Hemostasis Review

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Author:
AliciaBug
ID:
83410
Filename:
Hemostasis Review
Updated:
2011-05-03 23:30:22
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Hemostasis
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Review Exercise
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  1. Which of the following is
    the anticoagulant of choice for most coagulation studies?

    A. Sodium citrate 3.8%
    B. Heparin
    C. EDTA
    D. Sodium citrate 3.2%
    D. Sodium citrate 3.2%
    (this multiple choice question has been scrambled)
  2. Which ratio of anticoagulant to blood is correct for coagulation procedures
    1:9
  3. Which results would be expected
    for the prothrombin time (PT) and activated partial thromboplastin time (APTT)
    in a newborn with a hematocrit of 65%?

    a. Both prolonged
    b. Both shortened
    c. Normal PT, prolonged APTT
    d. Both normal
  4. What reagents are used in
    the PT test?
    • Thromboplastin
    • Calcium chloride
  5. Which tests will be
    abnormal in a patient with Stuart-Prower factor deficiency?

    a. PT
    b. APTT
    c. Thrombin time
    d. Two of the above
    d. Two of the above
  6. The following factors are
    measured by either the PT or APTT except:

    A. Factor VIII
    B. Factor XIII
    C. Factor IX
    D. Factor V
    B. Factor XIII
    (this multiple choice question has been scrambled)
  7. A modification of which
    procedure can be used to measure fibrinogen?

    A. PT
    B. APTT
    C. Thrombin time
    D. Fibrin degradation products
    C. Thrombin time
    (this multiple choice question has been scrambled)
  8. All of the following are characteristics
    of vitamin K except:

    A. It’s deficiency is caused by prolonged antibiotic treatment
    B. It is required for carboxylation of glutamine
    C. It’s activity is enhanced by heparin therapy
    D. It is required for biologic activity of some coagulation factors
    C. It’s activity is enhanced by heparin therapy
    (this multiple choice question has been scrambled)
  9. Which statement about the
    fibrin degradation product test is false?

    A. Evaluates the fibrinolytic system
    B. Detects late degradation products
    C. Elevated in disseminated intravascular coagulation
    D. Detects only degradation products from a stable fibrin clot
    D. Detects only degradation products from a stable fibrin clot
    (this multiple choice question has been scrambled)
  10. In a vitamin K deficient
    patient, which of the following coagulation tests will be abnormal?

    A. PT and APTT
    B. Bleeding time
    C. Fibrinogen level
    D. Thrombin time
    A. PT and APTT
    (this multiple choice question has been scrambled)
  11. Which of the following is
    incorrect regarding the international normalized ratio (INR)?

    A. Uses the international Sensitivity Index (ISI)
    B. Standardizes PT results
    C. Is valuable information for patients receiving oral anticoagulants
    D. Standardizes APTT results
    D. Standardizes APTT results
    (this multiple choice question has been scrambled)
  12. Which of the following is
    required for the endogenous activation of plasminogen?

    A. Tissue plasminogen factor
    B. Streptokinase
    C. Transamidase
    D. Stuart-Prower factor
    A. Tissue plasminogen factor
    (this multiple choice question has been scrambled)
  13. Which of the following is a primary inhibitor of the fibrinolytic system?

    A. Protein C
    B. Protein S
    C. α2- macroglobulin
    D. α2-antiplasmin
    D. α2-antiplasmin
    (this multiple choice question has been scrambled)
  14. All of the following are characteristics of thrombotic thrombocytopenic purpura except:

    A. Neurologic abnormalities
    B. Microangiopathic hemolytic anemia
    C. Renal dysfunction
    D. Thrombocytosis
    C. Renal dysfunction
    (this multiple choice question has been scrambled)
  15. All of the following physiological conditions may be associated with thrombocytopenia except:

    A. Increased production of pluripotential stem cells
    B. Increased platelet destruction
    C. Abnormal platelet distribution
    D. Decreased plateletproduction
    A. Increased production of pluripotential stem cells
    (this multiple choice question has been scrambled)
  16. Aspirin prevents platelet aggregation by inhibiting the action of which enzyme?

    A. Phospholipase
    B. Thomboxane α2 synthetase
    C. Prostacyclin synthetase
    D. Cyclooxygenase
    D. Cyclooxygenase
    (this multiple choice question has been scrambled)
  17. Which of the following factors is essential for normal platelet adhesion?

    A. Glycoprotein ΙΙb, ΙΙΙa complex
    B. Glycoprotein Ib
    C. Fibrinogen
    D. Calcium
    B. Glycoprotein Ib
    (this multiple choice question has been scrambled)
  18. Which of the following test result(s) is (are) normal in a patient with classic von Willebrand's disease?

    A. Factor VIII:C and vWF levels
    B. Bleeding time
    C. Activated partial thromboplastin time
    D. Platelet count
    D. Platelet count
    (this multiple choice question has been scrambled)
  19. All of the following laboratory results support the diagnosis of von Willebrand's disease except:

    A. Decreased factor VIII assay
    B. Increased bleeding time
    C. Normal platelet aggregation to ristocetin
    D. Decreased platelet retention
    C. Normal platelet aggregation to ristocetin
    (this multiple choice question has been scrambled)
  20. When performing platelet aggregation studies, which platelet aggregation responses would most likely
    occur in a patient with Bernard-Soulier syndrome?

    A. Normal platelet aggregation to collagen, ADP and ristocetin
    B. Normal platelet aggregation to epinephrine and ristocetin, decreased to collagen and ADP
    C. Normal platelet aggregation to collagen, ADP, and epinephrine, decreased aggregation to ristocetin
    D. Normal platelet aggregation to epinephrine, ristocetin and collagen, decreased to ADP
    C. Normal platelet aggregation to collagen, ADP, and epinephrine, decreased aggregation to ristocetin
    (this multiple choice question has been scrambled)
  21. Which of the following is characteristic of acute idiopathic thrombocytopenic purpura?

    A. Insidious onset
    B. Spontaneous remission within a few weeks
    C. Non-immune platelet destruction
    D. Found predominantly in adults
    D. Found predominantly in adults
    (this multiple choice question has been scrambled)
  22. TTP is different from DIC in that:

    A. Schistocytes are not seen in TTP but are present in DIC
    B. PT is prolonged in TTP but decreased in DIC
    C. Platelet count is decreased in TTP but normal in DIC
    D. APTT is normal in TTP but prolonged in DIC
    D. APTT is normal in TTP but prolonged in DIC
    (this multiple choice question has been scrambled)
  23. The APTT is sensitive to deficiency of:

    A. Platelet phospholipid
    B. Calcium
    C. Factor VII
    D. Factor X
    C. Factor VII
    (this multiple choice question has been scrambled)
  24. A patient with a prolonged PT is given intravenous vitamin K. After 24 hours the PT corrects to normal. What clinical condition most likely caused these results?

    A. Factor X deficiency
    B. Fibrinogen deficiency
    C. Obstructive jaundice
    D. Liver disease
    C. Obstructive jaundice
    (this multiple choice question has been scrambled)
  25. All of the following are characteristics of classic hemophilia A except:

    A. Normal bleeding time
    B. Severe hemarthrosis
    C. Decreased vWF:Ag
    D. Sex-linked inheritance
    C. Decreased vWF:Ag
    (this multiple choice question has been scrambled)
  26. In DIC, which test result is unlikely?

    A. Prolonged APTT
    B. Decrease platelet count
    C. Decreased APTT
    D. Prolonged thrombin time
    C. Decreased APTT
    (this multiple choice question has been scrambled)
  27. Which of the following is a predisposing condition for the development of DIC?

    a. Adenocarcinoma
    b. Sepsis
    c. Liver disease
    d. All of the above
    d. All of the above
  28. Factor XII deficiency is associated with:

    A. Bleeding history
    B. Epistaxis
    C. Decreased risk of thrombosis
    D. Increased risk of thrombosis
    D. Increased risk of thrombosis
    (this multiple choice question has been scrambled)
  29. The following results were obtained on a patient:

    Prolonged bleeding time, normal platelet count, normal PT, prolonged APTT. Which of the following disorders is most consistent with these results?

    A. Hemophilia B
    B. Hemophilia A
    C. Von Willebrand's disease
    D. Glanzmann's thrombasthenia
    C. Von Willebrand's disease
    (this multiple choice question has been scrambled)
  30. The following lab results have been obtained from a 40 year old woman: PT= 20 seconds↑, APTT = 50 seconds↑, Thrombin Time = 18 seconds↑. What is the
    most probable diagnosis?

    A. Factor X deficiency
    B. Hypofibrinogenemia
    C. Factor VIII deficiency
    D. Factor VII deficiency
    B. Hypofibrinogenemia
    (this multiple choice question has been scrambled)
  31. Christmas factor is the synonym for factor:

    A. X
    B. XII
    C. XI
    D. IX
    D. IX
    (this multiple choice question has been scrambled)
  32. Following aspirin ingestion, coagulation tests should be postponed for:

    A. 2-3 days
    B. 1 week
    C. 24 hours
    D. 1 month
    B. 1 week
    (this multiple choice question has been scrambled)
  33. A patient with a deficiency of factor XIII usually presents with a(n):

    A. Normal PT and elevated APTT
    B. Normal PT and APTT
    C. Elevated PT and normal APTT
    D. Elevated PT and APTT
    B. Normal PT and APTT
    (this multiple choice question has been scrambled)
  34. A patient's plasma produces an elevated PT and APTT and does not produce a normal PT and APTT when mixed with normal plasma: The most likely cause is:

    A. Prekallekrein deficiency
    B. Von Willebrand's disease
    C. Factor inhibitors
    D. Procedural error
    C. Factor inhibitors
    (this multiple choice question has been scrambled)
  35. Heparin:

    A. Blocks the final synthesis step of vitamin K dependent proteins
    B. Is removed from the blood via the liver
    C. Reduces the circulating level of factor X
    D. Binds with ATIII to inhibit thrombin
    D. Binds with ATIII to inhibit thrombin
    (this multiple choice question has been scrambled)
  36. A qualitative platelet defect will affect the:

    A. APTT
    B. Bleeding time
    C. PT
    D. Platelet count
    B. Bleeding time
    (this multiple choice question has been scrambled)
  37. An autosomal dominant inheritance, easy bruising, and a prolonged bleeding time are consistent with:

    A. Glanzmann's thrombasthenia
    B. Hemophilia A
    C. DIC
    D. Von Willebrand's factor
    D. Von Willebrand's factor
    (this multiple choice question has been scrambled)
  38. All of the following are characteristics of Antithrombin III except:

    A. It is a pathologic inhibitor of coagulation
    B. It is synthesized by the liver
    C. It is a cofactor of heparin
    D. It is an α2 glycoprotein
    A. It is a pathologic inhibitor of coagulation
    (this multiple choice question has been scrambled)
  39. All of the following tests are affected by heparin therapy except:

    A. Thrombin time
    B. Reptilase time
    C. Whole blood clotting time
    D. APTT
    B. Reptilase time
    (this multiple choice question has been scrambled)
  40. The lupus anticoagulant is directed against:

    A. Factor IX
    B. Phospholipid
    C. Factor X
    D. Factor VIII
    B. Phospholipid
    (this multiple choice question has been scrambled)
  41. All of the following statements regarding warfarin (Coumadin) are true except:

    A. It is a vitamin K antagonist
    B. It needs antithrombin as a cofactor
    C. It is not recommended for pregnant or lactating women
    D. PT is used to monitor its dosage
    B. It needs antithrombin as a cofactor
    (this multiple choice question has been scrambled)
  42. All of the following are characteristics of protein C except:

    A. It inhibits cofactors Va and VIIIA
    B. Its activity is inhibited by protein S
    C. It is a vitamin K zymogen
    D. It is activated by thrombin
    B. Its activity is inhibited by protein S
    (this multiple choice question has been scrambled)
  43. Which of the following is most commonly associated with activated protein C resistance?

    A. Thrombosis
    B. Menorrhagia
    C. Epistaxis
    D. Bleeding
    A. Thrombosis
    (this multiple choice question has been scrambled)
  44. A 50 year old woman develops signs and symptoms of thrombosis in her left lower leg following 3 days of heparin therapy. The patient had open heart surgery 3 days ago and has been on heparin since. Which of the following would be the most useful to investigate the cause of her thrombosis?

    A. Monitor the platelet count
    B. Increase the heparin dose
    C. Monitor the APTT
    D. Monitor the PT
    A. Monitor the platelet count
    (this multiple choice question has been scrambled)
  45. The following lab results were obtained on a 25 year old woman with menorrhagia after delivery of her second son. The patient has no previous bleeding history.

    Normal platelet count, normal bleeding time, normal PT, prolonged APTT

    Mixing of the patient's plasma with normal plasma corrected the prolonged APTT upon immediate testing. However, mixing followed by a 2-hour incubation at 37oC caused a prolonged APTT. What is the most probable cause of these laboratory results?

    A. Lupus anticoagulant
    B. Factor VIII inhibitor
    C. Factor IX deficiency
    D. Factor VIII deficiency
    B. Factor VIII inhibitor
    (this multiple choice question has been scrambled)
  46. A 50-year old white man has been on heparin for the past 7 days. Which combination of the following tests is expected to be abnormal?

    A. PT, APTT, TT
    B. APTT, TT
    C. PT and APTT
    D. APTT, TT, fibrinogen assay
    E. APTT, fibrinogen assay
    B. APTT, TT
    (this multiple choice question has been scrambled)
  47. Which of the following is characteristic of platelet disorders?

    A. Severely prolonged clotting times
    B. Deep muscle hemorrhage
    C. Mucous membrane hemorrhages
    D. Retroperitoneal hemorrhages
    C. Mucous membrane hemorrhages
    (this multiple choice question has been scrambled)
  48. Which of the following is characteristic of Bernard-Soulier syndrome?

    A. Normal bleeding time
    B. Giant platelets
    C. Increased platelet count
    D. Abnormal aggregation with ADP
    B. Giant platelets
    (this multiple choice question has been scrambled)
  49. The following results were obtained on a newborn:

    Reference ranges:
    PT 12.8 sec 9.5-14.5 sec
    APTT 34.5 sec 20-35 sec
    TT 14.0 sec 9-13 sec
    Fibrinogen 380 mg/dl 200-400 mg/dl

    The results are suggestive of:

    A. Factor VII deficiency
    B. Normal newborn results
    C. Hyperfibrinogenemia
    d. None of the above
    B. Normal newborn results
    (this multiple choice question has been scrambled)
  50. The following are true regarding warfarin;

    A. It is a vitamin K antagonist
    B. It is related to rat poison
    C. It is named after a Klingon space traveler
    D. A and C
    e. None of the above
    D. A and C
    (this multiple choice question has been scrambled)
  51. A deficiency in factor XIII can be determined by:

    A. An incomplete correction of the APTT when mixed with normal serum
    B. An abnormal APTT
    C. An abnormal urea solubility test
    D. An abnormal fibrinogen level
    C. An abnormal urea solubility test
    (this multiple choice question has been scrambled)
  52. All of the following entities are associated with thrombotic complications EXCEPT:

    A. Antithrombin Deficiency
    B. Protein S Deficiency
    C. Protein C Deficiency
    D. Factor VIII Inhibitor
    E. Antiphospholipid Antibody (Lupus Inhibitor)
    D. Factor VIII Inhibitor
    (this multiple choice question has been scrambled)

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