HEMA 2 SEMIS Flashcards
Which of the following is secreted by the Alpha granules of the platelets?
I. ADP
II. Fibrinogen
III. Serotonin
IV. VWf
a. I and III
b. I and II
c. II and III
d. II and IV
d. II and IV
“prevent progression of thrombosis” is the function of
a. Anticoagulatants
b. Fibrinolytics
c. Antiplatelets
d. All of the above
a. Anticoagulatants
Transient thrombocytopenia (HIT) is side effect of:
a. Protamine sulfate
b. Heparin
c. Warfarin
d. Aspirin
b. Heparin
Abnormal Increased activity of Inhibitors will result to which of the following?
a. Bleeding
b. Clotting
c. Fibrinolysis
d. All
a. Bleeding
Which of the following factors is not found in the serum?
a. V
b. X
c. XI
d. A and C
a. V
Prolonged APTT, Prothrombin Time, and Bleeding Time is a result for which condition?
a. Von Willebrand Disease
b. Hemophilia B
c. DIC
d. All of the above
c. DIC
A 13-year-old girl develops menorrhagia at the onset of menarche requiring several packed red blood cell transfusions. She also required a transfusion after a tonsillectomy and adenoidectomy when she was 5 years old, but it was never evaluated. She also has easy bruising and gingival bleeding daily when she brushes her teeth. She is referred to you by her pediatrician for an evaluation.
There is a history of menorrhagia in the mother though she never required any transfusions. In addition, there is a history of epistaxis and postsurgical bleeding
in the father. Her parents have normal aPTTs and the patient has an abnormal screening laboratory test. Which of the following is the most likely diagnosis?
a. Factor VII deficiency
b. Factor VIII deficiency
c. Factor IX deficiency
d. Factor XII deficiency
e. Factor XIII deficiency
a. Factor VII deficiency
A 3-year-old girl presents with prolonged oozing from her tongue after apparently biting it. Her platelet count is normal. Her PT is 68 seconds (normal range is 9–12
seconds), her aPTT is 123 seconds (normal range is 22–33 seconds) and her thrombin time is 58 seconds (normal range is 12–18 seconds). Which of the
following tests should be ordered next?
a. Factor XIII level
b. Fibrinogen level
c. Factor X level
d. Ristocetin cofactor activity
e. Prekallikrein level
b. Fibrinogen level
A 5 year old male presents with fulminant acute hepatic failure. He is noted to be bleeding from his gums, nose and has hematochezia. This patient’s bleeding is
most likely due to which of the following combinations:
a. Deficiency of fibrinogen, factor VII and factor II.
b. Thrombocytopenia and factor XI deficiency.
c. Factor VIII, IX and XI deficiency.
d. Factor V and VIII deficiency.
e. Low levels of von Willebrand factor and factor VIII.
a. Deficiency of fibrinogen, factor VII and factor II.
You are seeing a 10 year boy old with easy bruising and recurrent epistaxis as a second opinion. He is active in a variety of sports, however his mother feels that
his bruising is excessive. His pediatrician sent the following laboratory tests all of which are normal: WBC, Hemoglobin, platelet count, PT, PTT. Another hematologist ordered the following all of which were normal: VWF Ag, ristocetin cofactor activity, factor VIII activity, factor XIII activity, and platelet aggregation studies. Which of the following physical exam
indings would be most informative:
a. Petechiae where the blood pressure cuff was placed
b. Hypermobility of the finger joints
c. Palpable bruises over the tibial surface.
d. A conjunctival hemorrhage
e. Albinism
b. Hypermobility of the finger joints
A 4-year-old male is in the intensive care unit and has been intubated and sedated. You are asked to consult because of the presence of numerous generalized petechiae and some large ecchymosis on the abdomen and trunk. Laboratory evaluation demonstrates a platelet count of 45 × 109/L, a PT of 15.4 seconds (normal 9.7–11.2 seconds), a PTT of 48 seconds (normal 22–36
seconds), and a fibrinogen level of 0.87 g/L (normal 2–4 g/L). Which of the following most likely led to these clinical findings?
a. Immune thrombocytopenic purpura (ITP)
b. Systemic lupus erythematosus (SLE)
c. Congenital hypofibrinogenemia
d. Acute promyelocytic leukemia
e. Vitamin K deficiency
d. Acute promyelocytic leukemia
Kasabach Merritt Syndrome Is characterized by:
a. Vasculitis caused by allergy with Complement containing IgA
b. Collagen degradation due to Old age
c. Hemangioma
d. Missing Elastin
c. Hemangioma
Elevated APTT is observed in which of the following?
I. DIC
II. Parahemophilia
III. XIII Deficiency
IV. Thrombocytopenia
a. I only
b. NOTA
c. I and II
d. I, II, III and IV
a. I only
hich of the following Organisms is a VIT K Producer?
a. Orientia tsutsugamushi
b. Proteus mirabillis
c. Bacteroides fragilis
d. B and C
c. Bacteroides fragilis
A 1 year old male presents to the emergency room with irritability and vomiting, and a CT scan demonstrates a large intracranial parenchymal hemorrhage. The
mother reports that his only other bleeding symptom was prolonged bleeding from the umbilical stump. The patient comes from a large pedigree with numerous male and female first and second degree relatives, however there is
no history of excessive bleeding in any of them. Which of the laboratory test patterns are most consistent with this history?
a. Normal PT and PTT.
b. Prolonged PT, normal PTT.
c. Normal PT, prolonged PTT.
d. Prolonged PT, prolonged PTT.
a. Normal PT and PTT.
A 44-year-old man in acute distress is noted to have multiple ecchymoses of the
skin that have developed over the past 48 hours. His prothrombin time (PT) is 38
seconds and partial thromboplastin time (PTT) 55 seconds. A CBC shows a WBC count of 5300/microliter, hemoglobin 8.1 g/dL, hematocrit 24.9%, MCV 99 fL, and platelet count 16,300/microliter. His DDimer test is very high. Which of the
following is the most likely diagnosis?
a. Hemophilia A
b. Afibrinogenemia
c. Vitamin K deficiency
d. vonWillebrand disease
e. Disseminated intravascular coagulopathy
e. Disseminated intravascular coagulopathy
The following Results are obtained: PT: Normal, APTT: Prolonged; APTT with Ads Plasma: Not Corrected. What is the deficient factor?
a. Antihemophilic Factor
b. Stuart Prower Factor
c. Plasma Thromboplastin component
d. Hageman Factor
c. Plasma Thromboplastin component
A 56 Year old woman was admitted to the hospital with a history of a moderate to severe bleeding tendency of several duration. APTT was said to be prolonged and PT was normal. Abnormal result was corrected with Aged serum and
adsorbed plasma. Deficiency of which of the following is most likely?
a. Factor X
b. Factor XI
c. Factor VIII
d. Factor IX
b. Factor XI
Glanzmann Thrombasthenia will show a normal in vitro aggregation test result in which of the following stimulating agents?
a. ADP
b. Ristocetin
c. Collagen
d. Both A and B
b. Ristocetin
Which of the following laboratory Findings is associated with Factor XIII deficiency?
a. Prolonged APTT
b. Prolonged Thrombin Time
c. Clot solubility in 5 M urea solution
d. Prolonged PT
c. Clot solubility in 5 M urea solution
Used to detect deficiencies of the common Pathway:
a. Resptilase Time
b. Stypven Time
c. Thrombin Time
d. Duckert’s Test
b. Stypven Time
Fibrinogen affected by Heparin Therapy:
a. Thrombin Time
b. Duckert’s Test
c. Resptilase Time
d. Fibrin Time
a. Thrombin Time
Atroxin is associated with:
a. Resptilase Time
b. Stypven Time
c. Thrombin Time
d. Duckert’s Test
a. Resptilase Time
Prolonged PT and normal APTT denotes a deficiency in which pathway?
a. Extrinsic
b. Common
c. Intrinsic
d. All of the above
a. Extrinsic
Calcium Chloride is used in:
a. PT
b. APTT
c. Both
d. Neither
c. Both
Which of the following factors is not found in the serum?
a. V
b. X
c. XI
d. VII
a. V
What protein secreted by endothelial cells activate fibrinolysis?
a. Plasminogen
b. PAI-1
c. TPA
d. TAFI
c. TPA
Which drug promotes Fibrinolysis?
a. Warfarin
b. Heparin
c. Urokinase
d. Aspirin
c. Urokinase
The Active Enzyme Necessary for Fibrinolysis:
a. Plasminogen
b. TPA
c. Urokinase
d. Plasmin
d. Plasmin
Contraindicated during pregnancy:
a. Heparin
b. Warfarin
c. Hirudin
d. All of the Above
b. Warfarin
True of Warfarin:
a. S is metabolized primarily CYP3A4
b. Administered Intravenously
c. readily crosses placenta
d. None of The above
c. readily crosses placenta
DECREASE ANTICOAGULANT EFFICACY is noted in all except:
a. Grave’s Disease
b. Hashimoto’s Thyroiditis
c. Hyperlipidemia
d. Renal Failure
a. Grave’s Disease
APTT and PT are prolonged. Substitution studies was done by mixing patient sample with the correction reagents. Results are as follows: APTT with Adsorbed
Plasma: C; APTT with Aged Serum: NC; PT
a. II
b. XIII
c. Both/Either
d. Neither
d. Neither
Inhibiting fibrin binding to thrombin is a mechanism of which of the following?
a. Hirudin
b. Argatroban
c. Both
d. None
c. Both
Mode of Action of Warfarin:
a. Interfere with the synthesis of vitamin K
b. Increase the activity of protein C
c. Both
d. None
a. Interfere with the synthesis of vitamin K
A prolonged APTT is corrected with Aged serum but not with adsorbed plasma.
What factor is deficient?
a. V
b. VIII
c. IX
d. X
e. 2 of the choices
f. all of the above
a. V
Which of the following factors is not found in the serum?
a. V
b. X
c. XI
d. VII
a. V
Used to detect deficiencies of the common Pathway:
a. Resptilase Time
b. Stypven Time
c. Thrombin Time
d. Duckert’s Test
b. Stypven Time
Which drug promotes Fibrinolysis?
a. Warfarin
b. Heparin
c. Urokinase
d. Aspirin
c. Urokinase
What protein secreted by endothelial cells activate fibrinolysis?
a. Plasminogen
b. PAI-1
c. TPA
d. TAFI
c. TPA
Atroxin is associated with:
a. Resptilase Time
b. Stypven Time
c. Thrombin Time
d. Duckert’s Test
a. Resptilase Time
Fibrinogen affected by Heparin Therapy:
a. Thrombin Time
b. Duckert’s Test
c. Resptilase Time
d. Fibrin Time
a. Thrombin Time
Patients Results: PT:20 sec, APTT:50 sec, Thrombin Time:18 sec. What is the most probable diagnosis?
a. Hyperfibrinogenemia
b. Warfarin Therapy
c. Von Willebrand Disease
d. All of the above
e. None of the Above
e. None of the Above
A prolonged APTT and PT are corrected when mixed with normal plasma. Which factor is most likely deficient?
a. V
b. X
c. VIII
d. IX
e. Both
f. Neither
a. V
Consumable factor in coagulation is:
a. XIII
b. VII
c. IX
d. all of the above
e. None of the above
a. XIII
APTT and PT are prolonged. Substitution studies was done by mixing patient sample with the correction reagents. Results are as follows: APTT with Adsorbed
Plasma: C; APTT with Aged Serum: NC; PT with Adsorbed Plasma: C; PT with Aged Serum: NC. Identify the factor deficiency.
a. II
b. XIII
c. IV
d. all of the above
e. None of the above
e. None of the above
The Active Enzyme Necessary for Fibrinolysis:
a. Plasminogen
b. TPA
c. Urokinase
d. Plasmin
d. Plasmin
Calcium Chloride is used in:
a. PT
b. APTT
c. Both
d. Neither
c. Both
Prolonged PT and normal APTT denotes a deficiency in which pathway?
a. Extrinsic
b. Common
c. Intrinsic
d. All of the above
a. Extrinsic
Thrombophilia is associated with which of the following disorders:
a. Afibrinogenemia
b. Hypofibrinogenemia
c. Factor VIII Inhibitor
d. Hyperfibrinogenemia
d. Hyperfibrinogenemia
A stabilized clot is insoluble to what reagent?
a. 5 M urea
b. Both
c. 10% NaOH
d. None
a. 5 M urea
Hypofibrinogenemia:
a. PT Normal, APTT Prolonged
b. Both PT and APTT Prolonged
c. Both PT and APTT Normal
d. PT Prolonged, APTT Normal
b. Both PT and APTT Prolonged
Which of the following laboratory Findings is associated with Factor XIII deficiency?
a. Prolonged APTT
b. Prolonged Thrombin Time
c. Clot solubility in n 5 M urea solution
d. Prolonged PT
c. Clot solubility in n 5 M urea solution
Which results are associated with Hemophilia A?
a. PT Normal, APTT Prolonged
b. Both PT and APTT Prolonged
c. Both PT and APTT Normal
d. PT Prolonged, APTT Normal
a. PT Normal, APTT Prolonged
The most suitable product for the treatment of Hemophilia A:
a. Fresh Frozen Plasma
b. Cryopreciptate
c. Factor VIII concentrate
d. Factor V laden
c. Factor VIII concentrate
The most common subtype of Classic Von willebrand disease:
a. 1
b. 2a
c. 2b
d. 3
a. 1
The lupus Anticoagulant is directed Against:
a. Factor VIII
b. Factor IX
c. Both
d. Neither
d. Neither
APTT is used to?
a. Heparin Therapy
b. Common Pathway
c. Both
d. None
c. Both
Prolonged APTT, Prothrombin Time, and Bleeding Time is a result for which condition?
a. Von Willebrand Disease
b. Hemophilia B
c. DIC
d. All of the above
c. DIC
Rosenthal Syndrome will result to a prolonged result in:
a. Clot Retraction
b. APTT
c. Prothrombin Time
d. Both A and B
b. APTT
Acute Disseminated intravascular coagulation is characterized by:
a. Hypofibrinoginemia
b. Negative D-Dimer
c. Thrombocytosis
d. Shortened Prothrombin Time
a. Hypofibrinoginemia
Fletcher factor Deficiency may be associated with:
a. Bleeding
b. Thrombosis
c. Thrombocytopenia
d. Thrombocytosis
b. Thrombosis
10-16 sec is the Normal range for:
a. APTT
b. Both
c. Prothrombin Time
d. None
c. Prothrombin Time
Thrombocytopenia
a. Both PT and APTT Prolonged
b. PT Prolonged, APTT Normal
c. Both PT and APTT Normal
d. PT Normal, APTT Prolonged
c. Both PT and APTT Normal
Therapeutic Modality for Parahemophilia
a. FF Plasma
b. Antifibrinolytics
c. Supportive
d. Cryoprecipitate
a. FF Plasma
Hemophilia B is:
a. Autosomal Recessive
b. Autosomal Dominant
c. X-Linked
d. Mutation
c. X-Linked
Christmas Disease:
a. Both PT and APTT Prolonged
b. PT Normal, APTT Prolonged
c. Both PT and APTT Normal
d. PT Prolonged, APTT Normal
b. PT Normal, APTT Prolonged
Parahemophilia:
a. Both PT and APTT Prolonged
b. PT Normal, APTT Prolonged
c. Both PT and APTT Normal
d. PT Prolonged, APTT Normal
a. Both PT and APTT Prolonged
Which of the following is a characteristic of Classic Hemophilia?
a. Prolonged Bleeding Time
b. AR inheritance
c. Mild to severe Bleeding
d. Prolonged PT
c. Mild to severe Bleeding
Ehler-Danlos Syndrome:
a. PT Normal, APTT Prolonged
b. Both PT and APTT Normal
c. Both PT and APTT Prolonged
d. PT Prolonged, APTT Normal
b. Both PT and APTT Normal
The prothrombin Time requires that the patient’s citrated plasma be combined with:
a. Platelet Phospholipid
b. Thromboplastin
c. Ca++ and Thromboplastin
d. Both A and C
c. Ca++ and Thromboplastin
The most frequent bleeding disorder of childhood, which can lead to life
a. Scurvy
b. Hemophila A
c. Vitamin K deficiency
d. Both A and C
c. Vitamin K deficiency
Rosenthal Syndrome
a. Both PT and APTT Prolonged
b. PT Prolonged, APTT Normal
c. PT Normal, APTT Prolonged
d. Both PT and APTT Normal
c. PT Normal, APTT Prolonged
Glanzmann Thrombasthenia:
a. Both PT and APTT Prolonged
b. PT Prolonged, APTT Normal
c. PT Normal, APTT Prolonged
d. Both PT and APTT Normal
d. Both PT and APTT Normal
Von willebrand Disease
a. Both PT and APTT Normal
b. PT Prolonged, APTT Normal
c. Both PT and APTT Prolonged
d. PT Normal, APTT Prolonged
c. Both PT and APTT Prolonged
The test that is commonly used to monitor warfarin therapy:
a. APTT
b. INR
c. Both
d. Neither
b. INR
Disseminated Intravascular Coagulation
a. Both PT and APTT Normal
b. Both PT and APTT Prolonged
c. PT Normal, APTT Prolonged
d. PT Prolonged, APTT Normal
b. Both PT and APTT Prolonged
Which test result would be normal in patient with dysfribrinoginemia?
a. Thrombin Time
b. APTT
c. PT
d. Immunological Fibrinogen Level
d. Immunological Fibrinogen Level
PT: Normal, APTT: Prolonged, Bleeding Time: Increased. What is the possible condition
a. Bernard Soulier
b. Scott Syndrome
c. VWD
d. All
c. VWD
Which laboratory test is affected by heparin therapy?
a. Thrombin Time
b. Fibrinogen Assay
c. Bleeding Time
d. Resptilase Time
a. Thrombin Time
No bleeding is observed in deficiency of which of the following factors?
a. II
b. XII
c. IX
d. VIII
b. XII
Which of the following coagulation factors is considered to be labile?
a. V
b. III
c. II
d. VII
a. V
What role does vitamin K play in the Prothrombin group?
a. Provides surface on which the proteolytic reaction occurs
b. Carboxylates the factors to allow calcium binding
c. Protects them from inappropriate activation by compounds such as
thrombin
d. Accelerates the binding of the serine protease and their cofactors
b. Carboxylates the factors to allow calcium binding
Factor I deficiency will affect APTT and PT.
a. False
b. True
b. True
The APTT is sensitive to a deficiency of which clotting factor?
a. Calcium
b. BOTH
c. NONE
d. X
c. NONE
Which of the following factors will activate factor XI?
a. Fibrinogen
b. Stuart Factor
c. Plasma Thromboplastin Antecedent
d. Hageman Factor
d. Hageman Factor
APTT is used to?
a. Both
b. Evaluate the Common Pathway
c. Monitor Heparin Therapy
d. Non
a. Both
Neurologic findings may be commonly associated with which of the following
disorders?
a. PTP
b. TTP
c. HUS
d. ITP
b. TTP
True of TTP and DIC:
a. Schistocytes are present in DIC
b. PT is decreased in DIC
c. Platelet is decreased in TTP
d. APTT prolonged in DIC
d. APTT prolonged in DIC
No bleeding is observed in deficiency of which of the following factors?
a. XII
b. IX
c. VIII
d. II
a. XII
Coagulation Factors affected by Coumarin Drugs:
a. I, II, V, and VII
b. II, VII, IX, and X
c. II, V, and VII
d. VIII, IX, and X
b. II, VII, IX, and X
A protein that plays a vital role in both coagulation and platelet aggregation:
a. IX
b. XI
c. I
d. VIII
c. I
Factor XIII is activated by which factor?
a. IIa
b. Fibrinogen
c. Va
d. Xa
a. IIa
Factor V is a cofactor to factor X to activate factor II
a. False
b. True
b. True
What clotting factors are inhibited by Protein S?
a. V and X
b. V and VIII
c. VIII and IX
d. VIII and X
b. V and VIII
What is the second phase of secondary Hemostasis?
a. Contact Phase
b. Formation of Fibrin Clot
c. Activation of factor X
d. Activation of factor VI
c. Activation of factor X
Factor XIII is a serine protease
a. False
b. True
a. False
Which of the following Inhibitors inhibit Factor IIa?
a. Antithrombin III
b. Protein C
c. Both
d. Neither
c. Both
Which step requires calcium?
a. Factor VII activation
b. Factor XIII activation
c. Factor XII activation
d. Factor I activation
b. Factor XIII activation
Which of the Following Factors is used only in the Extrinsic Coagulation Pathway?
a. VII
b. II
c. VIII
d. V
a. VII
