Laboratory Evaluation of Coagulation (F) Flashcards
(120 cards)
1
Q
How is clotting time performed?
A
It is performed by measuring the time interval needed before an evident clot appears from skin puncture, assessing it at 30-sec interval, and reporting the result in mins and secs
2
Q
What is the principle followed by clotting time?
A
It follows the principle of visible clot formation evaluated using our eyes
3
Q
Who first designed clotting time?
A
Lee and White
4
Q
What is the normal range for clotting time?
A
2 - 4 mins
5
Q
How is prothrombin time performed?
A
It is performed by adding a small amt of PT rgnt to citrated PPP, measuring the time interval needed before an evident clot appears, and reporting the result in secs or in INR
6
Q
What is the principle followed by PT?
A
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
7
Q
What does PT measure?
A
It measures the integrity of extrinsic and common pathways
8
Q
What does PT monitor?
A
It monitors the effects of warfarin therapy
9
Q
PT is considered as the best what?
A
Best indicator of vitamin K deficiency
10
Q
What is the composition of PT rgnt?
A
Tissue thromboplastin + phospholipids + ionized calcium; no separate rgnt for calcium
11
Q
What is the normal range (in secs) for PT?
A
12.6 - 14.6 secs
12
Q
What is the formula for INR?
A
INR = PT test / PT normal (ISI)
13
Q
What is the normal range in INR w/out warfarin?
A
0.8 - 1.2
14
Q
What is the normal range in INR w/ warfarin?
A
2.0 - 3.0
15
Q
What is the result of increased / prolonged PT?
A
Decreased / low extrinsic and common pathway factors
16
Q
What is the process (or steps) of PT?
A
1) Incubate PT rgnt at 37 DC
2) Transfer 50 - 100 uL of citrated PPP into a cuvette
3) Incubate citrated PPP aliquot at 37 DC for 3 mins
4) Add 100 - 200 uL of PT rgnt directly to the citrated PPP aliquot
17
Q
What is the simplified process (or steps) of PT?
A
1) PPP + Tissue Factor (TF) + Phospholipid
2) Incubate at 37 DC
3) + Calcium
4) Record clotting time
18
Q
How is partial thromboplastin time performed?
A
It is performed by adding a small amt of PTT rgnt to citrated PPP followed by calcium chloride, measuring the time interval needed before an evident clot appears, and reporting the result in secs
19
Q
What is the principle followed by PTT?
A
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
20
Q
What are measured by PTT?
A
It measures the integrity of intrinsic and common pathways
21
Q
What are monitored by PTT?
A
It monitors the effects of unfractionated heparin therapy
22
Q
What are detected by PTT?
A
It detects the presence of lupus anticoagulants and factor inhibitors
23
Q
What is the composition of PTT rgnt?
A
phospholipids (cephalin or partial thromboplastin) + negatively charged particulate activators (silica, kaolin, ellagic acid, celite); has a separate rgnt for calcium
24
Q
What is the normal range of PTT in secs w/out heparin?
A
25 - 35 secs
25
What is the normal range of PTT in secs w/ heparin?
60 - 100 secs
26
What is the result if PTT is increased / prolonged?
Decreased / low intrinsic and common pathway factors
27
What is the meaning of APTT?
Activated Partial Thromboplastin Time
28
What is the process (or steps) of PTT?
1) Incubate PTT rgnt and CaCl2 rgnt at 37 DC
2) Transfer 50 - 100 uL of citrated PPP into cuvette
3) Incubate citrated PPP aliquot at 37 DC for 3 mins
4) Add 50 - 100 uL of PTT rgnt directly to the citrated PPP aliquot
5) Incubate the mixture at 37 DC for 3 mins
6) Add 50 - 100 uL of CaCl2 directly to the citrated PPP aliquot
29
What is the simplified process (or steps) of PTT?
1) PLT Poor Plasma (PPP) + activator (e.g. celite / silica) + phospholipid
2) Incubate
3) + Calcium
4) Record clotting time
30
How is thrombin clotting time performed?
It is performed by adding a small amt of thrombin rgnt to citrated PPP, measuring the time interval needed before an evident clot appears, and reporting the results in secs
31
What is the principle followed by thrombin clotting time?
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
32
What is measured by thrombin clotting time?
It measures the integrity of the last part of common pathway
33
What are monitored by thrombin clotting time?
It monitors the effects of dabigatran
34
What is determined by thrombin clotting time?
It determines the presence of unfractionated heparin, paraproteins, and fibrin degradation products
35
What is the composition of TCT rgnt?
exogenous thrombin + ionized calcium; no separate rgnt for calcium
36
What is the normal range of thrombin clotting time in secs?
< or equal to 21 secs
37
What is the meaning of TCT?
Thrombin Clotting Time
38
What are the result if TCT is increased / high?
1) Decreased / low fibrinogen
| 2) Increased / high fibrin degradation products, paraproteins
39
What is the meaning of TT?
Thrombin Time
40
What is the process (or steps) of TCT?
1) Incubate TCT rgnt at 37 DC for 3 - 10 mins
2) Transfer 100 uL of citrated PPP into a cuvette
3) Incubate citrated PPP aliquot at 37 DC for 3 - 10 mins
4) Add 200 uL of TCT rgnt directly to the citrated PPP aliquot
41
What is the simplified process (or steps) of TCT?
1) PPP + thrombin (bovine or human)
| 2) Record clotting time
42
How is reptilase time performed?
It is performed by adding a small amt of Bothrops atox venom to citrated PPP, measuring the time interval needed before an evident clot appears, and reporting the result in secs
43
What is the principle followed by reptilase time?
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
44
What does reptilase time measure?
It measures the integrity of the last part of common pathway
45
What is the purpose of reptilase time?
It determines the presence of paraproteins and fibrin degradation products
46
What is the composition of the RT rgnt?
Batroxobin + ionized calcium; no separate rgnt for calcium
47
What is the normal range for reptilase time?
< or equal to 21 secs
48
What are the results of RT is increased / high?
Decreased / low fibrinogen
Increased / high fibrin degradation products, paraproteins
49
What is the meaning of RT?
Reptilase time
50
What is the process (or steps) of RT?
1) Incubate RT rgnt at 37 DC for 3 - 10 mins
2) Transfer 100 uL of citrated PPP into a cuvette
3) Incubate citrated PPP aliquot at 37 DC for 3 - 10 mins
4) Add 200 uL of RT rgnt directly to the citrated PPP aliquot
51
What is the simplified process (or steps) of RT?
1) PPP + batroxobin
| 2) Record clotting time
52
How is stypven time performed?
It is performed by adding a small amt of Daboia russelii venom to citrated PPP, measuring the time interval needed before an evident clot appears, and reporting the result in secs
53
What is the principle followed by Stypven time?
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
54
What is the purpose of Stypven time?
It measures the integrity of common pathway
55
Stypven time is considered as an alternative to what?
It is considered as an alternative to PT, yet it became obsolete
56
What is the composition of ST rgnt?
Russell viper venom + ionized calcium; no separate rgnt for calcium
57
What is the normal range for Stypven time?
20 - 30 secs
58
What is the meaning of ST?
Stypven time
59
What is the result if ST is increased / high?
Decreased / low common pathway factors
60
What is the process (or steps) of ST?
1) Incubate ST rgnt at 37 DC for 3 - 10 mins
2) Transfer 100 uL of citrated PPP into a cuvette
3) Incubate citrated PPP aliquot at 37 DC for 3 mins
4) Add 200 uL of ST rgnt directly to the citrated PPP aliquot
61
What is the simplified process (or steps) of ST?
1) PPP + Russell viper venom
| 2) Record clotting time
62
What are the 2 types of protocol for mixing studies?
1) Mixing studies using old protocol
| 2) Mixing studies using current protocol
63
How are mixing studies (old) performed?
It is performed by using the pt's citrated PPP w/ a prolonged PT or PTT result and mixing it w/ rgnt plasma and rgnt serum, evaluating for result correction, and reporting the result in secs
64
What is the principle followed by mixing studies (old)?
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
65
What is the purpose of mixing studies (old)?
Distinguish bet coagulation factor deficiency, presence of lupus anticoagulant, or presence of inhibitors
66
What is corrected mixing studies (old)?
The PT or PTT of a sx w/c was originally prolonged will become normal after the addition of rgnt plasma and rgnt serum
67
What is not corrected mixing studies (old)?
The PT or PTT of a sx w/c was originally prolonged will remain prolonged after the addition of rgnt plasma and rgnt serum
68
If it is a coagulation factor deficiency, it can be what (in terms of mixing studies, old)?
It can be immediately determined after the test
69
What is the result of normal PT/PTT?
Normal PT/PTT = correction of mixture = coagulation factor deficiency
70
What is the result of prolonged PT/PTT?
Prolonged PT/PTT = failure of correction of mixture = presence of LAC or inhibitors
71
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + fresh plasma
Normal PT or PTT: prolonged PT or PTT
72
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + aged plasma
Normal PT or PTT: prolonged PT or PTT
73
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + adsorbed plasma
Normal PT or PTT: prolonged PT or PTT
74
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + fresh serum
Normal PT or PTT: prolonged PT or PTT
75
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + aged serum
Normal PT or PTT: prolonged PT or PTT
76
What is the status of factors for the ff:
Given factor: Factor I
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Present
4) Absent
5) Absent
* the deficient factor should be present in corrected and absent in not corrected
77
What is the status of factors for the ff:
Given factor: Factor II
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Absent
4) Present
5) Absent
* the deficient factor should be present in corrected and absent in not corrected
78
What is the status of factors for the ff:
Given factor: Factor V
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Absent
3) Present
4) Absent
5) Absent
* the deficient factor should be present in corrected and absent in not corrected
79
What is the status of factors for the ff:
Given factor: Factor VII
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Absent
4) Present
5) Present
* the deficient factor should be present in corrected and absent in not corrected
80
What is the status of factors for the ff:
Given factor: Factor VIII
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Absent
3) Present
4) Absent
5) Absent
* the deficient factor should be present in corrected and absent in not corrected
81
What is the status of factors for the ff:
Given factor: Factor IX
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Absent
4) Present
5) Present
* the deficient factor should be present in corrected and absent in not corrected
82
What is the status of factors for the ff:
Given factor: Factor X
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Absent
4) Present
5) Present
* the deficient factor should be present in corrected and absent in not corrected
83
What is the status of factors for the ff:
Given factor: Factor XI
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Present
4) Present
5) Present
* the deficient factor should be present in corrected and absent in not corrected
84
What is the status of factors for the ff:
Given factor: Factor XII
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Present
4) Present
5) Present
* the deficient factor should be present in corrected and absent in not corrected
85
What is the status of factors for the ff:
Given factor: Factor XIII
1) Fresh plasma
2) Aged plasma
3) Adsorbed plasma
4) Fresh serum
5) Aged serum
1) Present
2) Present
3) Present
4) Absent
5) Absent
* the deficient factor should be present in corrected and absent in not corrected
86
How are mixing studies (current) performed?
These are performed by mixing a rgnt PLT-poor normal plasma w/ a pt's citrated PPP w/ a prolonged PT or PTT, evaluating for result correction, and reporting the result in secs
87
What is the principle followed by mixing studies (current)?
It follows the principle of detectable clot formation evaluated using an optical sensor or electromechanical sensor
88
What is the purpose of mixing studies (current)?
Distinguish bet coagulation factor deficiency, presence of lupus anticoagulant, or presence of inhibitors
89
What is corrected mixing studies (current)?
The PT or PTT of a sx w/c was originally prolonged will become normal after the addition rgnt PLT-poor normal plasma
90
What is not corrected mixing studies (current)?
The PT or PTT of a sx w/c was originally prolonged will remain prolonged after the addition of rgnt PLT-poor normal plasma
91
If it is a coagulation factor deficiency (in terms of mixing studies, current), it cannot be what?
It cannot be immediately determined after the test
92
What is the result of correction of initial mix?
Coagulation factor deficiency
93
What is the result of correction w/ initial mix?
Presence of LAC
94
What is the result of incubated mix w/ bleeding?
Presence of inhibitors
95
What is the result of failure of correction of incubated mix w/out bleeding?
Presence of LAC
96
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + PLT-poor normal plasma (initial mix)
Normal PT or PTT: corrected
| Prolonged PT or PTT: not corrected
97
What is the result and interpretation of the mixture:
Mixture: Pt's citrated PPP + PLT-poor normal plasma (incubated mix -> 1 - 2 hrs at 37 DC)
Normal PT or PTT: corrected
| Prolonged PT or PTT: not corrected
98
What is the interpretation for the ff clot-based test profiles:
1) PT: prolonged
2) PTT: normal
3) TCT: normal
4) RT: normal
5) ST: normal
* w/out bleeding
Presence of lupus anticoagulant
99
What is the interpretation for the ff clot-based test profiles:
1) PT: prolonged
2) PTT: normal
3) TCT: normal
4) RT: normal
5) ST: normal
* w/ bleeding
Deficiency in factor VII
100
What is the interpretation for the ff clot-based test profiles:
1) PT: normal
2) PTT: prolonged
3) TCT: normal
4) RT: normal
5) ST: normal
* w/out bleeding
Deficiency in factor XII, PK, and HMWK
Presence of lupus anticoagulant
101
What is the interpretation for the ff clot-based test profiles:
1) PT: normal
2) PTT: prolonged
3) TCT: normal
4) RT: normal
5) ST: normal
* w/ bleeding
Deficiency in factor XI, IX, and VIII
102
What is the interpretation for the ff clot-based test profiles:
1) PT: prolonged
2) PTT: prolonged
3) TCT: normal
4) RT: normal
Deficiency in factor X, II, and V
Intake of warfarin & vitamin-K deficiency
103
What is the interpretation for the ff clot-based test profiles:
1) TCT: prolonged
2) RT: normal
If PTT is prolonged: intake of unfractionated heparin or dabigatran
104
What is the interpretation for the ff clot-based test profiles:
1) TCT: normal
2) RT: normal
If PTT is prolonged: no intake of unfractionated heparin
105
What is the interpretation for the ff clot-based test profiles:
1) PT: prolonged
2) PTT: prolonged
3) TCT: prolonged
4) RT: prolonged
5) ST: prolonged
Deficiency in factor I if less than 100 mg/dL
Paraproteinemia
106
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor I deficiency
Prolonged PT - prolonged PTT
106
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor I deficiency
Prolonged PT - prolonged PTT
107
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor XIII deficiency
Normal PT - normal PTT
108
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: corrected
4) Fresh serum: corrected
5) Aged serum: corrected
Factor XI deficiency
Normal PT - prolonged PTT
w/ bleeding
109
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: corrected
4) Fresh serum: corrected
5) Aged serum: corrected
Factor XII deficiency
Normal PT - prolonged PTT
w/out bleeding
110
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: uncorrected
4) Fresh serum: corrected
5) Aged serum: corrected
Factor VII deficiency
Prolonged PT - normal PTT
111
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: uncorrected
4) Fresh serum: corrected
5) Aged serum: corrected
Factor IX deficiency
Normal PT - prolonged PTT
112
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: uncorrected
4) Fresh serum: corrected
5) Aged serum: corrected
Factor X deficiency
Prolonged PT - prolonged PTT
113
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: corrected
3) Adsorbed plasma: uncorrected
4) Fresh serum: corrected
5) Aged serum: uncorrected
Factor II deficiency
Easiest to determine; these mixing study results are only sp for factor II
114
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor V deficiency
Prolonged PT - prolonged PTT
115
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor VIII deficiency
Normal PT - prolonged PTT
115
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor VIII deficiency
Normal PT - prolonged PTT
115
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor VIII deficiency
Normal PT - prolonged PTT
115
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor VIII deficiency
Normal PT - prolonged PTT
115
What is the interpretation for the ff clot-based test profiles:
1) Fresh plasma: corrected
2) Aged plasma: uncorrected
3) Adsorbed plasma: corrected
4) Fresh serum: uncorrected
5) Aged serum: uncorrected
Factor VIII deficiency
Normal PT - prolonged PTT
