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ANESTHESIA | Basic > Hemostasis and Coagulation | Basic > Flashcards

Hemostasis and Coagulation | Basic Flashcards

1
Q

All of the clotting factors are primarily produced in the liver EXCEPT:

A. Factor VIII

B. Factor X

C. Factor V

D. Factor IX

A

A. Factor VIII

It is also released by endothelial cells and is well maintained in liver disease.

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1
Q

The first screening test for hemostatic problems should always be the patient’s medical history

A. CBC

B. Medical history

C. Coagulation study

D. TEG

A

B. Medical history

The first screening test for hemostatic problems should always be the patient’s medical history.

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2
Q

TRUE or FALSE

Von Willebrand disease (vWD) is the most common hereditary bleeding disorder.

A

TRUE

1% of general population

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3
Q

The ______ complex is the target antigen for the antibodies causing heparin-induced
thrombocytopenia [HIT]:

A. Heparin–PF4
B. PKA–GP IIB
C. PGI2-cAMP
D. Ca-IP3

A

A. Heparin–PF4

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4
Q

This part of TEG reflects clot strength?

A. K time

B. R time

C. MA (max amplitude)

A

C. MA (max amplitude)

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5
Q

Which clotting factor is NOT vitamin-K dependent?

A. Factor VII
B. Factor IX
C. Factor VIII
D. Factor II

A

C. Factor VIII

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6
Q

TEG graph shows a prolongation of the R value/time. What should be the treatment of choice?

A. FFP

B. TXA

C. Cryoprecipitate

D. Platelet concentrate

A

A. FFP

The R value represents the time for initial fibrin formation and measures the intrinsic coagulation pathway, the extrinsic coagulation pathway, and the final common pathway.

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7
Q

In the TEG graph, __ is a measure of the speed of clot formation:

A. R value

B. K value

C. alpha angle

D. LY30

A

B. K value

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8
Q

The role of factor VIII in secondary
hemostasis is seen in _______

A. Extrinsic pathway
B. Intrinsic pathway
C. Both extrinsic and intrinsic pathway

A

B. Intrinsic pathway

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9
Q

Which clotting factor is NOT exclusively
produced by the liver?

A. Factor VII
B. Factor IX
C. Factor VIII
D. Factor II

A

C. Factor VIII

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10
Q

The abnormal protein in some patients with
amyloidosis absorbs and leads to a
deficiency of this factor:

A. Factor VII
B. Factor VIII
C. Factor II
D. Factor X

A

D. Factor X

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11
Q

This point of care test assesses the intrinsic clotting pathway and is used mainly to monitor heparin anticoagulation and its protamine reversal during cardiopulmonary bypass or vascular surger

A. ECT
B. ACT
C. PT
D. aPTT

A

B. ACT

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12
Q

This test is primarily used for measuring the
clinical effects of direct thrombin inhibitors
(DTIs) such as bivalirudin.
A. ECT
B. ACT
C. PT
D. aPTT

A

A. ECT

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13
Q

Reversal of urokinase in a hemorrhaging patient requiring surgery:

A. FFP

B. Cryoprecipitate

C. Platelet concentrate

A

B. Cryoprecipitate

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14
Q

1 unit of PRBC increases the Hct by:

A. 3%

B. 5%

C. 7%

A

A. 3%

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15
Q

Shelf life of PRBC is:

A. 21 days

B. 2 days

C. 2 weeks

D. 48 hrs

A

A. 21 days

16
Q

Which is NOT present in DIC?

A. Prolonged PT
B. Low platelet count
C. High fibrinogen
D. High fibrin split products

A

C. High fibrinogen

17
Q

Which of the following is INACCURATE regarding desmopressin:

A. It causes the release of FVIII and vWF from within vascular endothelial
cells.
B. Tachyphylaxis occurs with frequent repeat dosing.
C. Hypotension is the most commonly reported side effect.
D. It increases the synthesis of vWF and FVIII.

A

D. It increases the synthesis of vWF and FVIII.

18
Q

Which drug competitively inhibits the binding site on plasminogen thereby preventing cleavage to plasmin and the resultant fibrinolysis?

A. Lepirudin
B. Fondaparinux
C. Aprotinin
D. Tranexamic acid

A

D. Tranexamic acid

19
Q

This is the most common hereditary
bleeding disorder:

A. vWD
B. Hemophilia A
C. ITP
D. Factor V Leiden mutation

A

A. vWD

20
Q

Which procedure reduces the risk of human
leukocyte antigen (HLA) alloimmunization,
febrile nonhemolytic transfusion reactions
(FNHTRs), and CMV transmission?

A. Leukoreduction
B. Washing
C. Irradiation
D. RBC preservation

A

A. Leukoreduction

21
Q

This complication of warfarin therapy occurs in
patients with congenital protein C deficiency:

A. Warfarin-induced thrombocytopenia
B. Warfarin-induced skin necrosis
C. Warfarin-induced anemia
D. Warfarin-induced anaphylactic shock

A

B. Warfarin-induced skin necrosis

22
Q

The reversal agent Andexxa is indicated for life threatening or uncontrollable hemorrhage in patients receiving:

A. Enoxaparin (Lovenox)
B. Apixaban (Eliquis)
C. Pradaxa (Dabigatran)
D. Clopidogrel (Plavex)

A

B. Apixaban

Andexxa, (coagulation factor Xa [recombinant], inactivated-zhzo) is a specific antidote for direct factor Xa inhibitors. These include rivaroxaban, edoxaban and betrixaban.

There is also a specific reversal for Dabigatran,
idarucizumab, sold as Praxabind. Enoxaparin can be reversed with protamine, but clopidogrel has no specific reversal agent.

RIVAROXABAN = Andexxa

ENOXAPARIN = Protamine

CLOPIDOGREL = No reversal agent

ANESTHESIA | Basic (17 decks)

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