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Hematology 2 > Lecture - Module 3 > Flashcards

Lecture - Module 3 Flashcards

1
Q

Involves the activation of plasma proteins (serine proteases) in the coagulation system to form a fibrin meshwork.

A

Secondary Hemostasis

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2
Q

A process whereby, on vessel injury, plasma proteins, tissue factors, and calcium interact on the surface of platelets to form a stable fibrin clot. Platelets also interact with fibrin to form a stable platelet-fibrin clot.

A

Coagulation

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3
Q

Factor I

A

Fibrinogen

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4
Q

Factor Ia

A

Fibrin

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5
Q

Factor II

A

Prothrombin

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6
Q

Factor IIa

A

Thrombin

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7
Q

What type of proteins are Factor I and II

A

glycoprotein

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8
Q

Factor III

A

Tissue Factor

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9
Q

Factor III when activated is called

A

Thromboplastin

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10
Q

What type of protein is thromboplastin

A

lipoprotein

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11
Q

Factor IV

A

Calcium

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12
Q

Factor V

A

Proaccelerin

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13
Q

Factor V is also called as

A

labile factor

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14
Q

Also known as Christmas factor

A

Factor IX

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15
Q

Stable factor

A

Factor VII

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16
Q

Labile factor

A

Factor V

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17
Q

Factor VII

A

proconvertin

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18
Q

Proconvertin is also known as

A

serum prothrombin conversion accelerator

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19
Q

Factor VIII

A

AHF (anti hemophilic factor)

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20
Q

AHF is also known as

A

AHG (anti hemophilic globulin)

Anti hemophilic factor A

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21
Q

Factor IX

A

PTC (plasma thromboplastin component)

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22
Q

PTC is also known as

A

Anti hemophilic factor B

Christmas factor

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23
Q

Factor X

A

stuart-prower factor

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24
Q

Factor XI

A

PTA (plasma thromboplastin antecedent)

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25
Q

PTA is also known as

A

Anti hemophilic factor c

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26
Q

Factor XI is what type of protein

A

Beta/gamma globulin

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27
Q

Factor XII

A

Hageman factor

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28
Q

Hageman factor is also known as

A

Contact or glass surface

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29
Q

Factor XII is what type of protein

A

sialoglycoprotein

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30
Q

Factor XIII

A

FSF (fibrin stabilization factor)

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31
Q

FSF (fibrin stabilization factor) is also known as

A

Fibrinase

Laki lorand factor

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32
Q

Factor XIII is what type of protein

A

beta/gamma glycoprotein

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33
Q

Prekallikrein is also known as

A

Fletcher factor

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34
Q

High molecular weigh kininogen (HMWK) is also known as

A

Fitzregald/William/Flaujeac factor

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35
Q

Prekallikrein and HMWK is what type of proteins

A

plasma protein

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36
Q

Inactivated form of the coagulation factor

A

zymogens

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37
Q

Substances needed by the enzyme to proceed with the reaction.

A

Cofactors

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38
Q

Activated form of the coagulation factor.

A

Enzymes/Serine Protease

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39
Q

Classifications According to hemostatic function

A

Zymogens
Cofactor
Enzymes/Serine proteases

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40
Q

Requires Vitamin K for its production in the liver.

A

Prothrombin group/Vit. K dependeng group

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41
Q

Factors consumed during the clotting process.

A

Fibrinogen group/Labile group

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42
Q

First factors that are activated during the coagulation process. (Intrinsic pathway)

A

Contact group

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43
Q

Classifications According to Physical properties

A

Prothrombin/vitamin k dependent group
Fibrinogen/labile group
Contact group

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44
Q

Activated by contact with S.E.C.

A

Intrinsic pathway

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45
Q

Activated by contact with Tissue thromboplastin

A

Extrinsic pathway

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46
Q

A cascade that results in the activation of prothrombin that is needed to convert fibrinogen to fibrin.

A

Common pathway

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47
Q

Extrinsic pathway composed of

A

Factor VII

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48
Q

Activated by the release of Tissue factor from the injured vessel into the plasma.

A

Extrinsic pathway

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49
Q

capable of binding to Factor VII, converting it to Factor VIIa

A

Tissue factor

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50
Q

Factor VIIa will then activate

A

Factor X to Factor Xa

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51
Q

Intrinsic Pathway composed of

A

VIII, IX, XI, XII, HMWK and Prekallikrein

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52
Q

Activated when the S.E.C. comes into contact with the coagulation factors

A

Intrinsic Pathway

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53
Q

Negatively charged surfaces are capable of activating

A

Factor XII

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54
Q

Collagen, Elastin

in vivo or in vitro

A

in vivo

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55
Q

Glass, Kaolin

in vivo or in vitro

A

in vitro

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56
Q

Starts with the activation of Factor X to Factor Xa by either intrinsic or extrinsic pathway.

A

Common Pathway

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57
Q

Factor Xa, with the help of ____________ will activate ______ to ________

A

Calcium, PF3 and Factor V

prothrombin to thrombin

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58
Q

Thrombin will then activate

A

Fibrinogen to become Fibrin

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59
Q

Upon the action of ________, Fibrin monomers will be strengthened and produce a stable fibrin clot.

A

factor XIII

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60
Q

Tests the composite action of all plasma factors acting simultaneously

A

Coagulation Time

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61
Q

Clotting time is a measure of the ability of the blood to clot and is not influenced by the platelet functions other than

A

PF3

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62
Q

It also measures only the time required for the formation of the traces of thrombin sufficient to produce a visible clot.

A

Coagulation Time

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63
Q

Types of coagulation time

A

micromethods

macromethods

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64
Q

2 types of micromethods in coagulation time

A

SLIDE OR DROP METHOD

CAPILLARY or DALE AND LAIDLAW’S METHOD

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65
Q

 Puncture the ring/middle finger
 Start timer then transfer blood to slide every 30 seconds.
 Observe for fibrin string.

A

SLIDE OR DROP METHOD

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66
Q

 Collect non-heparinized blood
 Start timer and fill 3 capillets
 After 30 secs, break the capillet
 Observe for fibrin string.

A

CAPILLARY or DALE AND LAIDLAW’S METHOD

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67
Q

Superior for there is less contamination of the plasma with tissue fluids when blood is drawn from a vein.

A

Macro Methods

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68
Q

Test in macromethods of coagulation time

A

Lee-White Method or Whole Blood Clotting Time

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69
Q

 Wash the test tube using sterile NSS
 Collect 3 ml of blood and transfer it to the test tube
 Every 30 secs, tilt the tube and observe for clot.

A

Lee-White Method or Whole Blood Clotting Time

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70
Q

Normal value in Lee-White Method or Whole Blood Clotting Time

A

5-10 minutes

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71
Q

More sensitive method than the coagulation time of whole blood because there is an activator added.

A

Plasma Recalcification Time

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72
Q

May reveal abnormality which is not detectable by the determination of the clotting time of venous blood.

A

Plasma Recalcification Time

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73
Q

The activated recalcification time makes use of

A

0.025 M CaCl2

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74
Q

NORMAL VALUE in plasma recalcification time

A

Less than 50 seconds

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75
Q

Test for the INTRINSIC and COMMON pathways of coagulation

A

Partial Thromboplastin Time

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76
Q

Calcium ions and phospholipids that substitute for platelet phospholipids are added to blood plasma.

A

Partial Thromboplastin Time

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77
Q

Partial Thromboplastin Time Detects deficiencies in

A

Factors XII, XI, IX, VIII

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78
Q

Measures the EXTRINSIC and COMMON pathway of coagulation

A

Prothrombin Time

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79
Q

It is used to monitor oral anticoagulant therapy

A

Prothrombin Time

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80
Q

Used to detect VII deficiency.

A

Prothrombin Time

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81
Q

Prothrombin Time NORMAL RANGE

A

10-14 seconds

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82
Q

The prothrombin time is therefore prolonged if there is a deficiency of

A

Factors V, VII or X

severe defieciency of Factor I and II

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83
Q

Prothrombin Time NORMAL RANGE

A

10-14 seconds

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84
Q

Similar to PTT test but with the addition of activators to hasten the production of a visible result

A

Activated Partial Thromboplastin time

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85
Q

Activators in aPTT

A

silica or ellagic acid, kaolin, and phospholipids

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86
Q

normal range in aptt

A

25-35 seconds

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87
Q

Measures the time of the conversion of fibrinogen to fibrin clot

A

Thrombin time

88
Q

Evaluation of a prolonged thrombin time (TT)

It is mainly used to confirm or exclude the presence of heparin in the specimen or specimen type

A

Reptilase time

89
Q

Reptilase time uses Reptilase from the snake venom of

A

Bothrops atrox

90
Q

Reptilase time normal range

A

18-20 secs

91
Q

What coagulation factor deficiency
Afibrinogenemia
Hypofibrinogenemia
Dysfibrinogenemia

A

Factor I

92
Q

What coagulation factor deficiency

Prothrombin deficiency

A

Factor II

93
Q

What coagulation factor deficiency

Prothrombin deficiency

A

Factor II

94
Q

What coagulation factor deficiency

Hypoprothrombinemia

A

Factor II

95
Q

What coagulation factor deficiency

Owren’s Disease

A

Factor V

96
Q

What coagulation factor deficiency

Owren’s Disease

A

Factor V

97
Q

What coagulation factor deficiency

Parahemophilia

A

Factor V

98
Q

What coagulation factor deficiency

Hypoproconvertinemia

A

Factor VII

99
Q

What coagulation factor deficiency

Classic Hemophilia

A

Factor VIII

100
Q

What coagulation factor deficiency

Hemophilia A

A

Factor VIII

101
Q

What coagulation factor deficiency

Royal’s disease

A

Factor VIII

102
Q

What coagulation factor deficiency
Christmas factor disease
HemoPhilia B

A

Factor IX

103
Q

What coagulation factor deficiency

Stuart-Prower disease

A

Factor X

104
Q

What coagulation factor deficiency

HemoPhilia C

A

Factor XI

105
Q

What coagulation factor deficiency

Rosenthal Disease

A

Factor XI

106
Q

What coagulation factor deficiency

Associated with Poor wound healing

A

Factor XIII

107
Q

Stypven Time also known as

A

russel’s viper venom time

108
Q

Used to distinguish deficiencies of Factor X and those of Factor VII.

A

Stypven Time (Rusell’s viper venom Time)

109
Q

It is also used to detect deficiencies in prothrombin, fibrinogen and factors V and X.

A

Stypven Time

110
Q

It differs from prothrombin time in that deficiencies in factor VII are not detected.

A

Stypven Time

111
Q

Used to detect deficiency in Factor XIII

A

Duckert’s Test

112
Q

A test used to pinpoint the exact coagulation factor that is deficient

A

Mixing Studies/Substitution Test

113
Q

inhibitor that inhibits the cascade.

A

Warfarin

114
Q

In Mixing Studies/Substitution Test, If one or both of the results become normal, what does it indicate

A

a coagulation factor deficiency is suggested

115
Q

In Mixing Studies/Substitution Test, If the results remain the same, what does it indicate

A

there might be a presence of an inhibitor eg. Warfarin,

116
Q

Plasma that contains all coagulation factors

A

fresh plasma

117
Q

Aged plasma does not contain

A

V

VIII

118
Q

Adsorbed plasma does not contain

A

II
VII
IX
X

119
Q

Fresh serum does not contain

A

I
V
VIII
XIII

120
Q

Fresh serum does not contain

A

I
V
VIII
XIII

121
Q

Aged serum does not contain

A 
I
II
V
VIII
XIII
122
Q

most prominent pathway

A

intrinsic

123
Q

the most important factor according to salvage theory

A

TF

VII

124
Q
  • induce formation of stable fibrin clot

- factors that induce coagulation

A

Procoagulants

125
Q

Stable fibrin clot in vivo, in laboratory it is called

A

fibrin polymer

126
Q
  • first one to be discovered, most abundant of all the coagulation factors
A

Fibrinogen

127
Q

Most prominent coagulation factor is

A

thrombin

128
Q

Most coagulation factors came from

A

liver

129
Q

coagulation factor that is active in intrinsic pathway

*??

A

Proconvertin

130
Q

labile, doesn’t swim alone, partners with VWF

A

Factor VIII

131
Q

antihemophilic factor C, milder than hemophilia A

A

Factor XI

132
Q
  • products of liver, inactive, they are in blood but has no roles unless there is tissue injury
A

Zymogen or proenzyme

133
Q

4 cofactors/accelerators, will act on the next step for only few seconds

A

V
III
TF
HMWK

134
Q

Prothrombin group

A

II, VII, IX, X

135
Q

inhibitors under prothrombin group

A

protein C and S

136
Q

Prothrombin group - II, VII, IX, X, inhibitors - protein C and S, not procoagulants they are anticoagulant, has same characteristics physically and all of these will be absorbed by

A

aluminum hydroxide

barium sulfate

137
Q

major anticoagulant or regulator/inhibitor

A

Protein C

138
Q

cofactor of Protein C

A

protein S

139
Q

What factors are not found in adsorbed plasma-

A

prothrombin or vitamin k dependent group

140
Q
  • process in which aluminum hydroxide/barium sulfate are placed to let factors be absorbed, centrifugate is called adsorbed plasma
A

adsorption

141
Q

Fibrinogen group/labile group consists of what factors

A

I
V
VIII
XIII

142
Q

elevated amount during pregnancy and other inflammatory conditions

A

Fibrinogen group

143
Q

not that sensitive to temperature so they are not destroyed at once

A

contact group

144
Q

Enumerate those under contact group

A

XI
XII
prekallikrein
high molecular weight kininogen

145
Q

tests that replaced clotting time

A

PT

aPTT

146
Q

Deficiency or Inhibitors for intrinsic pathway and common pathway can be detected through

A

aPTT

PTT

147
Q

Deficiency or Inhibitors for extrinsic pathway and common pathway can be detected
through

A

Prothrombin time

148
Q

What assays is APTT

A

clot-based assays

149
Q

will happen when tissue factor/juice/thromboplastin is released then will activate FVII - FVIIa, then together with FIXa (serine proteases) will activate FX-FX

A

Extrinsic pathway

150
Q

When factor X becomes Xa and V becomes Va (serine protease) in the presence of calcium and ppl/platelet factor 3 they will now form

A

PROTHROMBINASE COMPLEX

151
Q

Prothrombinase - prothrombin to thrombin, Factor II-IIa will act on fibrinogen to form fibrin clot but will not happen without what factor

A

Factor XIII (Transglutaminase)

152
Q

what phase where there activation of factor X - Xa or common pathway

A

Contact phase

153
Q

Why we don’t like tissue factor/juice to contaminate our blood sample during collection

A

hasten/make reaction fast, result will be erroneously short

154
Q

what factor has feedback loop mechanism

A

XIIa (contact factor)

155
Q

Saan unang umaaksyon sa intrinsic pathway ang calcium? -

A

XIa to convert IX to IXa

156
Q

Routine hema uses what anticoagulant tube

A

EDTA

157
Q

Anticoagulant for special hema

A
  • heparin
158
Q

Anticoagulant for hemostatic and coagulation test

A

sodium citrate

159
Q

most used anticoagulant

A

3.2% buffered sodium citrate

160
Q

what plasma is used in almost all routine test

A

ordinary plasma

161
Q

prolongs clotting time, slower result

A

Plastic or siliconized container

162
Q

Factor XIII will become XIIIa because of the presence of

A

thrombin

163
Q

most abundant, acute phase protein

A

Fibrinogen

164
Q

abundant hemophilia c is common in

A

Jewish people

165
Q

more accurate method

macro or micro

A

macro

166
Q

In doing Dale and laidlaw’s method what will you be using

non-heparinized or heparinized

A
  • non heparinized (blue)
167
Q
  • anti thromboplastin
A

Heparin

168
Q

Reagent in PT

A

complete thromboplastin made up of lypoid/lipoprotein (lungs and brain)

169
Q

reptilase time replace what previous method

A

thrombine time

170
Q

substrate in TT

A

fibrinogen

171
Q

for measuring oral anticoagulant, more accurate than PT, derived from a computed formula where we incorporate international sensitivity index there is no unit, able to standardized results between laboratories.

A

INR - international normalized ratio

172
Q

inferential. used for patients with prolonged pt/aptt to identify which factors are deficient.

A

Mixing/substitution

173
Q

Patients with prolonged pt/aptt to identify which factors are deficient.

A

V and VIII -

174
Q

Activated when placed in refrigerator for long time

A

VII, XI

175
Q

how will you process Aged plasma

A

plasma from blue tube incubate for 24 hrs at 37 degC

176
Q

4 STAGES IN BLOOD COAGULATION : WATERFALL OR CASCADE THEORY

A
  1. Contact phase
  2. activation of common pathway
  3. conversion of prothrombin to thrombin
  4. formation of stable fibrin clot
177
Q

activated form; enzymes; denoted with subscript small letter “ a”

A

Serine proteases - Factors IIa, VIIa, IXa, Xa, Xia, XIIa

178
Q

hastens the coagulation factors’ activity

A

Cofactors/ Accelerators- Factor III, Factor V, Factor VIII, HMWK

179
Q

acted by enzymes/ serine proteases

A

Substrate- Factor I ( fibrinogen)

180
Q

Transamidase/ Transglutaminase

A

Factor XIII

181
Q

Preferred anticoagulant

A

0.109 M ( or 3.2% ) buffered sodium citrate and is with 1:10 dilution (1 part anticoagulant plus 9 parts blood)

182
Q

All tubes for coagulation studies should be

A

“non-contact” surface, meaning plastic and siliconized container

183
Q

Blood specimens with a hematocrit of 55%, what formula should be done

A

Amount of sodium citrate = 100 - hematocrit / 595-hematocrit x amount of blood used

184
Q

.Specimen should be centrifuged within

A

1 hour of obtaining the sample

185
Q

After centrifugation, blood should be removed immediately with what type of pipette and container

A

plastic or siliconized pipette and stored to a plastic or siliconized container.

186
Q

What fraction of plasma layer should be aspirated.

A

¾ of the plasma layer should be aspirated

187
Q

For some tests, centrifugation of the sample at a temperature of

A

2-4degrees Centigrade

188
Q

The buffering effect of red cells is lost when

A

it is centrifuged and the plasma exposed to air

189
Q

Testing should be done immediately on centrifuged samples or the plasma should be stored at

A

4 degrees Centigrade for a time not to exceed 2 hours

190
Q

Pipettes, test tubes, and other materials which come in contact with plasma should have a

A

“non-contact” surface (plastic, siliconized)

191
Q

Specimens should be stoppered always

TRUE OR FALSE

A

TRUE

192
Q

Specimens should not be frozen if testing can be done within

A

2 hours after collection

193
Q

If freezing is necessary, it should be done rapidly at

A

-20 degrees Centigrade or lower

194
Q

If frozen properly, fibrinogen is stable for at least

A

4 hours after thawing and survives refreezing and thawing

195
Q

With the exception of platelet function tests, plasma for coagulation testing should be

A

platelet poor( less than 10X 10 to the 9th/ L)

196
Q

Red cells contain _____ which is released in the plasma may activate the platelets.

A

ADP

197
Q

automated machines may not be able to detect the

A

end point on some lipemic or icteric plasma samples

198
Q

platelet-poor plasma (PPP) or ordinary plasma should be stored at

A

-40 degrees Centigrade or lower

199
Q

platelet-poor plasma (PPP) or ordinary plasma should be initially frozen in

A

liquid nitrogen or a temperature ofn-80 degrees Centigrade to -40 degrees Centigrade

200
Q

When thawing frozen plasma, it should be

A

done rapidly in a 37degrees Centigrade incubator or water bath

201
Q

plasma should be stored in

A

aliquots

202
Q

Normal samples collected collected in evacuated tubes and stored unopened at room temperature for as long as ______ show no significant changes in PT or APTT results.

A

6 hours

203
Q

If samples are left at room temperature for an extended time, these factors will deteriorate

A

factors V and VIII

204
Q

factors ___________ will tend to be prematurely activated at refrigerator temperature of ____

A

Factors VII and XI

4 degrees Centigrade

205
Q

Blood preparation for patient’s plasma

A

Mix 4.5 mL blood and 0.5 mL 0.109 M sodium citrate

Centrifuge at 1500 rpm for 5 minutes

206
Q

Blood preparation for adsorbed normal plasma

A

Mix 2 mL of plasma and add 0.2 mL adsorbing reagent.
Centriguge at 3,000 rpm for 3 minutes.
Refrigerated plasma should be used within 2 hours.

207
Q

Adsorption – process of removing factors II, VII, IX and X from normal plasma by the use of certain insoluble salts of alkaline earth like

A

aluminum hydroxide gel, barium sulfate and carbon phosphate.

208
Q

In adsorption, these factors are not adsorbed

A

Factors XII, V and VIII

209
Q

In adsorbed normal plasma

A

Mix 2 mL of plasma and add 0.2 mL adsorbing reagent.
Centrifuged at 3,000 rpm for 3 minutes.
Refrigerated plasma should be used within 2 hours.

210
Q

In Aged normal plasma

A

Collect plasma in the usual manner.
Incubate at 37 degrees Centigrade for 24 hours
Store in aliquots at 20 degrees Centigrade.

211
Q

In Aged normal serum

A

Collect serum in the usual manner.
Allow to stand at room temperature for 24 hours.
Divide in aliquots and freeze.

212
Q

Preparation for Platelet-poor plasma (PPP)

A

Mix 9 parts of blood and 1 part of 0.109 M sodium citrate

Centrifuge at 3,000 for 30 minutes

213
Q

Preparation for Platelet-rich plasma

A

Centrifuge at 1,500 rpm for 5 minutes

214
Q

Less than 100,000/uL=

A

abnormally low

215
Q

30,000-50,000=

A

bleeding possible with trauma

216
Q

Less than 30,000/uL=

A

spontaneous bleeding possible

217
Q

Less than 5,000/uL=

A

severe spontaneous bleeding

Hematology 2 (8 decks)

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