Hemostasis, Surgical Bleeding and Transfusion

Question 1

Hemostatic process involves interaction between

Answer 1

Blood vessel wall, platelets, coagulation factors

Question 2

Major physiologic processes that participate interdependently in the hemostatic process

Answer 2

Vascular constriction, platelet plug formation, fibrin formation, fibrinolysis

Question 3

Normal circulating number of platelets

Answer 3

150,000-400,000/ul

Question 4

Average life span of platelets

Answer 4

7-10 days

Question 5

T/F: Heparin interferes with primary hemostasis

Answer 5

False

Question 6

Primary vs secondary hemostasis

Answer 6

Primary - response of blood vessel and platelet to injured vessel
Secondary - response of protein coagulation factors to the injury

Question 7

Secondary hemostasis is inhibited by

Answer 7

Aspirin, NSAIDs, cAMP, NO

Question 8

Associated with abnormal function of intrinsic pathway

Answer 8

Elevated activated partial thromboplastin time

Question 9

Associated with abnormal extrinsic pathway

Answer 9

Elevated prothrombin time

Question 10

Prothrombinase complex

Answer 10

Factor Xa, Va, Ca2+, phospholipid

Question 11

T/F: Fibrinolysis begins at the same time as clot formation is initiated

Answer 11

True

Question 12

T/F: Acquired defects are much more common than acquired platelet abnormalities

Answer 12

False

Question 13

Excess of RBCs leading to spontaneous thrombosis

Answer 13

Polycythemia

Question 14

Etiology of thrombocytopenia in patients with liver disease is typically related to

Answer 14

Hypersplenism

Question 15

Vitamin k dependent factors

Answer 15

X, IX, VII, II

Question 16

Key initiators of coagulopathy of trauma

Answer 16

Shock and tissue injury

Question 17

Hallmark of APLS

Answer 17

Prolonged aPTT in vitro but an increased risk of thrombosis of thrombosis in vivo

Question 18

Most common complication of warfarin therapy

Answer 18

Abdominal bleeding

Question 19

Most common indication for blood transfusion for surgical patients

Answer 19

Volume replacement

Question 20

Increase in temperature associated with transfusion

Answer 20

Nonhemolytic Reactions

Question 21

Occurs with rapid infusion of blood, plasma expanders, and crystalloid especially in older patients with underlying heart disease

Answer 21

TACO

Question 22

Noncardiogenic pulmonary edema related to transfusion

Answer 22

TRALI

Question 23

Occur with the administration of ABO-incompatible blood and is fatal

Answer 23

Acute Reactions

Question 24

Occur when an individual has low antibody titer at the time of transfusion but increases resulting from an anamnestic response

Answer 24

Delayed reactions

Question 25

T/F: Hypothermia is indicated if antibodies present in hight titer

Answer 25

False

Question 26

What should always be performed before the administration of dextran

Answer 26

Cross-matching

Question 27

Shelf life of RBCs

Answer 27

42 days

Question 28

T/F: Frozen RBCs are not available for use in emergencies

Answer 28

True

Question 29

Shelf life of platelets

Answer 29

120 hours from time of donation

Question 30

Indications for platelet transfusion

Answer 30

1. Thrombocytopenia caused by massive blood loss and replacement with platelet-poor products 2. Thrombocytopenia caused by inadequate production 3. Qualitative platelet disorders

Question 31

Usual source of vitamin k-dependent factors and is the only source of factor V

Answer 31

Fresh frozen plasma

Question 32

Prothrombin time measures the function of which factors?

Answer 32

I, II, V, VII, X

Question 33

PT reagent

Answer 33

Thromboplastin and calcium

Question 34

Used to account for variations in thromboplastin activity

Answer 34

International Normalized Ratio

Question 35

aPTT measures the function of which factors

Answer 35

I, II, V, VIII, IX, X, XII

Question 36

aPTT reagent

Answer 36

Phospholipid substitute, activator, calcium

Question 37

Most commonly used evaluation of bleeding time because it is more accurate than capillary test

Answer 37

Ivy test

Question 38

Used to evaluate platelet and vascular dysfunction

Answer 38

Bleeding time

Question 39

Used to better assess the complex and rapidly changing interactions of an actively bleeding patient

Answer 39

Whole blood visco-elasticity testing

Question 40

Only test measuring all dynamic steps of clot formation until eventual clot lysis or retraction

Answer 40

TEG