Coag

Question 1

2 genes with greatest impact on coumadin

Answer 1

VKORC1 and CYP2C9

Question 2

Enoxaprin, dalteparin, nadroparin, tinzaparin, danaparoid are examples of?

Answer 2

LMWH

Question 3

Fondaparinux (Arixtra) is a

Answer 3

Direct Xa inhibitor

Question 4

Hirudin, lepirudin, desirudin, aragtroban, bivalirudin are examples of

Answer 4

Direct thrombin inhibitors

Question 5

Apixaban and rivaroxaban are examples of? Whats special about them?

Answer 5

direct Xa inhibitors that can be taken orally

Question 6

Dabigatran?

Answer 6

Direct thrombin inhibitor

Question 7

Give examples of drugs that block the P2Y12 receptor

Answer 7

Thienopyridines

• Ticlopidine (Ticlid)
• Clopidogrel (Plavix)
• Prasugrel
• Ticagrelor

Question 8

Name the platelet inhibitor that works through downstream effects of phosphodiesterase inhibition, reduces calcium concentrations.

Answer 8

Dipyridamole

Question 9

Aggrenox is composed of?

Answer 9

Low dose aspirin and dipyridamole

Question 10

Name the GPIIb/IIIa inhibitors

Answer 10

Tirofiban (Aggrastat)
Eptifibatide (Integrilin)
Abciximab (ReoPro)

Question 11

Resistance to what drug is associated with cytochrome P450?

Answer 11

Thienopyridines

Question 12

Upshaw-Schulman syndrome

Answer 12

Familial TTP

Question 13

Laboratory tests for HIT?

Answer 13

PF4 abs by ELISA
Serotonin Release Assay (SRA)
Heparin induced platelet aggregation assay (HIPA)

Question 14

Antithrombin inhibits what factors?

Answer 14

2, 9a, 10a, 11a, 12a

Question 15

SERPINC1 is a

Answer 15

antithrombin gene

Question 16

Coumadin induced skin necrosis is associated with which thrombophilia?

Answer 16

Protein C deficiency

Question 17

Of the anti-phospholipid syndrome, which antibody is more common and associated with arterial thrombosis? PTT is?

Answer 17

ACA syndrome

PTT is normal

Question 18

Of the anti-phospholipid syndrome, which antibody shows prolonged PTT?

Answer 18

LAC

Question 19

Of the anti-phospholipid syndrome, which antibody is associated with ineffective treatment with Warfarin?

Answer 19

ACA

Question 20

Glutamine for arginine substitution at position 506 in the factor V causes?

Answer 20

Activated protein C resistance (factor 5 leiden)

Question 21

A single inversion mutation of intron 22 on Xq28 has been shown to cause 40-45% of _____ in Caucasians

Answer 21

Hemophilia A

Question 22

Factor 9 leiden referns to?

Answer 22

Hemophilia B that spontaneous undergoes remission following puberty

Question 23

Which factor deficiency is tested by the clot solubility in 5 molar urea solution?

Answer 23

Factor 13

Question 24

In Amyloidosis, which factor deficiency is sometimes seen?

Answer 24

X deficiency

Question 25

What is a brodifacoum?

Answer 25

warfarin like compound present in pesticides

Question 26

Bernard Soulier is a defect in the?

Answer 26

CD42b or GP1b/5/9

Question 27

Name the 3 large platelets associated with MYH9 mutation

Answer 27

``` May-Hegglin anomaly (Dhole bodies) Fechtner syndrome (Hearing loss, cataracts, nephritis) Sebastian syndrome ( leukocyte inclusion) ```

Question 28

What are the 3 platelet storage pool disorder with a abnormal dense granules

Answer 28

Hermansky-Pudlak Chediak Higashi Wiskott-Aldrich

Question 29

Name that storage pool disease ``` Chrom 10q23 ( HPS1, AP3B1, DTNBP1) Childhood epistaxis oculocutaneous albinism Complicated by pulmonary fibrosis and granulomatous colitis Ceroid like bodies in macrophages Common in Puerto Rico ```

Answer 29

Hermansky-Pudlak

Question 30

Name that storage pool disease Ceroid bodies in granulocytes, platelets, and melanocytes Oculocutaneous albinism Lymphoproliferative disorders

Answer 30

Chediak-Higashi

Question 31

Name that storage pool disease X linked Thrombocytopenia Eczema Immunodeficiency

Answer 31

Wiskott-Aldrich

Question 32

Glanzman thrombasthenia is defined by

Answer 32

deficient GP2b/3a complex aka PLA1 aka CD41/CD61

Question 33

If serial dilutions results in apparent increase in factor activity, what should you consider?

Answer 33

Inhibitor

Question 34

In the platelet aggregation studies, what do you see with aspirin?

Answer 34

Decreased with Arachidonate acid Absent secondary wave with epinephrine and ADP

Question 35

Which coagulation factor is not made by the liver?

Answer 35

8 (endothelial cells) and vWF (endothelial cells and megs)

Question 36

Which coagulation factor has the shortest half life?

Answer 36

7 (6 hours) Protein C (6 hours) 8 (12 hours) 5 and 9 (24 hrs)

Question 37

Which coagulation factor | has the longest half life?

Answer 37

13 (150 hours) | 1/fibrinogen (100-150)

Question 38

Which coagulation factor is 4?

Answer 38

Calcium

Question 39

Which coagulation factor is 3?

Answer 39

tissue factor

Question 40

Whats in the alpha granules?

Answer 40

``` Fibrinogen PDFG vWF PF4 P-selectin ```

Question 41

Whats in the dense granules?

Answer 41

ADP/ATP Serotonin (5-HT) Ca

Question 42

GP1a/2a is a receptor for?

Answer 42

Collagen

Question 43

In gray platelet syndrome, what markers are decreased?

Answer 43

CD62 and PF4 expression on the surfacec of platelets.

Question 44

What disorder is marked by blunted aggregation with all agents except for ADP?

Answer 44

gray platelet syndrome (AR)

Question 45

Name the disorders with giant platelets

Answer 45

``` Bernard Soulier MHY9s (May Hegglin, Fechtner, Sebastian) Gray platelet syndrome ITP Montreal platelet syndrome ```

Question 46

Diminished clot retraction time is seen in?

Answer 46

Glanzmann