Heme/ID

Question 1

IgG antibodies against glycoprotein IIb/IIa and IR/IX; dx

Answer 1

Immune thrombocytopenia purpura

Question 2

Most significant factors influencing oxygen content in the blood

Answer 2

Hgb and Hct

Question 3

Binds to plasminogen and increases plasmin production

Answer 3

Streptokinase

Question 4

binds to glycoprotein Ib on the platelet

Answer 4

Von Willebrand factor

Question 5

Contributes to platelet aggregation and sealing at site of injury

Answer 5

Thromboxane A2

Question 6

Binds platelets to fibrinogen to form platelet plug

Answer 6

GPIIb/IIIa

Question 7

Catalyzes fibrin from fibrinogen stabilizing platelet plug

Answer 7

Thrombin

Question 8

Abciximab, eptifibatide, tirofiban; MOA

Answer 8

inhibit GPIIb/IIIa

Question 9

Most common inherited hypercoaguable disorder; mechanism

Answer 9

Factor V Leiden, cannot be activated by protein C

Question 10

Acute mild transfusion reaction; tx

Answer 10

Slow transfusion and observe 30min, can administer antihistamine

Question 11

First-line treatment surgical bleeding in patient with type I and II vW disease

Answer 11

Desmopression

Question 11

First-line treatment surgical bleeding in patient with type I and II vW disease

Answer 11

Desmopression

Question 12

Warfarin induced skin necrosis; tx

Answer 12

stop Warfarin, administer vit K, start systemic heparin

Question 13

Hx vW disease type 3 s/p trauma with large epidural hematoma; tx

Answer 13

factor VIII/vWF concentrate

Question 14

CHADS-VASc score

Answer 14

Congestive heart failure [1 point if present], Hypertension [1 point if present],
Age >75 years [2 points if present],
Diabetes [1 point if present],
Stroke/TIA/Embolism [2 points if present],
Vascular disease,
Age 65 to 74 years [1 point],
Sex category female [1 point]

Question 15

Non-valvular afi, CHA2DS2-VASc <5 undergoing low risk surgery ie IHR; periop warfarin mgmnt

Answer 15

Stop 5 days before

Question 16

Periop management of DOACs (apixaban)

Answer 16

Held 2 days pre-op

Question 17

Periop management warfarin with CHADS-VASc 6 or higher

Answer 17

Bridge

Question 18

HIT treatment

Answer 18

Stop heparin and switch to argatroban

Question 19

HIT; MOA

Answer 19

Heparin-dependent antibody IgG binds to platelets are formed when heparin binds to platelet factor 4 (PF4)

Question 20

HIT in patient with liver failure

Answer 20

Switch to Fondaparinux

Question 21

Post-op bleed in hypothermic patient; next step

Answer 21

Rewarm

Question 22

Uremic bleeding with renal failure; tx

Answer 22

desmopressin (dDAVP) or dialysis

Question 22

Uremic bleeding with renal failure; tx

Answer 22

desmopressin (dDAVP) or dialysis

Question 23

Only blood product without risk for viral hepatitis transmission

Answer 23

Albumin

Question 24

Consequence of massive transfusion

Answer 24

Hypocalcemia -> hypotension decreased pulse pressure, long QT

Question 25

Heparin; MOA, half-life and reversal agent

Answer 25

Activates antithrombin III, 1hr, protamine

Question 26

Enoxaparin; MOA, half-life and reversal agent

Answer 26

Activates antithrombin III, inhibits factor Xa, 5hrs, protamine

Question 27

Fondaparinux; MOA, half-life and reversal agent

Answer 27

Activates antithrombin III, inhibits factor Xa, 17-20hrs, none

Question 28

Dabigatran; MOA, half-life and reversal agent

Answer 28

Direct thrombin inhibitor,12-14hrs, Idarucizumab some PCC

Question 29

Argatroban; MOA, half-life and reversal agent

Answer 29

Direct thrombin inhibitor, <1hr, PCC

Question 30

Bivalrudin; MOA, half-life and reversal agent

Answer 30

Direct thrombin inhinbitor, 20-30min, none

Question 31

Rivaroxaban; MOA, half-life and reversal agent

Answer 31

Directly inhibits factor Xa, 5-9hrs, Andexanet alfa, some PCC

Question 32

Apixaban; MOA, half-life and reversal agent

Answer 32

Directly inhibits factor Xa, 9-13hrs, Andexanet alfa, some PCC

Question 33

Warfarin; MOA, half-life and reversal agent

Answer 33

Vit K antagaonist, PCC, vit K, FFP

Question 34

Hx of Factor XI deficiency, tx preop

Answer 34

FFP

Question 35

R time; what, issue and tx

Answer 35

Clotting time, no factors, FFP

Question 36

K value; what, issue and tx

Answer 36

Clot time to strengthen, Fibrinogen, cryo

Question 37

Alpha angle; what, issue and tx

Answer 37

Fibrin accumulation, fibrinogen, cryo

Question 38

MA; what, issue and tx

Answer 38

Max clot strength, platelets, platelets or dDAVP

Question 39

LY30; what, issue and tx

Answer 39

Lysis, Excess fibrinolysis, TXA