FINAL REVIEW

Beschreibung

HEML240 Quiz am FINAL REVIEW , erstellt von Nadia Persaud am 05/12/2017.
Nadia Persaud
Quiz von Nadia Persaud, aktualisiert more than 1 year ago
Nadia Persaud
Erstellt von Nadia Persaud vor mehr als 6 Jahre
16
1

Zusammenfassung der Ressource

Frage 1

Frage
Which of the following is NOT indicative of accelerated red cell destruction?
Antworten
  • decreased RBC, Hgb, Hct
  • increased unconjugated bilirubin, increased LDH
  • increase hemopexin
  • erythoid hyperplasia
  • URINE: increased urobilinogen, free hemoglobin, methemoglobin, hemosiderin

Frage 2

Frage
Which feature is present in BOTH intra- and extravascular hemolysis?
Antworten
  • increased retics
  • spherocytes/schistocytes
  • increased unconjugated bilirubin
  • decreased poikilocytosis
  • A, B, and C
  • All of the above.

Frage 3

Frage
Select all that apply for INTRAVASCULAR hemolysis:
Antworten
  • significant increase in LDH
  • hemoglobinemia
  • hemosiderinuria
  • IgG antibodies
  • decreased hemopexin
  • spherocytes

Frage 4

Frage
Select all that apply for EXTRAVASCULAR hemolysis:
Antworten
  • IgG antibodies
  • presence of gall stones
  • splenomegaly
  • spherocytes
  • fragments

Frage 5

Frage
Normal adult hemoglobin consists of: 95% - 100% HbA 0% - 2% HbF 0% - 3.5% HbA2
Antworten
  • True
  • False

Frage 6

Frage
Sickle Solubility screening test is a qualitative screening test that dectects the presence of sickling hemoglobins mainly HbA.
Antworten
  • True
  • False

Frage 7

Frage
What are the components of an alkaline hemoglobin electrophoresis?
Antworten
  • EDTA-borate buffer and cellulose acetate gel
  • pH 10.1
  • enzymatic reactions that move from cathode to anode
  • able to separate HbC from HbE

Frage 8

Frage
Alkaline electrophoresis runs SDG and CEOA2 together.
Antworten
  • True
  • False

Frage 9

Frage
What techniques can be used to separate hemoglobin?
Antworten
  • HbA2 ion exchange chromatography
  • HPLC: High Performance Liquid Chromatography
  • IEF: Isoelectric Focusing
  • Capillary Electrophoresis
  • Globin Chain Electrophoresis
  • All of the above

Frage 10

Frage
A positively charges cellulose attracts a negatively charged hemoglobin molecule. Which separation technique does this describe?
Antworten
  • HPLC
  • Ion Exchange Chromatography
  • IEF
  • Globin Chain Electrophoresis

Frage 11

Frage
During HbA2 Column Chromatography, A2 is eluted as the 3mL glycine reagent and the absorbance of the A2 fraction and total hemoglobin are measured to determine the %HbA2.
Antworten
  • True
  • False

Frage 12

Frage
Which hemoglobin fractions is HPLC able to detect and distinguish?
Antworten
  • HbS
  • HbA2
  • HbF
  • HbA
  • HbC

Frage 13

Frage
Which hemoglobin separation technique separates fractions based on the difference in charge to size ratio through an electric field?
Antworten
  • Isoelectric Focusing
  • Gas Chromatogrpahy
  • Ion Exchange Chromatography
  • Capillary Electrophoresis
  • Gel Electrophoresis

Frage 14

Frage
An increase in HbA2 is associated with which condition?
Antworten
  • IDA
  • Beta-Thal Major
  • Alpha-Thal Minor
  • Beta-Thal Minor
  • Megaloblastic Anemia

Frage 15

Frage
The principle behind the Kleihauer-Betke Acid Elution test is eluting HbF out of the solution, making the cells colourless, while HbA are resistant to elution and will stain pink.
Antworten
  • True
  • False

Frage 16

Frage
Which clinical condition is screened for using the sucrose hemolysis test?
Antworten
  • Hereditary Persistence of Fetal Hemoglobin (HPFH)
  • Paroxymal Nocturnal Hemoglobinuria (PNH)
  • Autoimmune Hemolytic Anemia (AIHA)
  • Filariasis

Frage 17

Frage
Less than 5% hemolysis indicates that RBCs of PNH are more sensitive to complement on their cell surface.
Antworten
  • True
  • False

Frage 18

Frage
HAM test for PNH is based on:
Antworten
  • acidified serum
  • neutral serum
  • alkaline serum

Frage 19

Frage
Which of the following interpretations matches G6PD deficiency screening test?
Antworten
  • persistant fluorescence
  • weak or no fluorescence
  • NADPH not produced
  • NAD produced

Frage 20

Frage
The amount of NAD produced is proportional to the amount of PK in patient cells
Antworten
  • True
  • False

Frage 21

Frage
What stain is required to see Heinz bodies?
Antworten
  • Gram stain
  • Wright stain
  • Supravital stain
  • Eosin stain

Frage 22

Frage
Cells that are osmotically fragile will start to lyse at:
Antworten
  • 0.85
  • 0.55
  • 0.45
  • 0.95

Frage 23

Frage
Which of the following is not included in the major hemostatic system?
Antworten
  • Vascular System
  • Platelet Activity
  • Coagulation System
  • Fibrinolytic System
  • Thrombin System
  • Regulatory System

Frage 24

Frage
Which of the following is an example of an anticoagulant?
Antworten
  • VonWillebrande's Factor
  • Thromboplastin
  • Protein S
  • Tissue Plasmimnogen Factor Inhibitor

Frage 25

Frage
What is needed for platelets to adhere to the sub-endothelium?
Antworten
  • Thrombin
  • vWF
  • Ca2+
  • Phospholipid
  • Negatively Charged Surface

Frage 26

Frage
Which of the following is true about thromboxane A2?
Antworten
  • produced by platelets
  • causes vasoconstriction
  • induces aggregation
  • inhibited by aspirin
  • all of the above are true

Frage 27

Frage
Which platelet membrane binding site is associated with aggregation?
Antworten
  • GPIb/IX
  • GPIIb/IIIa
  • vWF Ag
  • Collagen binding site
  • FVIII Ag

Frage 28

Frage
Which of the following is not a primary hemostasis disorder?
Antworten
  • Bernard-Soulier Syndrome
  • von Willebrande Disease
  • Gray Platelet Syndrome
  • Glanzmann's Thrombasthenia
  • Hemophilia A

Frage 29

Frage
Reduced aggregation with Ristocetin is associated with vWD and BSS.
Antworten
  • True
  • False

Frage 30

Frage
Which condition is present if a patient has vWF, but lacks the receptor site on the platelet for it?
Antworten
  • BSS
  • Glanzmann's Thrombasthenia
  • Grey Platelet Syndrome
  • vWD
  • Storage Pool Disease

Frage 31

Frage
What is the condition called if the platelets lack the receptor fibrinogen?
Antworten
  • BSS
  • Glanzmann's Thrombasthenia
  • Gray Platelet Syndrome
  • vWD
  • Storage Pool Disease

Frage 32

Frage
Which of the following does not contribute to clot formation?
Antworten
  • Tissue factor
  • Calcium
  • Heparin
  • Phospholipid
  • Thrombin

Frage 33

Frage
Which of the following does thrombin not have an effect on?
Antworten
  • FXI activation
  • FVIII activation
  • FXIII activation
  • Fibrinogen --> Fibrin
  • FVII activation

Frage 34

Frage
Which of the following factors is not Vitamin K dependent?
Antworten
  • FII
  • FV
  • FVII
  • FIX
  • FX

Frage 35

Frage
Select all that are TRUE:
Antworten
  • both VIII:C and VIII:Ag are deficient in hemophilia
  • FVIII is released from vWF by prothrombin
  • FVIII is labile and degrades rapidly when unbound from vWF
  • FVIII is synthesized in the liver

Frage 36

Frage
vWF is synthesized by:
Antworten
  • the liver
  • endothelial cells
  • plasma cells
  • Vitamin K
  • bone marrow

Frage 37

Frage
vWD is associated with a deficiency in:
Antworten
  • vWF:Rco
  • vWF:Ag
  • vWF:VIII
  • A and B
  • B and C

Frage 38

Frage
A decreased concentration of fibrinogen leads to bleeding disorders.
Antworten
  • True
  • False

Frage 39

Frage
A congenital deficiency in fibrinogen will result in:
Antworten
  • Prolonged PT
  • Normal aPTT
  • Normal TT
  • Prolonged aPTT
  • Prolonged TT

Frage 40

Frage
Which of the Hemophilia conditions is most rare?
Antworten
  • Hemophilia A (FVIII Deficiency)
  • Hemophilia B (FIX Deficiency)
  • Hemophilia C (FXI Deficiency)

Frage 41

Frage
Which of the following is not a coagulation regulator?
Antworten
  • Protein C
  • Thrombin
  • TFPI
  • Plasmin

Frage 42

Frage
Which of the following regarding Protein C and Protein S is incorrect?
Antworten
  • activated by thrombin generation by binging to thrombomodulin on endothelial cells
  • inactivates activated V and VIII
  • main regulatory system
  • plasminogen converted Protein C to APC

Frage 43

Frage
Tissue factor pathway inhibitor only affects the extrinsic pathway.
Antworten
  • True
  • False

Frage 44

Frage
What cofactor does Antithrombin III (AT) need to effectively inhibit IXa, Xa, IIa, and XIa?
Antworten
  • Warfarin
  • Ca2+
  • Heparin
  • Plasmin
  • vWF

Frage 45

Frage
Why is fibrinogen important?
Antworten
  • Prevent thrombi from getting too large
  • Aids in wound healing
  • Prevents thrombosis in undesirable places
  • All of the above
  • None of the above

Frage 46

Frage
Which of the following are components of the fibrinolytic system?
Antworten
  • alpha-2 antiplasmin
  • Plasminogen activator inhibitor-1 (PAI-1)
  • Tissue Plasminogen Activator
  • Thrombomodulin
  • Plasmin

Frage 47

Frage
Thrombocytopenia can be a result of:
Antworten
  • Hypersplenism
  • Post-splenectomy
  • Acute Blood Loss
  • Proliferation of stem cells

Frage 48

Frage
Thrombosis refers to:
Antworten
  • Formation of a blood clot following an injury to a blood vessel
  • Formation of a blood clot inside an intact blood vessel, obstructing the flow of blood
  • Formation of a blood clot that is easily solubilized
  • A portion of a larger clot that breaks free

Frage 49

Frage
Which of the following would cause a clotting disorder?
Antworten
  • Protein C deficiency
  • vWD
  • Factor Deficiency
  • Hemophilia A or B

Frage 50

Frage
Where do the majority of pulmonary emboli originate from?
Antworten
  • thrombi in arm
  • thrombi in abdomen
  • thrombi in deep leg
  • thrombi in kidney

Frage 51

Frage
Strokes results from the acute blockage of arterial blood flow in which artery?
Antworten
  • Pulmonary artery
  • Coronary artery
  • Corotid artery
  • Hepatic artery

Frage 52

Frage
Which of the following will affect platelet adhesion?
Antworten
  • Gp IIb receptor on platelet
  • Thromboxane A2
  • Fibrinogen
  • Gp Ib receptor on platelet

Frage 53

Frage
Which of the following regarding Lupus Anticoagulant is true?
Antworten
  • causes neutralization of phospholipid reagent in vitro
  • miscarriages are common in SLE
  • LA acts as an antibody to platelet
  • women are more commonly affected
  • followup tests include DRVVT

Frage 54

Frage
Which of the following regarding DIC is false?
Antworten
  • begins with excessive clotting stimulated by a substance that enters the blood
  • results in both excessive clotting and excessive bleeding
  • fibrin degradation products are generated
  • DIC is not a systemic problem, localized to specific area
  • plasminogen is consumed as it is converted into plasmin

Frage 55

Frage
Identify the correct lab results for DIC:
Antworten
  • increased platelets
  • schistocytes
  • PT and aPTT prolonged
  • D-dimer increased
  • Bleeding Time prolonged
  • Fibrinogen increased

Frage 56

Frage
D-dimer has a negative predicative value for DIC because:
Antworten
  • D-dimer measures split products formed after formation of fibrin clot, but is not specific for DIC
  • Usually present in chronic conditions
  • high levels of FDPs are specific for DIC
  • none of the above

Frage 57

Frage
Which of the following tests is normal in a patient with vWD?
Antworten
  • Bleeding Time
  • aPTT
  • Platelet count
  • PT

Frage 58

Frage
Congenital deficiencies of which proteins will cause thrombosis?
Antworten
  • Deficiency of Thrombin
  • Deficiency of factors
  • Deficiency of Coagulation and Fibrinolytic Regulators
  • Deficiency of Vitamin K

Frage 59

Frage
How is antithrombin deficiency acquired?
Antworten
  • Liver disease
  • Nephrotic Syndrome
  • DIC
  • Prolonged heparin therapy
  • all of the above

Frage 60

Frage
Protein C and Protein S are Vitamin K independent.
Antworten
  • True
  • False

Frage 61

Frage
If APC is added, aPTT is prolonged due to inhibition of coagulation.
Antworten
  • True
  • False

Frage 62

Frage
Which is the most common inherited cause of thrombosis?
Antworten
  • Protein C or Protein S deficiency
  • Factor V Leiden
  • Plasminogen deficiency
  • Antithrombin deficiency

Frage 63

Frage
Prothrombin nucleotide 20210 is:
Antworten
  • A deletion in the gene sequence
  • A single adenine to guanine mutation at position 20210
  • A single guanine to adenine mutation at position 20210
  • A nonsense codon in the sequence

Frage 64

Frage
FXII deficiency can lead to a bleeding disorder.
Antworten
  • True
  • False

Frage 65

Frage
An increase in plasminogen activator inhibitor 1 will result in
Antworten
  • a bleeding disorder
  • an increase in fibrinolysis
  • a clotting tendency
  • decrease inhibition of tPA

Frage 66

Frage
In a mixing study, a prolonged aPTT is corrected with FVIII deficient plasma, but not with FIX deficient plasma. What is the deficiency due to?
Antworten
  • FVIII
  • FIX
  • Heparin therapy
  • Coumadin therapy

Frage 67

Frage
A short-filled sodium citrate tube will have what effect on coagulation results?
Antworten
  • Normal
  • Prolonged for both
  • Only affects PT
  • Only affects aPTT

Frage 68

Frage
Platelet poor plasma is required for which studies?
Antworten
  • Coagulation studies
  • Aggregation studies
  • Adhesion studies
  • Fibrinogen studies

Frage 69

Frage
Which factors would be used up in a clotted specimen?
Antworten
  • FI
  • FII
  • FV
  • FVII
  • FVIII
  • FXI
  • FXIII

Frage 70

Frage
Plasma adsorbed with barium sulphate will remove which group of factors?
Antworten
  • Fibrinogen group factors (I, V, VIII, XIII)
  • Vitamin K dependent factors (II, VII, IX, X)
  • Contact Group Factor (XII, Pre-K, HMWK)
  • TF complex (VII, TF)

Frage 71

Frage
What is needed to initiate the intrinsic pathway in vitro?
Antworten
  • Kaolin
  • Tissue factor
  • Phospholipid
  • Calcium
  • Thromboplastin

Frage 72

Frage
INR is used to monitor heparin therapy.
Antworten
  • True
  • False

Frage 73

Frage
Select all that are true for aPTT:
Antworten
  • monitors Coumadin therapy
  • screens for defects in the intrinsic and common pathways
  • requires a source of phospholipid
  • required to calculate INR
  • Kaolin is an example of a negatively charged surface needed to activate cascade

Frage 74

Frage
A mixing studies was performed on a sample and was corrected. To determine if the correction was a result of a factor deficiency or factor antibody, another mixing studies was performed and incubated. The mixing studies results were corrected. This suggests the presence of a factor antibody. Is this interpretation correct?
Antworten
  • True
  • False

Frage 75

Frage
The euglobulin lysis time tests how long it takes for the sample to clot.
Antworten
  • True
  • False

Frage 76

Frage
Which of the following can prolong thrombin time, which looks at how long it takes a sample to clot.
Antworten
  • Warfarin
  • Heparin
  • FDPs
  • Tissue factor

Frage 77

Frage
Clot formation time is proportional to the concentration of fibrinogen in the sample plasma.
Antworten
  • True
  • False

Frage 78

Frage
The Clauss method of fibrinogen assay involves
Antworten
  • extended incubation time
  • using an undiluted plasma sample
  • excess thrombin
  • fibrinogen neutralized by protamine sulphate

Frage 79

Frage
5M Urea Test involves removing a clot and placing it in 5M urea and incubating it. Which of the following result interpretations are valid?
Antworten
  • If FII levels are normal, the clot will not dissolve in 24 hours
  • If FXIII is deficient, the clot will not dissolves in 24 hours.
  • If FXIII is normal, the clot will dissolve in 24 hours.
  • If FXIII is deficient, the clot will dissolve in 24 hours.

Frage 80

Frage
Low Molecular Weight Heparin (LMWH) monitors
Antworten
  • FVa
  • FVIIa
  • FXa
  • FXIa

Frage 81

Frage
In a plasma sample with APCr, we expect that
Antworten
  • Protein C is able to inactive FVa and FVIIIa
  • AT is able to inactivate FVa and FVIIIa
  • Protein C is unable to inactive FVa and FVIIIa
  • AT is unable to inactive FVa and FVIIIa

Frage 82

Frage
Reptilase time
Antworten
  • tests for FXIII deficiency
  • compares fibrinogen deficiency and heparin contamination
  • tests for factor antibody (eg. LA)
  • is inhibited by antithrombin

Frage 83

Frage
Select all that apply to the DRVVT for LA:
Antworten
  • venom is a potent activator for FX
  • LA binds to phospholipid, inhibiting RVV
  • RVV is affected by deficiency in factors XII, XI, IX, or VIII
  • LA confirmed if DRVVT is corrected in excess phospholipid

Frage 84

Frage
PT 20s, aPTT 50s, TT 25s What is the most probably diagnosis?
Antworten
  • FVII Deficiency
  • FVIII Deficiency
  • FX Deficiency
  • Hypofibrinogenemia

Frage 85

Frage
Which coagulation test(s) would be abnormal in a vitamin K-dependent patient?
Antworten
  • PT only
  • aPTT only
  • Both PT and aPTT
  • Fibrinogen level
  • Thrombin time

Frage 86

Frage
Which of the following is an anticoagulant therapy treatment options?
Antworten
  • Dabigatran
  • Heparin
  • Anti-platelet (ASA)
  • Warfarin
  • All of the above

Frage 87

Frage
How does Warfarin (Coumadin) act as a Vitamin K antagonist?
Antworten
  • Inactivates compound
  • Suppresses reductase activity
  • Competitively binds to Vitamin K
  • None of the above

Frage 88

Frage
Which factor monitored by Warfarin therapy has the shortest half-life?
Antworten
  • II
  • VII
  • IX
  • X
  • Protein C

Frage 89

Frage
If INR low, patient is at risk of bleeding.
Antworten
  • True
  • False

Frage 90

Frage
Which of the following can reduce the effect of Warfarin therapy?
Antworten
  • Drugs that interfere with Warfarin
  • Increased Vitamin K in diet
  • Taking Warfarin pill at different times every day (not at the same time each day)
  • All of the above

Frage 91

Frage
Which of the following anti-clotting substances acts on factors V and VIII?
Antworten
  • Antithrombin III
  • Protein C
  • TFPI
  • Plasmin
  • tPA

Frage 92

Frage
Which of the following is a cofactor?
Antworten
  • XII
  • X
  • VIII
  • VII
  • II

Frage 93

Frage
Heparin activates antithrombin to neutralize serine proteases activated by thrombin.
Antworten
  • True
  • False

Frage 94

Frage
How is Unfractionated Heparin administered?
Antworten
  • Subcutaneously
  • Intravenously
  • Superficially
  • Orally

Frage 95

Frage
How is a heparin overdose treated?
Antworten
  • Warfarin
  • Vitamin K
  • Dialysis
  • Protamine sulfate

Frage 96

Frage
What side affect may arise as a result of long-term Heparin use?
Antworten
  • Dyspnea
  • Photophobia
  • Osteoporosis
  • Hypotension

Frage 97

Frage
Low Molecular Weight Heparin (LMWH) has minimal affect on FIIa activity because it is too short to properly bind IIa.
Antworten
  • True
  • False

Frage 98

Frage
Fondaparinux is a
Antworten
  • natural drug - pentasaccharide
  • inactivates thrombin by combining with antithrombin
  • intravenous administration
  • requires lab monitoring

Frage 99

Frage
Which of the following are requires for coagulation in aPTT?
Antworten
  • Plasma + phospholipid + calcium
  • Plasma + thromboplastin + calcium
  • Plasma + phospholipid + thromboplastin
  • Plasma + thrombin + calcium

Frage 100

Frage
What is the most common inherited bleeding disorder?
Antworten
  • TTP
  • Hemophilia A
  • vWD
  • Factor V Leiden

Frage 101

Frage
Heparin Induced Thrombocytopenia:
Antworten
  • IgG binds to heparin/PF4 complex
  • leads to coagulation of platelets
  • increases platelet count
  • associated with LMWH

Frage 102

Frage
Which of the following should be avoided when treating HIT?
Antworten
  • Streptokinase
  • Urokinase
  • LMWH
  • Hirudin

Frage 103

Frage
Patients with which of the following diseases may have a normal PTT?
Antworten
  • vWD
  • Hemophilia A
  • HIT
  • Factor V Leiden

Frage 104

Frage
Which of the following does not directly inhibit FXa?
Antworten
  • Apixaban
  • Dabigatran
  • Riveroxaban
  • Edoxaban

Frage 105

Frage
Which direct thrombin inhibitor is not primarily used to treat HIT?
Antworten
  • Dabigatran
  • Argatroban
  • Bivalirudin
  • Lepirudin

Frage 106

Frage
Which of the following are advantages of using Dabigatran?
Antworten
  • no food interactions (eg. with Vitamin K)
  • no need for routine monitoring
  • reversal of bleeding with charcoal
  • none of the above
  • all of the above

Frage 107

Frage
Which of the following is false regarding direct FXa inhibitors?
Antworten
  • requires routine monitoring
  • does not need antithrombin
  • used for the prevention of thrombosis and venous thromboembolism
  • all of the above are true

Frage 108

Frage
How does Aspirin inhibit platelets from aggregating?
Antworten
  • Inhibits thrombin
  • Inhibits fibrinogen
  • Inhibits alpha granules
  • Inhibits Thromboxane A2

Frage 109

Frage
Which condition may thrombolytic therapy be used for?
Antworten
  • venous thrombosis
  • myocardial infarction
  • Hemophilia A
  • can be administered to any inpatient

Frage 110

Frage
Which of the following is a "clot buster drug"?
Antworten
  • Streptokinase
  • tPA
  • Urokinase
  • Thrombin Inhibitors

Frage 111

Frage
Which of the following is not a thrombolytic therapy?
Antworten
  • tPA
  • Streptokinase
  • Urokinase
  • Hirudin
  • All of the above are used for thrombolytic therapy
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