and heavy periods. A. Osler-Weber-Rendu Syndrome B. B-Thalassaemia C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. Haemophilia A G. Malignancy H. Bile acid malabsorption I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Warfarin overdose L. Sickle cell anaemia M. Antiphospholipid antibody syndrome N. Von Willebrand’s Disease
A
A. Osler-Weber-Rendu Syndrome
17
Q
A 3 year old boy is brought to see his GP by his mother. A fortnight ago he had been brought along because of cold-like symptoms, unsurprising since it was the middle of winter and he attends nursery. He was therefore sent home with some Calpol, and as expected his symptoms soon resolved. However this morning his mother noticed a rash on his bottom, and he said his tummy ached. A. Osler-Weber-Rendu Syndrome B. B-Thalassaemia C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. Haemophilia A G. Malignancy H. Bile acid malabsorption I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Warfarin overdose L. Sickle cell anaemia M. Antiphospholipid antibody syndrome N. Von Willebrand’s Disease
A
I. Henoch-Schonlein purpura
18
Q
22 year old Saharawi refugee presents with anaemia, weight loss, loose stools and blood tests reveal an increased PT and slightly increased APTT, with normal thrombin time and platelet count. A. Osler-Weber-Rendu Syndrome B. B-Thalassaemia C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. Haemophilia A G. Malignancy H. Bile acid malabsorption I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Warfarin overdose L. Sickle cell anaemia M. Antiphospholipid antibody syndrome N. Von Willebrand’s Disease
A
J. Vitamin K deficiency
19
Q
A 5 year old boy has the following blood results: normal PT, increased APTT, normal platelet count, decreased VIII:C and decreased vWF. A. Osler-Weber-Rendu Syndrome B. B-Thalassaemia C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. Haemophilia A G. Malignancy H. Bile acid malabsorption I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Warfarin overdose L. Sickle cell anaemia M. Antiphospholipid antibody syndrome N. Von Willebrand’s Disease
A
N. Von Willebrand’s disease
20
Q
A 32 week pregnant lady who has gestational diabetes and is epileptic has a caesarean section while on holiday in rural China. Her newborn baby is suffering from bleeding from the umbilical stump, as well as nose and gums. What is wrong with the baby? A. Osler-Weber-Rendu Syndrome B. B-Thalassaemia C. Disseminated intravascular coagulation D. Factor V Leiden E. Christmas Disease F. Haemophilia A G. Malignancy H. Bile acid malabsorption I. Henoch – Schönlein Purpura J. Vitamin K Deficiency K. Warfarin overdose L. Sickle cell anaemia M. Antiphospholipid antibody syndrome N. Von Willebrand’s Disease
A
J. Vitamin K deficiency
21
Q
A fit 48-year-old investment banker presents to A&E with a painful R arm that was present when he woke up that morning. He is otherwise well and there is no history of trauma or abnormalities of any system. On examination there is marked tenderness and mild erythema along the anterolateral aspect of the forearm and cubital fossa, with no abnormality of the upper arm or axilla. A. Superficial venous thrombosis B. Thrombophlebitis C. Axillary vein thrombosis D. Superior vena caval obstruction E. Varicose veins F. Deep vein thrombosis G. DIC H. Inferior vena caval obstruction I. Pulmonary embolism J. Postphlebitic syndrome
A
A. Superficial venous thrombosis
22
Q
A 45-year-old lady, known heavy smoker with chronic respiratory problems, presents to her GP with increasing dyspnoea and swelling of her R arm and face. On examination of her chest there is no asymmetry or tracheal deviation, but there are added sounds over the R upper lobe and on bending forward her face becomes congested. A. Superficial venous thrombosis B. Thrombophlebitis C. Axillary vein thrombosis D. Superior vena caval obstruction E. Varicose veins F. Deep vein thrombosis G. DIC H. Inferior vena caval obstruction I. Pulmonary embolism J. Postphlebitic syndrome
A
D. Superior vena caval obstruction
23
Q
A 56-year-old woman returns to the Vascular Clinic with recurrence of her L leg ulcer after the area has been knocked by a shopping trolley. On examination the ulcer is situated above the medial malleolus, its dimensions being 6cm x 5cm. The base is filled with yellowish slough and the surrounding area is erythematous, with prominent oedema. A. Superficial venous thrombosis B. Thrombophlebitis C. Axillary vein thrombosis D. Superior vena caval obstruction E. Varicose veins F. Deep vein thrombosis G. DIC H. Inferior vena caval obstruction I. Pulmonary embolism J. Postphlebitic syndrome
A
J. Postphlebitic syndrome
24
Q
A 48-year-old man develops R-sided pleuritic chest pain and coughs up a trace of bloodstained sputum 8 days after a R hemicolectomy. He has mild dyspnoea but chest examination and chest radiography are normal. A. Superficial venous thrombosis B. Thrombophlebitis C. Axillary vein thrombosis D. Superior vena caval obstruction E. Varicose veins F. Deep vein thrombosis G. DIC H. Inferior vena caval obstruction I. Pulmonary embolism J. Postphlebitic syndrome
A
I. Pulmonary embolism
25
Q
A 32-year-old lady develops acute swelling of her L leg 2 days post-partum. She had bilateral leg swelling during the pregnancy but the delivery was normal. On examination there is tense swelling of the leg and thigh and some deep tenderness over the calf and medial aspect of the thigh. A. Superficial venous thrombosis B. Thrombophlebitis C. Axillary vein thrombosis D. Superior vena caval obstruction E. Varicose veins F. Deep vein thrombosis G. DIC H. Inferior vena caval obstruction I. Pulmonary embolism J. Postphlebitic syndrome
A
F. Deep vein thrombosis
26
Q
A drug that is administered intravenously and has a rapid effect by potentiating the action of antithrombin. Action can be reversed quickly which is of relevance in myocardial infarction patients who may require early invasive treatment (ie PTCA). A. Prothrombin time (PT) B. Dalteparin (LMWH) C. Clopidogrel and aspirin D. Dipyridamole modified release (MR) and aspirin E. Calciparone F. APTT G. Clopidogrel H. Thrombin time (TT) I. Aspirin J. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days K. Unfractionated heparin (UFH) L. Streptokinase M. 10mg, 10mg, 5mg, measure on 4th day then every 2 days N. Warfarin O. LMWH and aspirin P. Pentapolysaccharide
A
K. Unfractionated heparin (UFH)
27
Q
Potentiates antithrombin III. Usually given subcutaneously. Can cause osteoporosis and hyperkalaemia. A. Prothrombin time (PT) B. Dalteparin (LMWH) C. Clopidogrel and aspirin D. Dipyridamole modified release (MR) and aspirin E. Calciparone F. APTT G. Clopidogrel H. Thrombin time (TT) I. Aspirin J. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days K. Unfractionated heparin (UFH) L. Streptokinase M. 10mg, 10mg, 5mg, measure on 4th day then every 2 days N. Warfarin O. LMWH and aspirin P. Pentapolysaccharide
A
B. Dalteparin (LMWH)
28
Q
Used to monitor patients undergoing warfarin therapy. A. Prothrombin time (PT) B. Dalteparin (LMWH) C. Clopidogrel and aspirin D. Dipyridamole modified release (MR) and aspirin E. Calciparone F. APTT G. Clopidogrel H. Thrombin time (TT) I. Aspirin J. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days K. Unfractionated heparin (UFH) L. Streptokinase M. 10mg, 10mg, 5mg, measure on 4th day then every 2 days N. Warfarin O. LMWH and aspirin P. Pentapolysaccharide
A
A. Prothrombin time (PT)
29
Q
Used to monitor patients undergoing unfractionated heparin therapy. A. Prothrombin time (PT) B. Dalteparin (LMWH) C. Clopidogrel and aspirin D. Dipyridamole modified release (MR) and aspirin E. Calciparone F. APTT G. Clopidogrel H. Thrombin time (TT) I. Aspirin J. 5mg, 5mg, 5mg, 5mg, measure on 5th day, 8th day and then every 4 days K. Unfractionated heparin (UFH) L. Streptokinase M. 10mg, 10mg, 5mg, measure on 4th day then every 2 days N. Warfarin O. LMWH and aspirin P. Pentapolysaccharide
A
F. APTT
