FINAL REVIEW

Descrição

HEML240 Quiz sobre FINAL REVIEW , criado por Nadia Persaud em 05-12-2017.
Nadia Persaud
Quiz por Nadia Persaud, atualizado more than 1 year ago
Nadia Persaud
Criado por Nadia Persaud mais de 6 anos atrás
16
1

Resumo de Recurso

Questão 1

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

Questão 2

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

Questão 3

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

Questão 4

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

Questão 5

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

Questão 6

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

Questão 7

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

Questão 8

Questão
Alkaline electrophoresis runs SDG and CEOA2 together.
Responda
  • True
  • False

Questão 9

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

Questão 10

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

Questão 11

Questão
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.
Responda
  • True
  • False

Questão 12

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

Questão 13

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

Questão 14

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

Questão 15

Questão
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.
Responda
  • True
  • False

Questão 16

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

Questão 17

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

Questão 18

Questão
HAM test for PNH is based on:
Responda
  • acidified serum
  • neutral serum
  • alkaline serum

Questão 19

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

Questão 20

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

Questão 21

Questão
What stain is required to see Heinz bodies?
Responda
  • Gram stain
  • Wright stain
  • Supravital stain
  • Eosin stain

Questão 22

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

Questão 23

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

Questão 24

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

Questão 25

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

Questão 26

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

Questão 27

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

Questão 28

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

Questão 29

Questão
Reduced aggregation with Ristocetin is associated with vWD and BSS.
Responda
  • True
  • False

Questão 30

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

Questão 31

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

Questão 32

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

Questão 33

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

Questão 34

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

Questão 35

Questão
Select all that are TRUE:
Responda
  • 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

Questão 36

Questão
vWF is synthesized by:
Responda
  • the liver
  • endothelial cells
  • plasma cells
  • Vitamin K
  • bone marrow

Questão 37

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

Questão 38

Questão
A decreased concentration of fibrinogen leads to bleeding disorders.
Responda
  • True
  • False

Questão 39

Questão
A congenital deficiency in fibrinogen will result in:
Responda
  • Prolonged PT
  • Normal aPTT
  • Normal TT
  • Prolonged aPTT
  • Prolonged TT

Questão 40

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

Questão 41

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

Questão 42

Questão
Which of the following regarding Protein C and Protein S is incorrect?
Responda
  • 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

Questão 43

Questão
Tissue factor pathway inhibitor only affects the extrinsic pathway.
Responda
  • True
  • False

Questão 44

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

Questão 45

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

Questão 46

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

Questão 47

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

Questão 48

Questão
Thrombosis refers to:
Responda
  • 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

Questão 49

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

Questão 50

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

Questão 51

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

Questão 52

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

Questão 53

Questão
Which of the following regarding Lupus Anticoagulant is true?
Responda
  • 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

Questão 54

Questão
Which of the following regarding DIC is false?
Responda
  • 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

Questão 55

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

Questão 56

Questão
D-dimer has a negative predicative value for DIC because:
Responda
  • 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

Questão 57

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

Questão 58

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

Questão 59

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

Questão 60

Questão
Protein C and Protein S are Vitamin K independent.
Responda
  • True
  • False

Questão 61

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

Questão 62

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

Questão 63

Questão
Prothrombin nucleotide 20210 is:
Responda
  • 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

Questão 64

Questão
FXII deficiency can lead to a bleeding disorder.
Responda
  • True
  • False

Questão 65

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

Questão 66

Questão
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?
Responda
  • FVIII
  • FIX
  • Heparin therapy
  • Coumadin therapy

Questão 67

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

Questão 68

Questão
Platelet poor plasma is required for which studies?
Responda
  • Coagulation studies
  • Aggregation studies
  • Adhesion studies
  • Fibrinogen studies

Questão 69

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

Questão 70

Questão
Plasma adsorbed with barium sulphate will remove which group of factors?
Responda
  • 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)

Questão 71

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

Questão 72

Questão
INR is used to monitor heparin therapy.
Responda
  • True
  • False

Questão 73

Questão
Select all that are true for aPTT:
Responda
  • 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

Questão 74

Questão
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?
Responda
  • True
  • False

Questão 75

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

Questão 76

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

Questão 77

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

Questão 78

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

Questão 79

Questão
5M Urea Test involves removing a clot and placing it in 5M urea and incubating it. Which of the following result interpretations are valid?
Responda
  • 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.

Questão 80

Questão
Low Molecular Weight Heparin (LMWH) monitors
Responda
  • FVa
  • FVIIa
  • FXa
  • FXIa

Questão 81

Questão
In a plasma sample with APCr, we expect that
Responda
  • 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

Questão 82

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

Questão 83

Questão
Select all that apply to the DRVVT for LA:
Responda
  • 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

Questão 84

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

Questão 85

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

Questão 86

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

Questão 87

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

Questão 88

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

Questão 89

Questão
If INR low, patient is at risk of bleeding.
Responda
  • True
  • False

Questão 90

Questão
Which of the following can reduce the effect of Warfarin therapy?
Responda
  • 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

Questão 91

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

Questão 92

Questão
Which of the following is a cofactor?
Responda
  • XII
  • X
  • VIII
  • VII
  • II

Questão 93

Questão
Heparin activates antithrombin to neutralize serine proteases activated by thrombin.
Responda
  • True
  • False

Questão 94

Questão
How is Unfractionated Heparin administered?
Responda
  • Subcutaneously
  • Intravenously
  • Superficially
  • Orally

Questão 95

Questão
How is a heparin overdose treated?
Responda
  • Warfarin
  • Vitamin K
  • Dialysis
  • Protamine sulfate

Questão 96

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

Questão 97

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

Questão 98

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

Questão 99

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

Questão 100

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

Questão 101

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

Questão 102

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

Questão 103

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

Questão 104

Questão
Which of the following does not directly inhibit FXa?
Responda
  • Apixaban
  • Dabigatran
  • Riveroxaban
  • Edoxaban

Questão 105

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

Questão 106

Questão
Which of the following are advantages of using Dabigatran?
Responda
  • 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

Questão 107

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

Questão 108

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

Questão 109

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

Questão 110

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

Questão 111

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

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