lab test for secondary hemostasis

Question 1

Measures period required for free formation of blood to clot after it has been removed from the body

a. clotting time
b. prothrombin time
c. APTT
d. bleeding time

Answer 1

CLOTTING TIME

❖ Measures period required for free formation of blood to clot after it has been removed from the body

❖ Capillary blood method N.V = 2-4 minutes

  - Slide and drop 
  - Capillary tube/ Dale and Laidlaw’s (risk- pinuputol tube/ not performed na ata)

❖ Whole blood/ Lee and White method (Tilt tube method)
N.V = 5-15 minutes
-uses glass tube 13x100mm in size (redtop)

Question 2

determine extrinsic and common pathway and it is used to monitor warfarin therapy

a. clotting time
b. prothrombin time
c. APTT
d. bleeding time

Answer 2

PROTHROMBIN TIME\
❖ NV 10-12 Seconds / 12.6 to 14.6 seconds (Rodak’s)
❖ Determine extrinsic and common pathway factor deficient
❖ It is used to monitor Warfarin/Coumadin therapy

Question 3

when the INR is 2.0 -4.0 what is the condition

a. prosthetic heart valves
b. DPT
c. recurrent DPT
d, myocardial infarction

Answer 3

2. 0-2.5
   - DVT, high risk surgery
3. 0-3.0
   
   • Hip surgery, femur fracture
4. 0-3.0
   
   • DVT, Pulmonary embolism, transient ischemic attack
5. 5-3.5
   
   • Mechanical/ prosthetic heart valves
6. 0-4.5
   - Recurrent DVT and pulmonary embolism, myocardial infarction, arterial disease

Question 4

what is the INR in femur fracture

a. 2.0-3.0
b. 2.0-4.5
c. 2.5 - 3.5
d. 2.0-3,5

Answer 4

2. 0-2.5
   - DVT, high risk surgery
3. 0-3.0
   
   • Hip surgery, femur fracture
4. 0-3.0
   
   • DVT, Pulmonary embolism, transient ischemic attack
5. 5-3.5
   
   • Mechanical/ prosthetic heart valves
6. 0-4.5
   - Recurrent DVT and pulmonary embolism, myocardial infarction, arterial disease

Question 5

Determines Intrinsic and common pathway factor deficient and used to monitors unfractionated heparin therapy

a. clotting time
b. prothrombin time
c. APTT
d. bleeding time

Answer 5

ACTIVATED PARTIAL THROMBOPLASTIN TIME

❖ Reference Value of 20-45 seconds
❖ Determines Intrinsic and common pathway factor deficient
❖ Monitors unfractionated heparin therapy

Question 6

which of the following is PTT reagent

a. calcium chloride
b. activator
c. tissue thromplastin
d. phospholipids

Answer 6

PTT reagent contains = Activator, Calcium chloride, and Phospholipids

PT reagent: tissue thromboplastin + CaCl2 (calcium chloride)

Question 7

Test for fibrinogen deficiency

a. APTT
b. bleeding time
c. reptilase deficiency
d. thrombin clotting time

Answer 7

thrombin time / thrombin clotting time

• Test for fibrinogen deficiency
• PPP + Thrombin calcium chloride
• thrombin reagent cleaves fibrinopeptides A and B from plasma fibrinogen

REPTILASE TEST
❖ Reptilase is an enzyme found in the venom of Bothrops athrox snake, capable of converting fibrinogen to fibrin
❖ Test for fibrinogen deficiency/ fibrinogen abnormality

answer : Reptilase and TcT

Question 8

It bypasses coagulation by directly activating factor X

a. APTT
b. bleeding time
c. reptilase deficiency
d. Stypven time

Answer 8

STYPVEN TIME/ RUSSEL VIPER VENOM TIME

❖ NV 6-10 Seconds
❖ From the viper (VIPERA RUSELLI) venom / from the DABOIA RUSSELLI VIPER
❖ It bypasses coagulation by directly activating factor X ❖ Determines coagulation factor deficiency in the common pathway

Question 9

capable of converting fibrinogen to fibrin

a. APTT
b. bleeding time
c. reptilase deficiency
d. Stypven time

Answer 9

REPTILASE TEST
❖ Reference value: 10-15seconds
❖ Reptilase is an enzyme found in the venom of BOTHROPS ANTHROX SNAKE , capable of converting fibrinogen to fibrin
❖ Test for fibrinogen deficiency/ fibrinogen abnormality ❖ PPP + ATROXIN (reptilase
❖ Principle: reptilase catalyzes the conversion of fibrinogen to fibrin. In contrast to thrombin, this enzyme cleaves only fibrinopeptide A.

Question 10

BOTHROPS ANTHROX SNAKE

a. APTT
b. bleeding time
c. reptilase deficiency
d. Stypven time

Answer 10

REPTILASE TEST
- enzyme found in the venom of BOTHROPS ANTHROX SNAKE , capable of converting fibrinogen to fibrin

STYPVEN TIME / RUSSEL VIPER VENOM TIME
- From the viper (VIPERA RUSELLI) venom / from the DABOIA RUSSELLI VIPER

Question 11

Screening test for factor XIII deficiency

a. APTT
b. Duckert’s tests
c. reptilase deficiency
d. Stypven time

Answer 11

DUCKERT’S TEST / 5 M UREA SOLUBILITY TEST
❖ Screening test for factor XIII deficiency
❖ Alternative reagents used can be:
1 % monochloroacetic acid
2 % acetic acid