Hemeonc 6

Question 1

Activation of platelets and formation of initial platelet plug in wall of injured vessel

Answer 1

Primary Hemostasis (PLT, PFA-platelet function assay)

Question 2

Activation of plasma coagulation factors and formation of a fibrin clot

Answer 2

Secondary Hemostasis (PT/PTT)

Question 3

Which coagulation test should be done for Extrinsic Pathway (Tissue Factor)

Answer 3

PT/INR

Question 4

Which coagulation test should be done for Intrinsic pathway

Answer 4

aPTT

Question 5

Where is your problem if you're experiencing: Superficial bleeding
Mucocutaneous bleeding
Petechiae, small ecchymoses
Immediate bleeding after trauma
Bleeding controlled by direct pressure

Answer 5

Problem with platelet plug = Primary hemostasis

Includes menstrual bleeding

Question 6

Where is your problem if you’re experiencing: Deep muscle bleeding Hemarthrosis
NOT petechiae
Delayed bleeding after trauma
Not controlled by direct pressure

Answer 6

Problem is with coagulation factors = Secondary hemostasis

Question 7

Which disorder presents with thrombocytopenia and giant platelets? Defective receptor on platelet that cannot make initial clot.

Answer 7

Bernard Soulier

Question 8

Which bleeding disorder has normal number of platelets of normal size, but has abnormal platelet aggregation and recruitment?

Answer 8

Glanzmann thrombasthenia

Question 9

Which acquired PLT disorder is characterized by low # of PLT’s due to destruction of megakaryocytes by the immune system and decreased production in the bone marrow?

Answer 9

ITP–Immune thrombocytopenia Purpura

Question 10

What is DIC?

Answer 10

Disseminated Intravascular Coagulation, aka “clotting all over the place” which means there is rapid consumption of PLT’s AND coagulation factors

Question 11

Deficit in clotting Factor VIII or IX. Which pathway does this affect?
So which test would be abnormal?

Answer 11

1) Hemophilia A and B, respectively
2) Intrinsic pathway
3) PTT only

Question 12

What does von Willebrand Factor do?

Answer 12

1) Adhesion to epithelium
2) PLT/PLT aggregation
3) Protects and transports Factor VIII

So it is necessary for primary and secondary hemostasis

Question 13

What is the most common bleeding disorder? And who is affected the most?

Answer 13

von Willebrand Disease. Males, Females, and all ethnicities get this equally

Question 14

Describe the “Type” classifications of vWD

Answer 14

type 1–75%, mild PLT-like symptoms
type 2–everything in between
type 3–abscense of vWF, severe bleeding (any female with ‘hemophilia’ symptoms likely has VWD