Pathophys II- Hemostasis

Question 1

Which test measures Extrinsic pathway?

Answer 1

PT

Question 2

Which test measures Intrinsic pathway?

Answer 2

aPTT

Question 3

aPTT means

Answer 3

activated Partial Thromboplastin Time

Question 4

Bleeding time measures=

Answer 4

PLT ability of adhesion to vessel walls

Question 5

Normal BT value

Answer 5

3-8 min

Question 6

BT↑ when PLT__

Answer 6

Decrease

Question 7

If BT↑ and PLT are normal=

Answer 7

Problem with PLT function

Question 8

What is needed for aPTT?

Answer 8

Phospholipid
Surface
Calcium

Question 9

Normal aPTT time=

Answer 9

30-40 sec

Question 10

When checking for aPTT, are there any PLT?

Answer 10

No

Only plasma

Question 11

How de we detect Inhibitors?

Answer 11

We mix patient plasma with normal plasma 1:1

Question 12

If PT and aPTT prolonged

Answer 12

Inhibitor of common pathway or strong lupus inhibitor

Question 13

Initiation of extrinsic pathway

Answer 13

TF
Lipid
Calcium

Question 14

Normal PT time

Answer 14

10-14 sec

Question 15

Normal INR

Answer 15

1

Question 16

Prolonged PT may mean-

Answer 16

Deficiency of:
I
II
V
VII
X
Oral anticoagulant

Question 17

TT determines

Answer 17

Rate of thrombin induced fibrinogen cleavage

Question 18

Normal value TT

Answer 18

<20 sec

Question 19

Prolonged TT means

Answer 19

Many things-

<100 mg/dL Fibrinogen

Question 20

Normal value Fibrinogen

Answer 20

200-400 mg/dL

Question 21

Decreased FIbrinogen seen in

Answer 21

Liver disease

DIC

Question 22

Which clotting factors need vitamin K?

Answer 22

II
VII
IX
X
Protein S
Protein C

Question 23

Warfarin mechanism

Answer 23

Blocks enzyme that activates vit.K

Question 24

D-dimer may be elevated in

Answer 24

DIC
Venous thromboembolism
Infection
Cancer
Pregnancy

Question 25

Heparin mecahnism

Answer 25

Binds Antithrombin III and activates it

Question 26

Laboratory alteration in DIC

Answer 26

PLT↓ FIbrinogen↓ D-dimer in serum and urine

Question 27

When do Purpura happens?

Answer 27

When small blood vessels burst

Question 28

High MPV may mean

Answer 28

We produce too many PLT

Question 29

Patient with thrombocyopenia and known history of SLE=

Answer 29

Idiopathic Thrombocytopenic purpura

Question 30

What shoould we check in order to determine Idiopathic Thrombocytopenic purpura

Answer 30

Auto ab

Question 31

Immune complex deposition is type __ HSN

Answer 31

III

Question 32

Patient with thrombocyopenia and known history of SLE. | How can we explain the renal failure?

Answer 32

Lupus nephritis- Immune complex deposition

Question 33

What can explain the anemia in this patient with SLE?

Answer 33

Renal failure means low EPO

Question 34

WHy low PLT in the patient with SLE

Answer 34

Spleen recognize the Ab coated PLT and destroys them

Question 35

BUN=

Answer 35

Blood Urea Nitrogen

Question 36

Recurrent epileptic seizures Fever Purpura Low PLT

Answer 36

Thrombotic Thrombocytopenic purpura

Question 37

Thrombotic Thrombocytopenic purpura mecahnism

Answer 37

- Antibodies inhibiting ADAMTS13 | - ADAMTS13 disfunction

Question 38

ADAMTS13 job

Answer 38

Breaks down multimers of vWF

Question 39

What happens when multimers of vWF are not broken down?

Answer 39

More prone to coagulation | Coagulation happens ,ore frequently in the microcirculation

Question 40

Why LDH is high in Thrombotic Thrombocytopenic purpura

Answer 40

RBC passing microscopic clots are subject to shear stress→Membrane damage→Rupture of RBC

Question 41

Why anemia and schistocyte in Thrombotic Thrombocytopenic purpura?

Answer 41

RBC passing microscopic clots are subject to shear stress→Membrane damage→Rupture of RBC

Question 42

Why renal failure in Thrombotic Thrombocytopenic purpura?

Answer 42

Microthrombi in renal vessels

Question 43

Why Haptaglobin is low in Thrombotic Thrombocytopenic purpura?

Answer 43

Intravascular hemolysis

Question 44

What od we expect to see on blood smear in case of Thrombotic Thrombocytopenic purpura?

Answer 44

Schistocytes

Question 45

Normal ESR values

Answer 45

0-20 mm/h

Question 46

Is CK 160 U/l normal?

Answer 46

Yes

Question 47

Which cardiac marker should be elevated in MI?

Answer 47

CK-MB

Question 48

CK-MB means

Answer 48

Creatine Kinase Myocardial Band

Question 49

Right swollen thigh Dilated superficial veins Dyspnea Chest pain

Answer 49

DVT with PE

Question 50

How to confirm DVT with PE

Answer 50

Ultrasound Chest CT angiogram ECG

Question 51

What pattern on ECG can we see in PE

Answer 51

S1Q3T3

Question 52

Patient with: PLT↓↓↓ BT↑ Normal coagulation parameters

Answer 52

Severe Thrombocytopenia

Question 53

What can cause Severe Thrombocytopenia?

Answer 53

Acute Leukemia Autoimmune Thrombocytopenia Drug induced

Question 54

TT normal value | Thrombin Time

Answer 54

<20 sec

Question 55

Why we see aPTT↑ in vWF disease?

Answer 55

Bcs it is bound to fVIII usually and without it fVIII has shorter life time and it effects the Intrinsic pathway

Question 56

How can we make sure it is vWF disease except genetics?

Answer 56

Ristocetin aggregation test

Question 57

Describe Ristocetin

Answer 57

Ristocetin enhance vWF ans PLT GPbI addhesion

Question 58

GPbI deficieny is called

Answer 58

BSS | Bernard Soulier Syndrome

Question 59

Normal ESR

Answer 59

<20 mm/h

Question 60

TT value

Answer 60

<20 sec

Question 61

Pain in the leg+elevaated D-Dimer can be due to

Answer 61

DVT

Question 62

What can trigger formation of Anti-phospholipid Ab?

Answer 62

HLA-DR7 mutation

Question 63

HLA-DR7 makes what protein

Answer 63

MHC-II on B cells

Question 64

Young women eith SLE and aPTT↑

Answer 64

Antiphospholipid syndrome

Question 65

We can diagnose TTP while checking for

Answer 65

ADAMTS-13