SPECIAL EVALUATION FOR COAGULATION DISORDERS

Question 1

reptilase is an enzyme found in the venom of

Answer 1

bothrops atrox

Question 2

this enzyme is Capable of converting fibrinogen to fibrin and is unaffected
by heparin

Answer 2

REPTILASE

Question 3

Helpful in testing for functional fibrinogen
when the thrombin time is prolonged because of heparin.

Answer 3

reptilase time

Question 4

REPTILASE TIME has the same function as

Answer 4

thrombin

Question 5

both __ and __ time will be PROLONGED when the level of fibrinogen is decreased

Answer 5

reptilase time and thrombin time

Question 6

conditions wherein a level of fibrinogen is normal but not functional

Answer 6

dysfibrinogenemia

Question 7

a treatment for thrombolytic agent and used in treatment with Myocardial infarction and bleeding? thrombosis to dissolve the clot

Answer 7

streptokinase therapy

Question 8

substances released during fibrinolysis

Answer 8

fibrin degradation products

Question 9

cases wherein reptilase time is increased or prolonged

Answer 9

dysfibrinogenemia
streptokinase therapy
fibrin degradation products

Question 10

Reference range of reptilase time

Answer 10

10-15 seconds

Question 11

explain why reptilase time increase in the presence of FDP

Answer 11

there’s a lysis of fibrin

Question 12

Specimen for reptilase time

Answer 12

citrated plasma

Question 13

Testing should be performed within how many hours in reptilase time

Answer 13

within 4 hrs

Question 14

if the testing for reptilase time can’t be conducted immediately, what is the correct temperature to store the sample?

Answer 14

freeze specimen at -20*C

Question 15

principle behind reptilase time

Answer 15

Reptilase is added to plasma ,it act by releasing fibrinopeptide A from the fibrinogen molecule, The resultant
monomers polymerize end to end ,forming a clotq

Question 16

in reptilase time ,

Reptilase is added to plasma ,it act by releasing ___ from the fibrinogen molecule,

Answer 16

fibrinopeptide A

Question 17

aside from the fibrinopeptide A that is released by fibrinogen molecule induced by reptilase, what is the other one being released?

Answer 17

fibrinopeptide B

Question 18

this 2 test is to assess the function of Fibrinogen

Answer 18

reptilase time and thrombin time

Question 19

ristocetin cofactor assay evaluates what

Answer 19

evaluate the function of von willebrand factor and assess if the patient has vWb disease

Question 20

ristocetin alone is used before as a treatment for?

Answer 20

staphylococcal infection

Question 21

reference range of ristocetin cofactor assay

Answer 21

60-180 %

Question 22

specimen of choice for ristocetin cofactor assay

Answer 22

platelet rich plasma

Question 23

plasma may be refrigerated up to how many hours prior to testing for ristocetin cofactor assay?

Answer 23

up to 8 hrs

Question 24

in ristocetin cofactor assay, if the test can’t be performed immediately, we must store the specimen to __

Answer 24

-20*C up to 8 weeks

Question 25

PROCEDURE for ristocetin cofactor assay

Answer 25

a blood sample is collected from the patient and the platelet-rich plasma is isolated ristocetin is added to plasma. If von willebrand factor is functioning normally, it will bind to the plt glycoprotein (GP1B) receptor and cause platelet aggregation in ristocetin

Question 26

Normal von Willebrand Factor Activity

Answer 26

if the von willbrand factor in the patient's plasma is functioning properly, ristocetin will induce normal platelet aggregation

Question 27

Decreased or Absent Aggregation interpretation in ristocetin cofactor assay

Answer 27

deficiency or dysfunction of von willebrand factor, which is characteristics of von willebrand disease

Question 28

The ristocetin cofactor assay is particularly sensitive for ______, where there is an abnormal interaction between vWF and platelets

Answer 28

Type 2B von Willebrand disease

Question 29

If the test results show 25 % ristocetin cofactor activity repeat the test using the ___ The final result would then be divided by2

Answer 29

undiluted plasma

Question 30

Duckert’s Assay is called as

Answer 30

5m urea solubility test

Question 31

Duckert’s Assay/5M Urea Solubility Test also known as

Answer 31

factor XIII assay

Question 32

Used to check for stability of clot

Answer 32

Duckert’s Assay/5M Urea Solubility Test/FXIII assay

Question 33

Stable Clot in Duckert's assay means

Answer 33

normal factor XIII activity - the clot remains intact after 24hrs in 5M urea

Question 34

dissolved Clot in Duckert's assay means

Answer 34

deficiency in factor XIII activity - the clot was been dissolved within 24hrs in 5M urea, which means the fibrin strands are not being properly cross-linked and stabilized

Question 35

In duckert's assay, if the 5M urea is not available, what are the other alternatives?

Answer 35

1% monochloroacetic acid 2% hydrochloric acid

Question 36

specimen of choice for fletcher factor assay

Answer 36

citrated platelet-poor plasma

Question 37

fletcher factor assay is used to check for __

Answer 37

pre kallikrein

Question 38

specimen for fletcher factor assay

Answer 38

citrated platelet poor plasma

Question 39

deficiency in fletcher factor assay will cause prolonged ___

Answer 39

prolonged APTT remember PT-EX and PTT-IX prothrombin is for extrinsic partial thromboplastin time is for intrinsic since fletcher factor is in intrinsic pathway, the one that will be prolonged in PTT

Question 40

are all patients with deficiency in fletcher factor exhibits bleeding?

Answer 40

not all patients, some may not and asymptomatic

Question 41

reagent for fletcher factor assay

Answer 41

aptt reagent, CaCl2

Question 42

in fletcher factor assay, the sample must be incubated for how many minutes

Answer 42

10 mns

Question 43

if there's a deficiency in fletcher factor, the APTT will become normal after 10 mn incubation true or false

Answer 43

true

Question 44

AGAROSE PLASMA GEL TECHNIQUE is used to assess ___

Answer 44

factor VIII inhibitors

Question 45

specimen of choice for AGAROSE PLASMA GEL TECHNIQUE

Answer 45

citrated platelet poor plasma

Question 46

reagent for AGAROSE PLASMA GEL TECHNIQUE

Answer 46

control plasma and CaCl2

Question 47

Agarose contains __ is poured on a plate

Answer 47

fresh normal plasma

Question 48

result in agarose plasma gel technique that means no inhibitors of factor VIII

Answer 48

cloudy or opaque wall shows due to fibrin clot

Question 49

result in agarose plasma gel technique that means a presence of inhibitors of factor VIII

Answer 49

clear zone around the well

Question 50

aside from inhibitors of factor VIII, we are checking ___ as well in agarose plasma gel technique

Answer 50

lupus anticoagulant

Question 51

effect if there's factor VIII inhibitors

Answer 51

both PT and aPPT are prolonged

Question 52

AGAROSE PLASMA GEL TECHNIQUE also used to differentiate ___

Answer 52

deficiency in clotting factor or just an inhibitor

Question 53

specimen of choice for bethesda inhibitor assay

Answer 53

citrated platelet poor plasma

Question 54

reagent in bethesda inhibitor assay

Answer 54

factor VIII and control

Question 55

procedure for bethesda inhibitor assay

Answer 55

PPP is mixed with known amount of Factor VIII and incubated at 37 C for 2 hours

Question 56

two assay that evaluates factor VIII inhibitors

Answer 56

bethesda inhibitor assay and agarose plasma gel technique

Question 57

Result: expressed in Bethesda units (1 Bethesda unit means _____ of Factor VIII is inhibited)

Answer 57

50%

Question 58

when do we perform mixing studies

Answer 58

if the PT or PTT are prolonged

Question 59

Mixing Study is also called as

Answer 59

substitution test

Question 60

purpose of mixing study

Answer 60

to know if the patient's problem is inhibitors or clotting factor deficiency

Question 61

coagulation factor that our normal plasma has

Answer 61

all coag factors

Question 62

how to make substitution reagent

Answer 62

look for 20 individual with normal coag factors