Hematology Quiz: 7

Coagulation factors affected by warfarin (Coumadin) drugs are:
a) VIII, IX, AND X
b) I, II,V,AND VII
c) II, VII, IX, and X
d) II, V, AND VII

Which one of the following statements concerning Vitamin K is not true?

a) there are 2 sources of Vitamin K; Vegetabke and bacterial
b) Vitamin K converts precursor molecule into functional coagulation factors
c) Haperin inhibits the action of Vitamin K
d) Vitamine K is fat soluble

Which of the following is Vitamin K dependent?
a) Factor XII
b) fibrinogen
c) antithrombim III
d) Factor VII

Which of the following factors is used only in the extrinsic coagulation pathway?
a) II
b) V
c) VII
d) VIII

Hageman Factor (XII) is involved in each of the following reactions except:
a) activation of C1 to C1 esterase
b) activation of plaminogen
c) activation of Factor XI
d) transformation of fibrinogen to fibrin

Prothrombin is:
a) a protein formed by the liver in the presence of Vitamin K
b) an enzyme that converts fibrinogen into fibrin threads
c) the end product of the reaction between fibrinogen and thrombin
d) a protein released by platelets during coagulation

Which of the following coagulation factors is considered to be labile?
a) II
b) V
c) VII
d) X

The most potent plasminogen activator in the contact phase of coagulation is:
a) kallikrein
b) streptokinase
c) HMWK
d) fibrinogen

Which of the following factor deficiencies is associated with either no bleeding or only a minot bleeding tendency, even after trauma or surgery?
a) Factor X
b) Factor XII
c) Factor XIII
d) Factor V

Which of the following is a characteristic of Factor XII deficiency?
a) negative bleeding history
b) normal clotting times
c) decreased rist of thrombosis
d) epistaxis

The 2 factors that differentiate liver disease from Vitamin K deficeincy are:
a) II and VII
b) IX and VII
c) VIII and IX
d) V and VII

Which one of the following factors typically shows an increase in liver disease?
a) Factor VII
b) Factor VIII
c) Factor IX
d) Factor X

A patient has a normal prothrombin time and a prolonged activated partial thromboplastin time (APTT) using a kaolin activator. The APTT corrects to normal when the incubation time is increased. These results suggest that the patient has:
a) hemophilia A ( Factor VIII deficeincy)
b) Hageman Factor (XII) deficiency
c) Fletcher Factor deficiency (prekallikrein)
d) Factor V deficiency

A hemophiliac make and a normal female can produce a:
a) female carrier
b) male carrier
c) male hemophiliac
d) normal female

Hemophilia B is a sex-linked recessive disorder that presents with a decrease in Factor:
a) VIII
b) IX
c) X
d) XI

Plasma from a patient with lupus coagulation inhibitor can show:
a) a prolonged APTT and normal PT
b) a prolonged thrombin time
c) no change with platelet neutralization
d) complete correction when incubated wtih normal plasma

The activation of plaminogen to plasmin resulting in the degradation of fibrin occurs by:
a) PAI-1
b) alpha 2 antiplasmin
c) tPA
d) alpha 2 macroglobulin

A deficiency of protein C is associated with which of the following?
a) prolonged activated partial thromboplastin time (APTT)
b) decreased fibrogen level (<100 mg/dL [<1.0 g/L])
c) increased risk of thrombosis
d) spontaneous hemorrhage

Biological assays for antithrombin III (AT III) are based on the inhibition of:
a) Factor VIII
b) heparin
c) serine proteases
d) anti-ATIII globulin

A patient present with a low Protein S activity, antigen and free antigen. The C4b binding protein is normal. This is classified as:
a) no deficiency
b) Type I
c) Type II
d) Type III

APC resistance is confirmed by the molecular test for:
a) PAI 1 4G/5G
b) MTHFR
c) FVL
d) G20210A

Acute disseminated intravascular coagulation is characterized by:
a) hypofibrinogenemia
b) thrombocytosis
c) negative D-dimer
d) shortened thrombin time

The prothrombine time test requires that the patient's citrated plasma be combined with:
a) platelet lipids
b) thromboplastin
c) Ca++ and platelet lipids
d) Ca++ and thromboplastin

In the APTT test, the patient's plasma is mixed with:
a) ADP and calcium
b) tissue thromboplastin and collagen
c) phospholipid and calcium
d) tissue thromboplastin and calcium

The APTT:
a) tests the extrinsic coagulation pathway
b) monitors Coumadin therapy
c) requires tissue thromboplastin
d) monitors heparin therapy

Aliquots of plasma with a prolonged PT and prolonged APTT are mixed using various rations of patient plasma and normal plasma. All samples are incubated at 37 celcious and tested at 10-, 30-, and 60 minute intervals. The PT and APTT results on all of the mixtures are corrected. These results would indicate the presence of:
a) circulating anticoagulant
b) factor deficiency
c) contaminated reagent
d) antibodies

A patient is taking 10 mg per day of Coumadin (warfarin). The results of which of the following lab tests will be most impacted?
a) protein C level
b) antithrombin III level
c) Factor V Leiden mutation
d) Factor VIII level

A patient's thrombin time is 25.5 sec, and the control is 11.5 sec. The patient's plasma is mixed with an equal part of normal plasma. The thrombin time is rerun and is 28.0 sec with a control of 11.5 sec. These results indicate:
a) fibrinogen deficiency
b) thrombocyte antibodies present
c) Factor VII deficiency
d) circulating anticoagulant

A prolonged thrombin time and a normal reptilase-R time are characteristic of:
a) dysfibrinogenemia
b) increased D-dimer
c) fibrin monomer-split product complexes
d) therapeutic heparinization

A 54-year old man was admitted with pulmonary embolism and given streptokinase. Which of the following would be most useful in monitoring this therapy?
a) activated partial thromboplastin time
b) bleeding time
c) prothrombin time
d) thrombin time

The best test to determin if a sample is contaminated with heparin is:
a) fibrinogen
b) thrombin time
c) prothrombin time
d) stypven time

In the Clauss fibrinogen method, the time to clot formation in plasma is measured after the addition of:
a) calcium
b) thrombin
c) phospholipids
d) kaolin

If a patient presents with a prolonged APTT that does not correct upon mixing, the next performed should be:
a) Factor II
b) DRVVT
c) Factor VIII
d) platelet count

Excess D-dimer indicate that clots have been:
a) converted to fibrin monomers
b) released into circulation
c) formed and are being excessively lysed
d) stimulated to activate platelets

D-dimers are produced from:
a) cross-linked and stabilized fibrin clot
b) decreased fibrinogen and platelets
c) plasminogen converting to plasmin
d) generation of thrombin from enothelial cells

Which of the following lab procedure is most helpful in differentiating severe liver disease and accompanying secondary fibrinolysis from disseminated intravascular coagulation?
a) presence of fibrin split products
b) increased APTT
c) Factor VIII activity
d) fibrinogen level

A bedside test that can be used to monitor heparin activity is the:
a) activated clotting time
b) stypven time
c) reptilase time
d) partial thromboplastin time

Which of the following lab findings is associated with Factor XIII deficiency?
a) prolonged activated partial thromboplastin time
b) clot solubility in a 5 molar urea solution
c) prolonged thrombin time
d) prolonged prothrombin time

Heparin acts by:
a) precipitatin fibrinogen
b) binding calcium
c) activating plasmin
d) inhibiting thrombin

Low molecular weight heparin is monitored by a:
a) anti-Xa assay
b) APTT
c) PT
d) anti- IIa assay