NORMALHEMOSTASIS Flashcards
(36 cards)
1
Q
- What intimal cell synthesizes and stores von Willebrand factor (VWF)?
a. Smooth muscle cell
b. Endothelial cell
c. Fibroblast
d. Platelet
A
b
2
Q
What subendothelial structural protein triggers coagulation through activation of factor VII?
a. Thrombomodulin
b. Nitric oxide
c. Tissue factor
d. Thrombin
A
c
3
Q
- What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
a. Factor VIII
b. Fibrinogen
c. Thrombin
d. Factor X
A
b
4
Q
- What is the primary role of vitamin K for the prothrombin group factors?
a. Provides a surface on which the proteolytic reactions of the factors occur
b. Protects them from inappropriate activation by compounds such as thrombin
c. Accelerates the binding of the serine proteases and their cofactors
d. Carboxylates the factors to allow calcium binding
A
D
5
Q
- What is the source of prothrombin fragment F1.2?
a. Plasmin proteolysis of fibrin polymer
b. Thrombin proteolysis of fibrinogen
c. Proteolysis of prothrombin by factor Xa
d. Plasmin proteolysis of cross-linked fibrin
A
b
6
Q
What serine protease forms a complex with factor VIIIa, and what is the substrate of this complex?
a. Factor VIIa, factor X
b. Factor Va, prothrombin
c. Factor Xa, prothrombin
d. Factor IXa, factor X
A
d
7
Q
- What protein secreted by endothelial cells activates fibrinolysis?
a. Plasminogen
b. TPA
c. PAI-1
d. TAFI
A
b
8
Q
- What two regulatory proteins form a complex that digests activated factors V and VIII?
a. TFPI and Xa
b. Antithrombin and protein C
c. APC and protein S
d. Thrombomodulin and plasmin
A
c
9
Q
- What are the primary roles of VWF?
a. Inhibit excess coagulation and activate protein C
b. Activate plasmin and promote lysis of fibrinogen
c. Mediate platelet adhesion and serve as a carrier molecule for factor VIII
A
c
10
Q
- Most coagulation factors are synthesized in:
a. The liver
b. Monocytes
c. Endothelial cells
d. Megakaryocytes
A
a
11
Q
- The events involved in secondary hemostasis:
a. Lead to the formation of a stable fibrin clot
b. Usually occur independently of primary hemostasis
c. Occur in a random fashion
d. Are the first line of defense against blood loss
A
a
12
Q
- Which of the following coagulation factors is activated by thrombin and mediates the stabilization of the fibrin clot?
a. Tissue factor
b. Factor VII
c. Factor IX
d. Factor XIII
A
d
13
Q
- Which of the following endogenous plasma inhibitors is (are) important for the control of excessive thrombin generation?
a. AT, TFPI
b. Platelet factor 4
c. TAT, F1.2
d. a and b
A
a
14
Q
- What is the most common acquired bleeding disorder?
a. Trauma-induced coagulopathy
b. Vitamin K deficiency
c. Liver disease
d. VWD
A
a
15
Q
- Which is a typical form of anatomic bleeding?
a. Epistaxis
b. Menorrhagia
c. Hematemesis
d. Central nervous system bleed
A
d
16
Q
- What factor becomes deficient early in liver disease, and what assay does its deficiency prolong?
a. Prothrombin deficiency, the PT
b. Factor VII deficiency, the PT
c. FVIII deficiency, the PTT
d. Factor IX deficiency, the PTT
A
b
17
Q
- Which of the following conditions causes a prolonged thrombin time?
a. Antithrombin deficiency
b. Prothrombin deficiency
c. Hypofibrinogenemia
d. Warfarin therapy
A
c
18
Q
- In what type or subtype of VWD is the RIPA test result positive when ristocetin is used at a concentration of less than 0.5 mg/mL?
a. Subtype 2A
b. Subtype 2B
c. Subtype 2N
d. Type 3
A
b
19
Q
- What is the typical treatment for vitamin K deficiency when the patient is bleeding?
a. Vitamin K and plasma
b. Vitamin K and four-factor PCC
c. Vitamin K and platelet concentrate
d. Vitamin K and FVIII concentrate
A
b
20
Q
- If a patient has anatomic soft tissue bleeding and poor wound healing, but the PT, PTT, TT, platelet count, and platelet functional assay results are normal, what factor deficiency is possible?
a. Fibrinogen
b. Prothrombin
c. Factor XII
d. Factor XIII
A
d
21
Q
- What therapy may be used for a hemophilic boy who is bleeding and who has a high FVIII inhibitor titer?
a. rFVIIa
b. Plasma
c. Cryoprecipitate
d. FVIII concentrate
A
a
22
Q
- What is the most prevalent form of VWD?
a. Type 1
b. Type 2A
c. Type 2B
d. Type 3
A
a
23
Q
- Which of the following assays is used to distinguish vitamin K deficiency from liver disease?
a. PT
b. Protein C assay
c. Factor V assay
d. Factor VII assay
A
c
24
Q
- Mucocutaneous hemorrhage is typical of:
a. Acquired hemorrhagic disorders
b. Localized hemorrhagic disorders
c. Defects in primary hemostasis
d. Defects in fibrinolysis
A
c
25
1. The clinical presentation of platelet-related bleeding may include all of the following except:
a. Bruising
b. Nosebleeds
c. Gastrointestinal bleeding
d. Bleeding into the joints (hemarthroses)
d
26
2. A defect in GP IIb/IIIa causes:
a. Glanzmann thrombasthenia
b. Bernard-Soulier syndrome
c. Gray platelet syndrome
d. Storage pool disease
a
27
3. Patients with Bernard-Soulier syndrome have which of the following laboratory test findings?
a. Abnormal platelet response to arachidonic acid
b. Abnormal platelet response to ristocetin
c. Abnormal platelet response to collagen
d. Thrombocytosis
b
28
4. Which of the following is the most common of the hereditary platelet function defects?
a. Glanzmann thrombasthenia
b. Bernard-Soulier syndrome
c. Storage pool defects
d. Multiple myeloma
c
29
5. A reduction in thrombin generation in patients with Scott syndrome results from:
a. Defective granule secretion
b. Altered platelet aggregation
c. Altered expression of phospholipids on the platelet membrane
d. Deficiency of vitamin K-dependent clotting factors
c
30
6. The impaired platelet function in myeloproliferative neoplasms
results from:
a. Abnormally shaped platelets
b. Extended platelet life span
c. Increased procoagulant activity
d. Decreased numbers of a granules and dense granules
d
31
7. The platelet defect associated with increased paraproteins is:
a. Impaired membrane activation, owing to protein coating
b. Hypercoagulability, owing to antibody binding and membrane activation
c. Impaired aggregation, because the hyperviscous plasma
prevents platelet-endothelium interaction
d. Hypercoagulability, because the increased proteins bring
platelets closer together, which leads to inappropriate
aggregation
a
32
8. In uremia, platelet function is impaired by higher than normal levels of:
a. Urea
b. Uric acid
c. Creatinine
d. NO
d
33
9. Thrombocytopenia associated with the use of cardiopulmonary bypass is not caused by:
a. Anti-GP IIb/IIIa antibodies
b. Hemodilution
c. Platelet binding to bypass circuitry
d. Platelet consumption associated with normal postsurgical hemostatic activity
a
34
10. Aspirin ingestion blocks the synthesis of:
a. Thromboxane A2
b. Ionized calcium
c. Collagen
d. ADP
a
35
11. A mechanism of antiplatelet drugs targeting GP IIb/IIIa function is:
a. Interference with platelet adhesion to the subendothelium by blocking of the collagen binding site
b. Inhibition of transcription of the GP IIb/IIIa gene
c. Direct binding to GP IIb/IIIa
d. Interference with platelet secretion
c
36
12. Which is a congenital qualitative platelet disorder?
a. Senile purpura
b. Ehlers-Danlos syndrome
c. Henoch-Schönlein purpura
d. Waldenström macroglobulinemia
b
