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HEMATOLOGY 2 > SPECIAL EVALUATION FOR COAGULATION DISORDERS > Flashcards

SPECIAL EVALUATION FOR COAGULATION DISORDERS Flashcards

1
Q

reptilase is an enzyme found in the venom of

A

bothrops atrox

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2
Q

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

A

REPTILASE

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3
Q

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

A

reptilase time

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4
Q

REPTILASE TIME has the same function as

A

thrombin

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5
Q

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

A

reptilase time and thrombin time

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6
Q

conditions wherein a level of fibrinogen is normal but not functional

A

dysfibrinogenemia

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7
Q

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

A

streptokinase therapy

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8
Q

substances released during fibrinolysis

A

fibrin degradation products

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9
Q

cases wherein reptilase time is increased or prolonged

A

dysfibrinogenemia
streptokinase therapy
fibrin degradation products

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10
Q

Reference range of reptilase time

A

10-15 seconds

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11
Q

explain why reptilase time increase in the presence of FDP

A

there’s a lysis of fibrin

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12
Q

Specimen for reptilase time

A

citrated plasma

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13
Q

Testing should be performed within how many hours in reptilase time

A

within 4 hrs

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14
Q

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

A

freeze specimen at -20*C

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15
Q

principle behind reptilase time

A

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

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16
Q

in reptilase time ,

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

A

fibrinopeptide A

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17
Q

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

A

fibrinopeptide B

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18
Q

this 2 test is to assess the function of Fibrinogen

A

reptilase time and thrombin time

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19
Q

ristocetin cofactor assay evaluates what

A

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

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20
Q

ristocetin alone is used before as a treatment for?

A

staphylococcal infection

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21
Q

reference range of ristocetin cofactor assay

A

60-180 %

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22
Q

specimen of choice for ristocetin cofactor assay

A

platelet rich plasma

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23
Q

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

A

up to 8 hrs

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24
Q

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

A

-20*C up to 8 weeks

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25
Q

PROCEDURE for ristocetin cofactor assay

A

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

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26
Q

Normal von Willebrand Factor
Activity

A

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

27
Q

Decreased or Absent Aggregation interpretation in ristocetin cofactor assay

A

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

28
Q

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

A

Type 2B von Willebrand
disease

29
Q

If the test results show 25 % ristocetin cofactor activity repeat the test using the ___

The final result would then be divided by2

A

undiluted plasma

30
Q

Duckert’s Assay is called as

A

5m urea solubility test

31
Q

Duckert’s Assay/5M Urea Solubility Test

also known as

A

factor XIII assay

32
Q

Used to check for stability of clot

A

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

33
Q

Stable Clot in Duckert’s assay means

A

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

34
Q

dissolved Clot in Duckert’s assay means

A

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

35
Q

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

A

1% monochloroacetic acid
2% hydrochloric acid

36
Q

specimen of choice for fletcher factor assay

A

citrated platelet-poor plasma

37
Q

fletcher factor assay is used to check for __

A

pre kallikrein

38
Q

specimen for fletcher factor assay

A

citrated platelet poor plasma

39
Q

deficiency in fletcher factor assay will cause prolonged ___

A

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

40
Q

are all patients with deficiency in fletcher factor exhibits bleeding?

A

not all patients, some may not and asymptomatic

41
Q

reagent for fletcher factor assay

A

aptt reagent, CaCl2

42
Q

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

A

10 mns

43
Q

if there’s a deficiency in fletcher factor, the APTT will become normal after 10 mn incubation

true or false

A

true

44
Q

AGAROSE PLASMA GEL TECHNIQUE is used to assess ___

A

factor VIII inhibitors

45
Q

specimen of choice for AGAROSE PLASMA GEL TECHNIQUE

A

citrated platelet poor plasma

46
Q

reagent for AGAROSE PLASMA GEL TECHNIQUE

A

control plasma and CaCl2

47
Q

Agarose contains __ is poured on a plate

A

fresh normal plasma

48
Q

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

A

cloudy or opaque wall shows due to fibrin clot

49
Q

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

A

clear zone around the well

50
Q

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

A

lupus anticoagulant

51
Q

effect if there’s factor VIII inhibitors

A

both PT and aPPT are prolonged

52
Q

AGAROSE PLASMA GEL TECHNIQUE also used to differentiate ___

A

deficiency in clotting factor or just an inhibitor

53
Q

specimen of choice for bethesda inhibitor assay

A

citrated platelet poor plasma

54
Q

reagent in bethesda inhibitor assay

A

factor VIII and control

55
Q

procedure for bethesda inhibitor assay

A

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

56
Q

two assay that evaluates factor VIII inhibitors

A

bethesda inhibitor assay and agarose plasma gel technique

57
Q

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

A

50%

58
Q

when do we perform mixing studies

A

if the PT or PTT are prolonged

59
Q

Mixing Study is also called as

A

substitution test

60
Q

purpose of mixing study

A

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

61
Q

coagulation factor that our normal plasma has

A

all coag factors

62
Q

how to make substitution reagent

A

look for 20 individual with normal coag factors

63
Q
A

HEMATOLOGY 2 (14 decks)

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