Coagulation Section Final

Question 1

What is Hemostasis?

Answer 1

The body’s ability to stop bleeding while keeping blood flowing smoothly.

Question 2

What are the three key systems involved in Hemostasis?

Answer 2

• Vascular System
• Platelets
• Coagulation System

Question 3

What is Primary Hemostasis?

Answer 3

Immediate response using platelets and blood vessel constriction.

Question 4

What are the symptoms of disorders related to Primary Hemostasis?

Answer 4

Mucous membrane bleeding such as nosebleeds and gum bleeding.

Question 5

What is Secondary Hemostasis?

Answer 5

The reinforcement phase using plasma coagulation factors to form a stable fibrin clot.

Question 6

What are the symptoms of disorders related to Secondary Hemostasis?

Answer 6

Deep tissue bleeding such as muscle and joint bleeds.

Question 7

How long do platelets circulate in the body?

Answer 7

9–12 days.

Question 8

What are the three crucial actions of platelets in hemostasis?

Answer 8

• Adhesion
• Activation
• Aggregation

Question 9

What happens to endothelial cells when they are damaged?

Answer 9

They shift to pro-coagulant mode, releasing signals that trigger clot formation.

Question 10

What is the Coagulation Cascade?

Answer 10

A cascade of events converting liquid blood into a gel-like clot.

Question 11

What are the three pathways of the Coagulation Cascade?

Answer 11

• Intrinsic Pathway
• Extrinsic Pathway
• Common Pathway

Question 12

What triggers the Intrinsic Pathway?

Answer 12

Exposure to collagen or negative surfaces inside the blood vessel.

Question 13

What triggers the Extrinsic Pathway?

Answer 13

External injury when tissue factor (Factor III) is released.

Question 14

What role does thrombin play in the coagulation process?

Answer 14

Converts fibrinogen into fibrin, activates Factor XIII, and enhances platelet aggregation.

Question 15

What is the role of the Fibrinolytic System?

Answer 15

To break down clots after healing begins.

Question 16

What is plasmin?

Answer 16

The active enzyme that breaks down fibrin into fibrin degradation products (FDPs).

Question 17

What are the plasmid activators?

Answer 17

• Factor XIIa
• Kallikrein
• Tissue plasminogen activator (tPA)
• Urokinase
• Streptokinase

Question 18

What are the consequences of an imbalance in clotting and fibrinolysis?

Answer 18

Too much clotting leads to thrombosis; too much breakdown leads to bleeding.

Question 19

What is a normal Bleeding Time?

Answer 19

2-8 minutes.

Question 20

What is the normal range for Platelet Counts?

Answer 20

150,000-450,000/uL.

Question 21

What does Prothrombin Time (PT) measure?

Answer 21

Fibrin clot formation in the extrinsic and common pathways.

Question 22

What is the normal range for Prothrombin Time (PT)?

Answer 22

10-14 seconds.

Question 23

What does Activated Partial Thromboplastin Time (aPTT) measure?

Answer 23

All coagulation factors except VII, XIII, and PF3.

Question 24

What is a normal range for Activated Partial Thromboplastin Time (aPTT)?

Answer 24

25-40 seconds.

Question 25

What does a high D-Dimer level indicate?

Answer 25

Possible deep vein thrombosis (DVT), pulmonary embolism (PE), or disseminated intravascular coagulation (DIC).

Question 26

What are the symptoms of Primary Hemostasis Disorders?

Answer 26

* Mucosal bleeding * Menorrhagia * Gingival bleeding

Question 27

What are the symptoms of Secondary Hemostasis Disorders?

Answer 27

* Deep joint hemorrhages * Major hematomas

Question 28

What is Immune Thrombocytopenic Purpura (ITP)?

Answer 28

A condition where the immune system attacks platelets.

Question 29

What are the two types of fibrinolysis disorders?

Answer 29

* Primary Fibrinolysis * Disseminated Intravascular Coagulation (DIC)

Question 30

What is the most common inherited bleeding disorder?

Answer 30

von Willebrand Disease (vWD).

Question 31

What is the role of Heparin in coagulation therapy?

Answer 31

Fast-acting anticoagulant that inhibits thrombin.

Question 32

What is Warfarin used for?

Answer 32

A slower acting anticoagulant monitored via PT/INR.

Question 33

What is the antidote for Heparin?

Answer 33

Protamine sulfate.

Question 34

What is the typical lab finding in DIC?

Answer 34

↑ PT, aPTT, TT, D-Dimer; ↓ Platelets, fibrinogen.

Question 35

What is the difference between DIC and Primary Fibrinolysis?

Answer 35

DIC has low platelets and positive D-dimer; Primary Fibrinolysis has normal platelets and negative D-dimer.

Question 36

What are the key laboratory tests associated with coagulation?

Answer 36

↑ PT, aPTT, TT, D-Dimer ## Footnote PT = Prothrombin Time, aPTT = Activated Partial Thromboplastin Time, TT = Thrombin Time, D-Dimer = a fibrin degradation product.

Question 37

What laboratory findings indicate low platelet levels and fibrinogen?

Answer 37

↓ Platelets, fibrinogen

Question 38

What are schistocytes and their significance in blood smears?

Answer 38

Helmet cells present on blood smear

Question 39

How to differentiate between DIC and Primary Fibrinolysis?

Answer 39

DIC: Low platelets & positive D-dimer; Primary Fibrinolysis: Normal platelets & negative D-dimer

Question 40

What is the action of Heparin?

Answer 40

Antithrombin Activator with immediate action ## Footnote Heparin is commonly used in acute settings to prevent clot formation.

Question 41

How is Heparin monitored?

Answer 41

Monitored with: aPTT

Question 42

What is the antidote for Heparin?

Answer 42

Protamine sulfate

Question 43

What type of medication is Warfarin?

Answer 43

Vitamin K Antagonist

Question 44

How long does it take for Warfarin to work?

Answer 44

Takes days to work

Question 45

How is Warfarin monitored?

Answer 45

Monitored with: PT/INR

Question 46

What is the antidote for Warfarin?

Answer 46

Vitamin K

Question 47

What are examples of newer anticoagulants?

Answer 47

Rivaroxaban, Apixaban, Dabigatran

Question 48

Do newer anticoagulants require routine lab monitoring?

Answer 48

No routine lab monitoring needed

Question 49

What is a significant drawback of some newer anticoagulants?

Answer 49

No antidote yet for some

Question 50

What are the consequences of too much clotting?

Answer 50

DVT, PE, stroke

Question 51

What are the consequences of too little clotting?

Answer 51

Hemophilia, DIC, vWD

Question 52

What is key to finding the problem and treating it correctly in coagulation disorders?

Answer 52

Testing