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Coagulation CCMLS > quizzes 3 review > Flashcards

quizzes 3 review Flashcards

1
Q

. Plasminogen is activated to plasmin by all of the following except:
Calcium
TPA - Tissue Plasminogen Activator
Kallekrein
Urokinase
Streptokinase

A

Calcium

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2
Q

Which factor of the contact system, if deficient, may lead to a bleeding disorder? 1.HMWK
2. Prekallikrein
3. Factor XII
4. Factor XI
5. None of the above

A
  1. Factor XI
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3
Q

A patient with a known Factor IX deficiency can expect:

A

A prolonged APTT
clinical bleeding problems
a normal platelet count

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4
Q

This anticoagulant drug is a Vitamin K antagonist:

A

Coumadin

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5
Q

Protein C helps to control coagulation by:

A

Inactivating factors Va and VIIIa

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6
Q

All of the following are decreased in Von Willebrand’s disease except:
VIII:c
VIII:VWF Antigen
IX
VWF:Rco

A

IX

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7
Q

Which of the following should be considered if a patient has a prolonged APTT?

A

Patient may being treated with heparin
Hypofibrinogenemia and/or DIC
Patient Hct of 68%

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8
Q

Which of the following is/are true concerning FSP?

A

They are cleared by the reticuloendothelial system If present in large amounts, they may inhibit fibrin formation
They are formed by the action of plasmin on fibrin(ogen)

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9
Q

The reptilase time is a test that can be used to differentiate the presence of ____________ from a
fibrinogen abnormality

A

heparin

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10
Q

The factor deficient plasma used in a factor assay:

A

contains less than 1% of the factor being tested contains normal amounts of all factors except the one being tested
is added to the patient plasma before the PT or APTT is done

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11
Q

Factor XII can be activated by

A

contact with negatively charged surfaces kallekrein
collagen

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12
Q

When doing correction studies on a patient with a lupus inhibitor, what can be expected?

A

no correction with normal plasma, correction with saline, correction with reagent platelets

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13
Q

The anticoagulant and blood ratio used for routine coagulation testing:

A

sodium citrate; 1 part anticoagulant to 9 parts blood

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14
Q

Factor V Leiden is:

A

a genetic mutation of factor V a deficiency of factor V

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15
Q

A prolonged PT can result from all of the following EXCEPT:
Vitamin K deficiency
Liver disease
Presence of circulating anticoagulants (inhibitors) hypofibrinogenemia
Von Willebrand’s disease

A

Von Willebrand’s disease

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16
Q

Both the PT and APTT are sensitive to deficiencies of Factor:

A

II

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17
Q

Which of the following are consistent with a prolonged thrombin time?

A

Factor I deficiency

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18
Q

A PIVKA test is used primarily to diagnose:

A

Vitamin K deficiency

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19
Q

Which of the following present with an increased APTT and a clinical picture of thrombosis?

A

patient with lupus anticoagulant

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20
Q

true or false: If a patient has a severe Factor XIII deficiency, the following tests will be normal:
PT
APTT
TT
FSP

A

true

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21
Q

Which of the following tests will be abnormal for a patient with severe hemophilia B who has
developed a factor IX inhibitor:

A

APTT

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22
Q

Which of the following correction studies will be corrected for a patient with severe Factor V
deficiency:

A

PT 1:1 with normal plasma at 0 hours

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23
Q

Normal synthesis of Vitamin K dependent factors is impaired in:

A

liver disease
extremely poor diet
coumadin therapy
malabsorption
non-supplemented parenteral nutrition

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24
Q

The secondary phase of platelet aggregation is______ and induced by____from the platelet
granules.

A

irreversible; ADP

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25
Q

An inducer of platelet aggregation that is released from the platelet dense granules is:

A

adenosine diphosphate (ADP)

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26
Q

The ___________is a thin coating of proteins and mucopolysaccharides on the endothelial cells in the
vessels.

A

glycocalyx

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27
Q

Aspirin interferes with platelet function by:

A

inhibiting cyclooxygenase

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28
Q

Which of the following regulate vasoconstriction?
1. glycocalyx
2. thromboxane A2
3. serotonin
4. ADP

A
  1. thromboxane A2
  2. serotonin
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29
Q

Fibronectin is produced in the ______________ and has a role in________________.

A

endothelial cells; binding cells to one another

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30
Q

Heparan sulfate and thrombomodulin serve to:

A

inhibit fibrin formation

31
Q

Which are the most numerous of the platelet granules?

A

Alpha granules

32
Q

Which of the following are contained in the dense granules?
1. ADP
2. ATP
3. Calcium
4. Serotonin

A
  1. ADP
  2. ATP
  3. Calcium
  4. Serotonin
33
Q

Which of the following causes vasodilation?

A

prostacylin or PGI2

34
Q

In the platelet membrane, which of the following serves as the receptor for VonWillebrand factor?

A

Glycoprotein Ib

35
Q

Which of the following are roles of thromboxane A2?

A

stimulation of granule secretion and vasoconstriction

36
Q

Which of the following factors is exclusive to the extrinsic pathway of coagulation?
IV
VIII
IX
VII
XII

A

VII

37
Q

Which platelet membrane system stores intracellular calcium without connecting to the platelet
surface?

A

dense tubular system

38
Q

Which of the following statements are true regarding VonWillebrand’s factor?
1. it is found in the endothelium
2. it is found in the platelet
3. it is part of the circulating factor VIII molecule
4. it provides energy for platelet aggregation

A
  1. it is found in the endothelium
  2. it is found in the platelet
  3. it is part of the circulating factor VIII molecule
39
Q

true or false:
Primary platelet aggregation is
reversible

A

true

40
Q

true or false
Secondary platelet aggregation is
reversible

A

false

41
Q

true or false
Platelet adhesion and aggregation
requires the presence of calcium ions

A

false

42
Q

true or false
Coagulation proteins are produced in
the liver and the endothelium

A

true

43
Q

true or false
Factors I,II,V,VIII are the Vitamin K
dependent factors

A

false

44
Q

true or false
Factors XI, XII, PK, HMWK are the
contact factors

A

true

45
Q

true or false
Vitamin K acts to carboxylate certain
coagulation factors

A

true

46
Q

The APTT will be abnormally prolonged with:

A

deficiency of factor VIII

47
Q

The most common bleeding tendency of platelet defects is/are:

A

mucocutaneous bleeding

48
Q

Both the PT and APTT are sensitive to deficiencies of

A

Factor II

49
Q

The patient has a normal platelet count. Platelet aggregation studies show normal aggregation with
ristocetin, but abnormal aggregation with all other aggregating agents. The bleeding time and clot
retraction were abnormal. What disorder is suspected?

A

Glanzman’s thrombasthenia

50
Q

Which of the following may cause an increased bleeding time?
aspirin ingestion
Von Willebrands disease Vessel defect
platelet function defect

A

aspirin ingestion
Von Willebrands disease Vessel defect
platelet function defect

51
Q

Stabilization of the fibrin clot requires adequate amounts of:

A

Factor XIII

52
Q

Following receipt of a specimen in the lab, there is an 8 hour delay before the PT can be done. The
results would most likely be:

A

prolonged due to the loss of factor V

53
Q

The thrombin time evaluates which reaction(s) in the coagulation cascade?

A

fibrinogen to fibrin

54
Q

The proper anticoagulant to blood ratio for routine coagulation testing is:

A

1:9

55
Q

The following factors are consumed during in vitro clotting:

A

I,II,V,VIII,XIII

56
Q

Plasma is diluted in a fibrinogen assay to decrease the:

A

influence of inhibitors

57
Q

Normal value for PT is approximately:

A

12-15 sec

58
Q

A patient has the following results: history of mucocutaneous bleeding; PT=11 sec; APTT=30 sec;
prothrombin consumption test=33 sec; thrombin time=11 sec. What is a likely cause of this patient’s
coagulation difficulties?

A

thrombocytopenia

59
Q

Functions of activated factor XII include:

A

initiation of clotting cascade
positive feedback to PK to kallekrein reaction activation of factor XI activation of plasminogen activation of factor XI and initiation of clotting cascade

60
Q

The activated partial thromboplastin reagent in the APTT:

A

provides maximum contact activation

61
Q

Hemostatic disorders involving vessel or vascular supporting tissue abnormalities include:

A

hereditary hemorrhagic telangectasia and senile purpura

62
Q

Substances that have anti-plasmin activity include:

A

alpha 2 macroglobulin and alpha 2 antiplasmin

63
Q

A patient who has a hct >60% should have the anticoagulant adjusted in the blue top tube because:

A

excess anticoagulant will neutralize reagents

64
Q

Platelet adhesion means platelets sticking to___________; aggregation means platelets sticking
to____________.

A

the vessel; each other

65
Q

Primary hemostasis is defined as:

A

formation of platelet plug

66
Q

Factor I

A

fibrinogen

67
Q

Factor V

A

labile factor

68
Q

Factor X

A

Stuart-Prower factor

69
Q

Factor XII

A

Hageman factor

70
Q

The difference between ITP and TTP is/are:

A

TTP is characterized by thrombosis and ITP is characterized by immune destruction of platelets

71
Q

Which of the following aggregating agents normally have a biphasic curve?

A

ADP and epinephrine

72
Q

Vascular abnormalities that cause bleeding problems are often:

A

a diagnosis of exclusion

73
Q

Effects of aspirin on platelet function include(s)

A

inhibition of cyclooxygenase abnormal aggregation prolongation of the bleeding time

Coagulation CCMLS (8 decks)

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