International Normalize Ratio

Question 1

This is a standardized way of reporting PT in monitoring
oral anticoagulant therapy, calculated as a ratio of the
patient’s PT to a control PT standardized for the potency
of the thromboplastin reagent developed by the World
Health Organization

Answer 1

International Normalized Ratio

Question 2

Formula of INR?

Answer 2

𝐼𝑁𝑅 = {(𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑃𝑇) / 𝑃𝑇 (𝑐𝑜𝑛𝑡𝑟𝑜𝑙 𝑚𝑒𝑎𝑛} 𝐼𝑆I

Question 3

International Sensitivity Index stands for?

Answer 3

ISI

Question 4

(calibration index) and indicated on the reagent bottle?

Answer 4

ISI

Question 4

high risk for bleeding; blood is thin means Greater or Lesser INR?

Answer 4

Greater than INR

Question 4

Reference values for INR for 2.0-3.0?

Answer 4

■ In prevention and treatment of venous
thrombosis
■ Treatment of pulmonary embolism
■ Prevention of stroke in myocardial infarction
■ Peripheral arterial disease
■ Prevention of systemic embolism in atrial
fibrillation
■ Cardiac valve replacement (tissue valve)

Question 5

High risk for thrombosis; blood is viscous means Greater or Lesser INR?

Answer 5

Less than INR

Question 5

This uses a venom from Vipera russelli or Daboia
russelli, which has a thromboplastin-like action?

Answer 5

Stypven time or Russell viper venom test

Question 5

Reference values for INR for 2.5-3.5?

Answer 5

■ In prevention of recurrent MI
■ Reduction of mortality in MI
■ Mechanical prosthetic heart valve (high risk)

Question 6

Stypven time or Russell viper venom test uses what venum?

Answer 6

Vipera russelli or Daboia
russelli

Question 7

Stypven time is similar to Factor?

Answer 7

VIIa-TF complex

Question 8

Addition of the venom bypasses the activation of
VII and directly activates factor X

Answer 8

Vipera russelli or Daboia
russelli

Question 9

Dilute Russell viper venom time, together with APTT, is
used to test for (?) which inhibits
phospholipid

Answer 9

lupus anticoagulant

Question 10

INDIRECT TESTS

Answer 10

Thrombin time
Reptilase time
Dukert test

Question 11

• This is a modification of thrombin clotting time by
  Clauss
• This measures the availability of functional fibrinogen;
  used to monitor heparin therapy and is sensitive to the
  presence of increased levels of FSP

Answer 11

Thrombin time (fibrinogen deficiency test)

Question 12

Other name of Thrombin time?

Answer 12

(fibrinogen deficiency test)

Question 13

Thrombin time Specimen? and diluted to?

Answer 13

citrated PPP (diluted at 1:10)

Question 14

Thrombin time Reagent?

Answer 14

standardized thrombin solution and calcium

Question 15

Thrombin time Reference time

Answer 15

17-25 seconds

Question 16

Causes of prolonged thrombin time

Answer 16

Fibrinogen level is below 75-100 mg/dL
■ Functional disorder of fibrinogen
■ Presence of heparin, FSP, and thrombolytic agents
■ Normally prolonged in newborns and in multiple
myeloma

Question 16

This uses the reagent reptilase enzyme, collected from
Bothrops atrox, which has a thrombin-like effect

Answer 16

Reptilase time

Question 17

Reptilase time uses the reagent (?), collected from (?), which has a thrombin-like effect

Answer 17

reptilase enzyme, Bothrops atrox

Question 17

This anticoagulant is unable to inhibit reptilase

Answer 17

Heparin

Question 18

Reptilase time Reference time

Answer 18

18-20 seconds

Question 18

Dukert test is also called?

Answer 18

t (5M urea solubility test)

Question 18

Causes of prolonged reptilase time:

Answer 18

Fibrinogen deficiency and other functional disorders of fibrinogen ■ Presence of FSP

Question 19

- PT is performed on serum - Deficiency in factors V, VIII, IX X, XI, XII, or platelets will slow the rate of (?) leaving significant amount of prothrombin in the serum

Answer 19

Prothrombin consumption time

Question 19

In duker test, If (?) is deficient in the patient’s plasma, the clot is dissolved in less than (?) by the urea

Answer 19

factor XIII, 24 hours

Question 19

Clot formed in normal plasma is insoluble in 5M urea during a 24-hour incubation

Answer 19

Dukert test (5M urea solubility test)

Question 20

- If the residual prothrombin is (?), there is deficiency in coagulation factors

Answer 20

>20%

Question 21

Deficiency in factors in Prothrombin consumption time?

Answer 21

factors V, VIII, IX X, XI, XII, or platelets

Question 21

Thromboplastin generation time made by?

Answer 21

Biggs and Douglas

Question 21

This uses BaSO4/Al(OH)3-adsorbed plasma or fresh serum

Answer 21

Thromboplastin generation time

Question 21

This is a modification of thromboplastin generation time and requires recalcification of diluted plasma

Answer 21

Hicks-Pitney test

Question 21

: a semi-automated mechanical instrument that detects fibrin strand formation using a wire loop or hook and it is under what type of automation?

Answer 21

Fibrometer, Electromechanical

Question 22

Fibrometer checks for fibrin threads every (?) which allows more accuracy

Answer 22

0.5 seconds

Question 23

This depends on the increase in light scattering associated with the conversion of soluble fibrinogen molecules to the insoluble polymerized fibrin clot

Answer 23

Photo-optical

Question 24

What are the Semi-automated instruments?

Answer 24

Electra 750 and 750A; Fibrintimer series; and FP 910 Coagulation Analyzer

Question 25

what are the Automated instruments?

Answer 25

Ortho Koagulab 16S and 40A; COag-A-Mate X2 and XC; MLA Electra 700 and 800

Question 26

This is performed when PTT and PT are prolonged to determine whether it is caused by a nonspecific inhibitor, specific inhibitor, or coagulation factor deficiency, and to determine the deficient coagulation factor

Answer 26

MIXING OR SUBSTITUTION STUDIES

Question 27

To determine if it is factor deficiency and or inhibitor, we will add?

Answer 27

Normal fresh plasma

Question 27

Fiirst to dissappear and shortest life span in vivo

Answer 27

VII

Question 28

When it become uncorrected, it means?

Answer 28

Presence of pathological circulating anticoagulant

Question 29

Under Presence of pathological circulating anticoagulant, Specific inhibitor means using?

Answer 29

perform APTT and DRVVP

Question 29

Adsorbed plasma (present)

Answer 29

I, V, VIII, XI, XII, XIII, HK, PK

Question 30

Fresh plasma (present)

Answer 30

All factors

Question 30

what is need to do in Identification of deficient factor

Answer 30

mix equal parts of patient’s plasma + an appropriate mixing sample

Question 31

Under Presence of pathological circulating anticoagulant, Non Specific inhibitor means using?

Answer 31

. lupus anticoagulant; Bethesda assay (screening); immunoassay (confirmatory)

Question 31

Aged plasma (present)

Answer 31

I, II, VII, IX, X, XI, XII, XIII, PK, HK

Question 31

if repeated test is corrected when mixed with normal plasma, it means?

Answer 31

Factor deficiency

Question 32

Fresh plasma (absent)

Answer 32

None

Question 32

Aged plasma (absent)

Answer 32

V, VIII

Question 32

Fresh serum (absent)

Answer 32

I, V, VIII, XIII

Question 33

Fresh serum (present)

Answer 33

II, VII, IX, X, XI, XII, HK,. PK

Question 33

Adsorbed plasma (absent)

Answer 33

II, VII, IX, X

Question 34

Aged serum (present)

Answer 34

VII, IX, X, XI, XII, HK, PK

Question 35

Aged serum (absent)

Answer 35

I, II, V, VIII, XIII

Question 36

Adsorbed serum (present)

Answer 36

XI, XII, HK, PK

Question 37

Adsorbed serum (absent)

Answer 37

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

Question 38

PT normal and APTT prolonged

Answer 38

Intrinsic: VIII, IX, XI, XII, HMWK, PK

Question 39

PT Prolonged and APTT prolonged

Answer 39

Common: I, II, V, X

Question 40

Sample problem: PT and APTT: prolonged ✓ Adsorbed plasma X Fresh serum

Answer 40

Factor I and V is deficient

Question 41

PT prolong and APTT normal

Answer 41

Extrinsic: VII

Question 42

Sample problem: PT and APTT: prolonged ✓ Aged serum X Adsorbed plasma

Answer 42

Factor X is deficient

Question 43

Sample problem: PT: normal and APTT: prolonged ✓ Adsorbed plasma X Fresh serum

Answer 43

Factor VIII is deficient

Question 44

Sample problem: PT: normal and APTT: prolonged ✓ Aged serum X Adsorbed serum

Answer 44

Factor IX is deficient

Question 45

(modification of thrombin time by Clauss

Answer 45

Fibrinogen assay

Question 46

Used for diagnosis of types of hemophilia

Answer 46

Single factor assay using PTT and PT

Question 47

common to occur and produces severe bleeding

Answer 47

Hemophilia A and B

Question 47

rare to occur and does not produce severe bleeding

Answer 47

Hemophilia C

Question 48

is performed on patient’s diluted plasma, with 3-4 dilutions (1: 10; 1:20; 1:40; 1:80)

Answer 48

APTT

Question 49

The interval of the test is compared to the

Answer 49

laboratory’s reference curve (percent activity