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MT2 > HEMA COAGULATION TEST P2 > Flashcards

HEMA COAGULATION TEST P2 Flashcards

1
Q

Principle: The coagulation time of the whole blood is the length of time required for a measured amount
of blood to clot under certain specified conditions.

A

LEE AND WHITE METHOD

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2
Q

The Calcium in whole blood is bound by Na citrate thus preventing coagulation. Tissue thromboplastin, to which Ca has been added, is mixed with the plasma, and the clotting time is noted. Factor VII reacts with the tissue factor in the presence of Ca ions to activate factor X.

A

PROTHROMBIN TIME

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3
Q

PROTHROMBIN TIME NV

A

10 TO 12 SECS

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4
Q

The Ca in whole blood is bound by the Na citrate anticoagulant to prevent coagulation. The plasma, after centrifugation, contains all intrinsic coagulation factors except Ca and platelets. Ca, a phospholipid substitute for platelets and an activator are added to the plasma. The time required for the plasma to
clot is the _______.

A

ACTIVATED PARTIAL THROMBOPLASTIN TIME

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5
Q

ACTIVATED PARTIAL THROMBOPLASTIN TIME NV

A

25-35 SECS

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6
Q

Calcium chloride is added to platelet poor
plasma and the clotting time is determined.

A

PLASMA RECALCIFICATION TIME

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7
Q

PLASMA RECALCIFICATION TIME NV

A

90 TO 150 SECS

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8
Q

PLASMA RECALCIFICATION TIME MODIFICATION: ACTIVATED RECALCIFICATION TIME

A

0.1 ml platelet rich plasma + 0.1 ml of 0.025 M CaCl2 and 0.1 mL of 1% Celite as an activator

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9
Q

ACTIVATED RECALCIFICATION TIME NV

A

LESS THAN 50 SECS

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10
Q

Principle: _____________ is a thromboplastin like substance that activates factor X. When this reagent is added to plasma, together with platelets and calcium chloride, the coagulation process is begun at the point of factor X activation with subsequent conversion of prothrombin to thrombin and fibrinogen to fibrin.

A

STYPEN TIME (RUSSELL’S VIPER VENOM TIME)

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11
Q

When Atroxin (reptilase) is added to plasma, it acts by releasing fibrinopeptide A from the fibrinogen molecule. The resultant monomers polymerize end to end, forming a clot.

A

REPTILASE TIME

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12
Q

REPTILASE TIME NV

A

10-15 SECS

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13
Q

A measured amount of thrombin is added to plasma. The length of time for a fibrin clot to form is recorded as the ________.

A

THROMBIN TIME

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14
Q

THROMBIN TIME NV

A

10-14 SECS

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15
Q

Principle: Patients with _________ deficiency will have prolonged APTT. If the plasma + APTT reagent mixture is incubated for 10 minutes (instead of the routine for 3-5 minutes) the prolonged APTT will be shortened to normal, or almost normal, if the deficiency is due to _______

A

PREKALLIKREIN (FLETCHER FACTOR
SCREENING TEST) ; Fletcher factor.

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16
Q

The patient’s plasma is clotted by the addition of CaCl2. Urea (5M) is added to the clot. If ________ is absent in the patient’s plasma, the clot is dissolved in less than 24 hours by the Urea.

A

FACTOR XIII SCREENING TEST

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17
Q

An excess amount of thrombin is added to a specimen of diluted plasma and the clotting time is noted. The concentration of fibrinogen in the unknown sample is determined by comparing results with clotting times of standard reference plasma dilutions containing known amounts of fibrinogen.

A

QUANTITATIVE FIBRINOGEN

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18
Q

In QUANTITATIVE FIBRINOGEN, the clotting time of the plasma is inversely proportional to the concentration of __________ in the specimen (the higher the ______, the lower the _________)

A

fibrinogen ; clotting time/fibrinogen conc

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19
Q

A prothrombin time is performed on ______ deficient substrates containing varying dilutions of the patient’s plasma, which is used to correct the prothrombin time. The amount of correction by the patient’s plasma correlates with its factor activity level and is compared to the results of the prothrombin time performed on varying dilutions of an assayed reference plasma in place of the patients plasma. The _____ content of the patient’s plasma is expressed as the percentage of normal.

A

FACTOR V (II, VII, X) ASSAY

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20
Q

A dilution of the patient’s plasma is mixed with latex particles coated with monoclonal antibodies to the ______. If fibrin degradation products containing the ______ portion are present, agglutination of the latex particles will occur.

A

D-DIMER TEST FOR FIBRIN DEGRADATION

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21
Q

Patient and control plasmas are mixed with varying dilutions of _________. Each tube is incubated at room temperature for 30 minutes and then observed for fibrin strand or gel formation. The _________ causes gel formation of fibrin monomers and/ or early fibrin split products when they are present in the plasma.

A

PROTAMINE SULFATE

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22
Q

During the process of disseminated intravascular coagulation, the level of fibrin monomer in the blood increases. NaOH is added to the plasma to elevate the pH to above 7.70. Ethyl alcohol, added to plasma, will cause precipitation of fibrin monomers which maybe present.

A

ETHANOL GELATION TEST

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23
Q

Addition of ________ to diluted plasma causes the euglobulin portion of the plasma to precipitate. After removing the supernatant, the euglobulins are dissolved in a buffer solution. _____ is added to clot the euglobulins. The clot is incubated at _____ and the time of complete clot lysis is noted

A

EUGLOBULIN CLOT LYSIS TIME ; 1% acetic acid ; Thrombin ; 37oC

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24
Q

Patient’s plasma is incubated with platelet rich plasma from a normal control in the presence of heparin. The degree of platelet aggregation observed is measured by an aggregometer and compared to the aggregation obtained in the absence of heparin. If the heparin induced antibody is present, platelet aggregation will occur in the presence of heparin.

A

HEPARIN ASSOCIATED THROMBOCYTOPENIA
TEST (HATT)

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25
Q

Patient plasma is mixed 1:4 with factor Vdepleted plasma. PTT reagent is added to two aliquots of the mixture and incubated for 3 minutes. A solution of CaCl2 is pipetted into one mixture and the clot formation is timed. A solution of CaCl2 with APC is added to the second mixture, and clotting time is timed.

A

ACTIVATED PROTEIN C RESISTANCE CLOTBASED ASSAY

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26
Q

Patient plasma is incubated in microtiter plate wells that are coated with a solid-phase complex of purified PF4 and polysulfonate, aplastic molecule integral to plate construction that resemble heparin.

A

IMMUNOASSAY FOR THE ANTI-PLATELET FACTOR 4 (HEPARIN-INDUCED THROMBOCYTOPENIA) ANTIBODY

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27
Q

In IMMUNOASSAY FOR THE ANTI-PLATELET FACTOR 4 (HEPARIN-INDUCED THROMBOCYTOPENIA) ANTIBODY, Heparin dependent anti PF4 antibodies bind the _____________

A

PF4 polysulfonate complex

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28
Q

In IMMUNOASSAY FOR THE ANTI-PLATELET FACTOR 4 (HEPARIN-INDUCED THROMBOCYTOPENIA) ANTIBODY, Bound antibodies are detected using enzymeconjugated anti-human immunoglobulin G ____, ______, and ______ antibodies and a substrate ________.

A

(IgG), IgA, and IgM ; chromophore

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29
Q
  • Detects Ab early in the development of HIT
  • Other immunoassay kits uses PF4-heparin
A

IMMUNOASSAY FOR THE ANTI-PLATELET FACTOR 4 (HEPARIN-INDUCED THROMBOCYTOPENIA) ANTIBODY

30
Q

In Assay for Platelet Activation Markers, Elevated levels of platelet-specific proteins ß- thromboglobulin and PF4 may accompany ________ or __________

A

thrombotic stroke or coronary thrombosis

31
Q

Diagnostica Stago, Inc (Parsipany, NJ)- Brand names Asserachrom PF4 and Asserachrom ß- TG-produces enzyme immunoassay kits for PF4 and ß-thromboglobulin

A

Assay for Platelet Activation Markers

32
Q

IMMUNOASSAYS of urine 11- dehydrothromboxane B2 are employed to characterize __________

A

in vivo platelet activation

33
Q

o Can be performed randomly
o Used to monitor aspirin therapy and to identify cases of therapy failure or aspirin resistance

A

IMMUNOASSAYS of urine 11-dehydrothromboxane B2

34
Q
  • Used to confirm the presence of and quantify an anti factor VIII inhibitor
  • Which is an IgG4-class immunoglobulin
  • Uses 200uL of patient PPP
  • Control specimen; 200uL of imidazole buffer at pH 7.4 mixed with 200uL of rgt normal plasma
  • One bethesda unit of activity is the amount of Activity in the mixture
A

BETHESDA TITER FOR ANTI-FACTOR VIII INHIBITOR

35
Q

FIBRINOLYSIS TESTS

A
  • FDPS (Fibrin degradation products)
  • D-dimer
  • Plasminogen
  • TPA
  • PAI-1
36
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

During coagulation, _______ become cross-linked by factor XIIIa and binds plasma plasminogen and tissue plasminogen activator.

A

fibrin polymers

37
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

Bound TPA activates plasminogen to _______

38
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

Bound plasmin cleaves fibrin and yields _____, __, __, and __ and _______

A

FDPs D, E, X and Y and D-dimer

39
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

FDPs and D-dimer normal conc- less than _____

40
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

Fibrinolysis yields FDPs and D-dimer at conc greater than _____

41
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

Increased FDPs and D-dimer: ___________, ________, ________ and __________

A

acute and chronic DIC ; systemic fibrinolysis ; deep vein thrombosis ; pulmonary embolism

42
Q

PHYSIOLOGY OF FDPS AND D-DIMERS

FDPs and D-dimer-detected in plasma after _______

A

thrombolytic therapy

43
Q

PRINCIPLE OF THE QUANTITATIVE D-DIMER
ASSAY

  1. Microlatex particles in buffered saline are coated
    with ____________
A

monoclonal anti D-dimer antibodies

44
Q

PRINCIPLE OF THE QUANTITATIVE D-DIMER
ASSAY

  1. Coated particles are agglutinated by patient _________
A

plasma D-dimer

45
Q

PRINCIPLE OF THE QUANTITATIVE D-DIMER
ASSAY

  1. Resultant turbidity is measured using _________ or __________
A

turbidometric or nephelometric technology

46
Q

PRINCIPLE OF THE QUANTITATIVE D-DIMER
ASSAY

  1. Most methods detect conc as low as ______
47
Q

CLINICAL SIGNIFICANCE OF QUANTITATIVE
D-DIMER

D-dimer assay is essential for ruling out _________

A

venous thromboembolic disease

48
Q

CLINICAL SIGNIFICANCE OF QUANTITATIVE
D-DIMER

  • Acute myocardial infarction
  • Ischemic stroke
49
Q

CLINICAL SIGNIFICANCE OF QUANTITATIVE
D-DIMER

Monitor the efficacy of __________

A

Coumadin therapy

50
Q

CLINICAL SIGNIFICANCE OF QUANTITATIVE D-DIMER

Normal values- __________

A

250ng/mL to 500 ng/mL

51
Q

CLINICAL SIGNIFICANCE OF QUANTITATIVE D-DIMER

DIC, D-dimer levels- __________

A

10,000-20,000 ng/mL

52
Q

QUALITATIVE D-DIMER ASSAY

  • __________ is a manual method that uses visible latex particles coated with monoclonal antibody
A

SimpliRED D-dimer assay

53
Q

o Suited to low-volume or near-patient (point of care) applications
o Clin sensitivity for pulmonary embolus (94%) and specificity (67%)

A

SimpliRED D-dimer assay

54
Q

PRINCIPLE OF PLASMINOGEN CHROMOGENIC SUBSTRATE ASSAY

  • Chromogenic substrate employ ___________ whose amino acid sequences are designed to be specific for their chosen enzymes
A

synthetic oligopeptides

55
Q

PRINCIPLE OF PLASMINOGEN CHROMOGENIC SUBSTRATE ASSAY

  • ________ hydrolyzes a bond in the oligopeptide sequence _____________
A

Plasmin ; Valine-Leucine-Lysine

56
Q

PRINCIPLE OF PLASMINOGEN CHROMOGENIC SUBSTRATE ASSAY

  • Fluorophore or a chromophore such as _________ is covalently bound to carboxyl terminus of the oligopeptide and maybe released on digestion
A

para-nitroaniline

57
Q

PRINCIPLE OF PLASMINOGEN CHROMOGENIC SUBSTRATE ASSAY

  • Streptokinase is a plasminogen activator derived
    from cultures of ________.
  • Streptokinase is added to ______ where it binds
    and activates plasminogen.
  • Streptokinase-plasmin complex reacts with
    chromogenic substrate such as ______ to
    release color whose intensity is proportional to
    the plasminogen concentration.
A

ß-hemolytic streptococci ; PPP ; S-2251

58
Q

CHROMOGENIC SUBSTRATE METHOD FOR
PLASMA PLASMINOGEN

Plasminogen + Streptokinase ——> Plasmin: _______

A

Streptokinase

59
Q

CHROMOGENIC SUBSTRATE METHOD FOR PLASMA PLASMINOGEN

___________: Streptokinase R-COOH + pNA
(color)

A

R-pNA Plasmin

60
Q

CLINICAL SIGNIFICANCE OF PLASMINOGEN
* Plasminogen Reference Interval _______

A

5-13.5MG/DL

61
Q

CLINICAL SIGNIFICANCE OF PLASMINOGEN

  • Decreased in:
A

o Thrombolytic therapy
o DIC
o Hepatitis
o Cancer
o Thrombosis

62
Q

CLINICAL SIGNIFICANCE OF PLASMINOGEN

  • Increased in:
A

o Inflammation
o During pregnancy
o Hemorrhage
o Systemic fibrinolysis

63
Q

2 physiologic human plasminogen activators:
______ and _______

A

TPA and Urokinase

64
Q

Are serine protease that form ternnary complexes w/bound plasminogen at the fibrin surface activating the plasminogen and initiating thrombus degradation

A

TISSUE PLASMINOGEN ACTIVATOR (TPA)

65
Q

TPA – synthesized by _________; half life in the circulation - ______ and its plasma concentration averages ______

A

vascular endothelial cells; 3 minutes ; 5ng/mL

66
Q

Urokinase - produced in the ______ and _______; half life - _______ and con is _______

A

kidney and vascular endothelial cells; 7 minutes ; 2-4ng/mL

67
Q

CLINICAL SIGNIFICANCE OF TISSUE PLASMINOGEN ACTIVATOR

  • Reference upper limit for TPA – ________
A

1.1 units/mL

68
Q

CLINICAL SIGNIFICANCE OF TISSUE PLASMINOGEN ACTIVATOR

  • Upper limit for TPA antigen is _______
69
Q

CLINICAL SIGNIFICANCE OF TISSUE PLASMINOGEN ACTIVATOR

  • _____ is mediator of fibrinolysis
70
Q

CLINICAL SIGNIFICANCE OF TISSUE PLASMINOGEN ACTIVATOR

  • Decreased TPA levels - __________, _______, __________
A

Myocardial Infarction, stroke, deep vein thrombosis

71
Q

CLINICAL SIGNIFICANCE OF TISSUE PLASMINOGEN ACTIVATOR

  • _________ or ___________ is associated with deep vein thrombosis and MI
A

TPA deficiency or PAI-1 (plasminogen activator inhibitor-1) excess

MT2 (45 decks)

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