WK9: Lab Monitoring of Secondary Hemostatic Disorders Flashcards
low PLTs
N or low fibrinogen
high D-dimer
DIC
N or low PLTs
N INR
N aPTT
Pregnancy
True or False:
PTT is used in alcoholic hepatitis and cirrhosis
True
N or low PLTs
N D-dimer and Fibrinogen
vWF disease
Clotting test can be abnormal due to either a _____ or ______
clotting factor deficiency
inhibitor or normal factor activity
ratio of patients plasma and pooled normal plasma
1:1
When a clotting test NORMALIZES the patient has a _______
factor deficiency
When a clotting test DOES NOT NORMALIZE the patient has a _______
factor inhibitor
True or False
If CT in the mixture is normalized when checked initially the test should be repeated and the mixed plasma is incubated at 30C
False (37C)
____ and ____ have low sensitivity and specificity for bleeding disorders
INR
PTT
True or False
Personal or family history of excessive bleeding is not as predictive or perioperative bleeding than coagulation tests
False (much more predictive)
_______ are proteins that precipitate when plasma is diluted with water and acidified
Euglobulin
Test in which inhibitors of fibrinolysis (antiplasmin and anti-plasminogen
activators) remains in the supernatant fluid
Euglobulin lysis time
plasminogen in the euglobulin fraction is converted to
______
plasmin
Action of thrombin on fibrinogen results in the formation of fibrin monomers that spontaneously polymerize to form a fibrin mesh
Protamine sulfate dilution test
largest competitive inhibitor of thrombin
X
detected in patients with DIC
D, E
When ________ is added to plasma, it displaces the secondary (smaller) degradation products from fibrin monomers and primary (larger) FDP, which will polymerize spontaneously
protamine sulfate
Normal result for protamine sulfate dilution test
no gel formation
In the presence of 50% solution of ethanol, any soluble fibrin monomers complexes present will dissociate
Ethanol gelation test
True or False
Ethanol gelation test is more sensitive and specific than protamine sulfate dilution test
False (less sensitive, more specific)
Latex particles coated with antibody against either fibrin(ogen) fragments D and E or human fibrinogen are mixed with patients serum
Latex FDP Assay
In latex FDP assay, If heparin is present in the sample ______ must be added to ensure complete clotting
snake venom
Added when plasma from patients with excessive fibrinolytic activity
trypsin
Whole blood is added to thrombin and soya bean enzyme
Thrombo-Wellcotest Method
In the Thrombo-Wellcotest Method, when fibrin split products are present, ________ occurs
agglutination
Fibrin split products are present in increased amounts with normal hepatic and renal function - it is assumed that _____ has taken place
fibrinolytic event
Source of Error:
Underfilling of citrate tube,
Polycythemia,
Sample from indwelling catheters (dilution or contamination with anticoagulants)
Falsely prolonged CT
Source of Error:
Overfilling citrate tube
Falsely shortened CT
Source of Error:
Elevated factor VIII
Falsely shortened aPTT in patients on heparin
Source of Error:
Heparin-like anticoagulants (in malignancies)
Falsely prolonged TT
Source of Error:
RF
Falsely high FDP and D-dimer
Source of Error:
Heparin, Lepirudin, Danaparoid, Argatroban
Falsely low factor levels
