Thrombotic Disorders

Question 1

Confer a risk of venous/arterial thrombosis (a condition called antiphospholipid syndrome or APS)

Answer 1

Chronic antiphospholipid antibodies (APLAs)

Question 2

Often accompany autoimmune connective tissue disorder

Answer 2

Chronic antiphospholipid antibodies (APLAs)

Question 3

Caused by stem cell mutation that modifies membrane-anchored platelet activation suppressors

Answer 3

PNH

Question 4

most common inherited thrombosis risk factor

Answer 4

FVL gene mutation

Question 5

second most common inherited thrombophilia in patients with a personal and family history of deep vein thrombosis

Answer 5

Prothrombin G20210A gene mutation

Question 6

Thrombosis is often associated with a combination of genetic defect, disease, and lifestyle influences

Answer 6

Thrombosis Double Hit

Question 7

Comprise a family of immunoglobulins that bind protein-phospholipid complexes

Answer 7

Antiphospholipid Antibodies

Question 8

Are sometimes called nonspecific inhibitors

Answer 8

Antiphospholipid Antibodies

Question 9

the plasma protein most often bound to APLAs

Answer 9

B2-GPI

Question 10

Most APLAs arise in response to a bacterial, viral, fungal, or parasitic infection or to treatment with one of a variety of drugs

Answer 10

Transient alloimmune APLAs

Question 11

Part of the autoantibodies that arise in collagen vascular diseases, SLE, RA, scleroderma, and Sjogren’s syndrome

Answer 11

Autoimmune APLAs

Question 12

Detection and confirmation of antiphospholipid antibodies

Answer 12

1. Mixing study
2. Lupus anticoagulant Test profile
3. Dilute thromboplastin time (dtt)

Question 13

Detection and confirmation of antiphospholipid antibodies

Important first step

Answer 13

Mixing study

Question 14

Detection and confirmation of antiphospholipid antibodies

Con differentiate Lac from a factor deficiency

Answer 14

Mixing study

Question 15

Detection and confirmation of antiphospholipid antibodies

In Lupus Anticoagulant Test Profile, what are the two commonly used test and both are required

Answer 15

A. Dilute Russel Viper Venom Time (DRVVT)
B. Silica-based PTT or Silica clot time (SCT)

Question 16

Detection and confirmation of antiphospholipid antibodies

A confirmed positive result in one system is conclusive despite a negative result from the other

Answer 16

Lupus Anticoagulant Test Profile

Question 17

Detection and confirmation of antiphospholipid antibodies

Also named tissue thromboplastin inhibitor (TTI)

Answer 17

Dilute thromboplastin time (DTT)

Question 18

Review the Detection and confirmation of antiphospholipid antibodies

Answer 18

PTT initiates coagulation at factor XII
DRVV at factor X
DTT at factor VII

Question 19

considered the more specific of the LAC assay.

Answer 19

DRVVT

Question 20

uses low-phospholipid reagent.

Answer 20

DRVVT Screening

Question 21

uses high-phospholipid reagent

Answer 21

DRVVT Confirmatory

Question 22

In Factor V Leiden Mutation, there is A mutation in the factor V gene

Answer 22

substitutes glutamine for arginine at position 506 of the factor V molecule (FV R506Q)

Question 23

named for the city it, Leiden mutation (or APC resistance)

Answer 23

factor V R506Q mutation

Question 24

A guanine-to-adenine mutation at base 20210 of the 3’ untranslated region of the prothrombin gene has been associated with mildly elevated plasma prothrombin levels

Answer 24

Prothrombin G20210A

Question 25

Is a serine protease inhibitor (SERPIN) that neutralizes factors IIa, IXa, Xa, XIa, XIIa, all of the coagulation system serine proteases except factor VIIa.

Answer 25

Antithrombin

Question 26

Arterial Thrombosis Predictors

Answer 26

Lipoprotein A
CRP
Fibrinogen
Plasma Homocysteine and Factor VIII

Question 27

A low-density lipoprotein that may contribute to thrombosis by its antifibrinolytic property

Competes with plasminogen for binding sites
on newly formed fibrin polymer

Answer 27

Lipoprotein A

Question 28

An acute phase reactant whose plasma concentration rises 1000-fold 6 to 8 hours after the onset of an inflammatory event

Answer 28

CRP

Question 29

a naturally occurring sulfur-containing amino acid intermediate in the metabolism of dietary methionine

Answer 29

Homocysteine

Question 30

Misidentified as muscle strain or a
“charley horse”

Answer 30

Deep vein thrombosis (DVT)

Question 31

the most prevalent VTE; caused by clots that form in the iliac, popliteal, and femoral veins of the calves and upper legs

Answer 31

Deep vein thrombosis (DVT)

Question 32

fragments of thrombi (called emboli) may separate from the proximal end of a venous thrombus, move swiftly through the right chambers of the heart, and lodge in the arterial pulmonary vasculature, causing ischemia and necrosis of lung tissue

Answer 32

Pulmonary embolism (PE)

Question 33

Nicknamed “the great masquerader”

Answer 33

Pulmonary embolism (PE)

Question 34

e ective for most DVT cases

Answer 34

Ultrasonography

Question 35

reference method for PE

Answer 35

Multislice or spiral chest computed
tomography (CT) angiography

Question 36

can not be employed to “rule in” DVT or PE but a normal result reliably rules out either condition without the need for imaging

Answer 36

D-dimer assay

Question 37

A term for tumor-induced DIC that generates DVT and migrating sub-epithelial thromboses causing ecchymosis and purpura fulminans

Answer 37

Trousseau syndrome

Question 38

Is the consequence of an immune response to UFH (standard IV heparin), and LMWH that is reflected in a reduced platelet count

Answer 38

Heparin-Induced Thrombocytopenia

Question 39

HIT antibodies are specific for

Answer 39

platelet factor 4 (PF4) complexed with heparin

Question 40

is a hapten that triggers immune production of IgG isotype anti-H:PF4 antibodies

Answer 40

H:PF4