Hematology- Coagulation System Disorders

Question 1

1. The APTT is sensitive to a deficiency of which
   clotting factor?
   A. Factor VII
   B. Factor X
   C. PF3
   D. Calcium

Answer 1

B. Factor X

Question 2

2. Which test result would be normal in a patient
   with dysfibrinogenemia?
   A. Thrombin time
   B. APTT
   C. PT
   D. Immunologic fibrinogen level

Answer 2

D. Immunologic fibrinogen level

Question 3

3. A patient with a prolonged PT is given intravenous
   vitamin K. The PT corrects to normal after
   24 hours. What clinical condition most likely
   caused these results?
   A. Necrotic liver disease
   B. Factor X deficiency
   C. Fibrinogen deficiency
   D. Obstructive jaundice

Answer 3

D. Obstructive jaundice

Question 4

4. Which factor deficiency is associated with a
   prolonged PT and APTT?
   A. X
   B. VIII
   C. IX
   D. XI

Answer 4

A. X

Question 5

5. A prolonged APTT is corrected with factor
   VIII– deficient plasma but not with factor
   IX–deficient plasma. Which factor is deficient?
   A. V
   B. VIII
   C. IX
   D. X

Answer 5

C. IX

Question 6

6. Which of the following is a characteristic of classic
   hemophilia A?
   A. Prolonged bleeding time
   B. Autosomal recessive inheritance
   C. Mild to severe bleeding episodes
   D. Prolonged PT

Answer 6

C. Mild to severe bleeding episodes

Question 7

7. Refer to the following results:
   PT = prolonged
   APTT = prolonged
   Platelet count = decreased
   Which disorder may be indicated?
   A. Factor VIII deficiency
   B. von Willebrand’s disease
   C. DIC
   D. Factor IX deficiency

Answer 7

C. DIC

Question 8

8. Which of the following is a predisposing condition
   for the development of DIC?
   A. Adenocarcinoma
   B. Idiopathic thrombocytopenic purpura (ITP)
   C. Post-transfusion purpura (PTP)
   D. Heparin-induced thrombocytopenia (HIT)

Answer 8

A. Adenocarcinoma

Question 9

9. Factor XII deficiency is associated with:
   A. Bleeding episodes
   B. Epistaxis
   C. Decreased risk of thrombosis
   D. Increased risk of thrombosis

Answer 9

D. Increased risk of thrombosis

Question 10

10. The following results were obtained on a patient:
    normal platelet count and function, normal PT,
    and prolonged APTT. Which of the following
    disorders is most consistent with these results?
    A. Hemophilia A
    B. Bernard–Soulier syndrome
    C. von Willebrand’s disease
    D. Glanzmann’s thrombasthenia

Answer 10

A. Hemophilia A

Question 11

11. The following laboratory results were obtained
    from a 40-year-old woman: PT = 20 sec; APTT =
    50 sec; thrombin time = 18 sec. What is the most
    probable diagnosis?
    A. Factor VII deficiency
    B. Factor VIII deficiency
    C. Factor X deficiency
    D. Hypofibrinogenemia

Answer 11

D. Hypofibrinogenemia

Question 12

12. When performing a factor VIII activity assay, a
    patient’s plasma is mixed with:
    A. Normal patient’s plasma
    B. Factor VIII deficient plasma
    C. Plasma with a high concentration of factor VIII
    D. Normal control plasma

Answer 12

B. Factor VIII deficient plasma

Question 13

13. The most suitable product for treatment of factor
    VIII deficiency is:
    A. Fresh frozen plasma
    B. Factor VIII concentrate
    C. Prothrombin complex concentrate
    D. Factor V Leiden

Answer 13

B. Factor VIII concentrate

Question 14

14. Which of the following is associated with an
    abnormal platelet aggregation test?
    A. Factor VIII deficiency
    B. Factor VIII inhibitor
    C. Lupus anticoagulant
    D. Afibrinogenemia

Answer 14

D. Afibrinogenemia

Question 15

15. Refer to the following results:
    PT = normal
    APTT = prolonged
    Bleeding time= increased
    Platelet count = normal
    Platelet aggregation to ristocetin = abnormal
    Which of the following disorders may be
    indicated?
    A. Factor VIII deficiency
    B. DIC
    C. von Willebrand’s disease
    D. Factor IX deficiency

Answer 15

C. von Willebrand’s disease

Question 16

16. Which results are associated with hemophilia A?
    A. Prolonged APTT, normal PT
    B. Prolonged PT and APTT
    C. Prolonged PT, normal APTT
    D. Normal PT and APTT

Answer 16

A. Prolonged APTT, normal PT

Question 17

17. Fibrin monomers are increased in which of the
    following conditions?
    A. Primary fibrinolysis
    B. DIC
    C. Factor VIII deficiency
    D. Fibrinogen deficiency

Answer 17

B. DIC

Question 18

18. Which of the following is associated with multiple
    factor deficiencies?
    A. An inherited disorder of coagulation
    B. Severe liver disease
    C. Dysfibrinogenemia
    D. Lupus anticoagulant

Answer 18

B. Severe liver disease

Question 19

19. Normal PT and APTT results in a patient with a
    poor wound healing may be associated with:
    A. Factor VII deficiency
    B. Factor VIII deficiency
    C. Factor XII deficiency
    D. Factor XIII deficiency

Answer 19

D. Factor XIII deficiency

Question 20

20. Fletcher factor (prekallikrein) deficiency may be
    associated with:
    A. Bleeding
    B. Thrombosis
    C. Thrombocytopenia
    D. Thrombocytosis

Answer 20

B. Thrombosis

Question 21

21. One of the complications associated with a severe
    hemophilia A is:
    A. Hemarthrosis
    B. Mucous membrane bleeding
    C. Mild bleeding during surgery
    D. Immune-mediated thrombocytopenia

Answer 21

A. Hemarthrosis

Question 22

22. The most common subtype of classic von
    Willebrand’s disease is:
    A. Type 1
    B. Type 2A
    C. Type 2B
    D. Type 3

Answer 22

A. Type 1

Question 23

23. A prolonged APTT and PT are corrected when
    mixed with normal plasma. Which factor is most
    likely deficient?
    A. VIII
    B. V
    C. XI
    D. IX

Answer 23

B. V