TEST FOR SECONDARY HEMOSTASIS

Question 1

What are the 8 tests for SECONDARY HEMOSTASIS?

Answer 1

1. Clotting Time
2. Prothrombin Time (PT)
3. Activated Partial Thromboplastin Time (aPTT)
4. Stypven Time (Russel Viper Venom Time)
5. Thrombin Time
6. Reptilase Time
7. Duckert’s Test/5M Urea Solubility Test
8. Substitution Studies

Question 2

Used to screen for problems in the blood clotting or coagulation mechanism

Answer 2

Clotting Time

Question 3

• Measure’s period required for free formation of blood to clot after it has been removed from the body

Answer 3

Clotting Time

Question 4

Clotting time (3)

Answer 4

Capillary Blood - Slide Drop Method

Capillary Method (Dale and Laidlaw’s Method)

Whole blood (Lee and White Method)

Question 5

Commonly used

A. Prick the patient
B. Wipe the first blood
C. Drop one drop of blood on a glass slide
D. Simultaneously start the timer
E. Once a string is produced, stop the timer

Answer 5

Slide Drop Method

Question 6

Slide Drop Method

NV:

Answer 6

2-4 minutes

Question 7

Dangerous
Uses capillary tube (plain)

Answer 7

Capillary Method
(Dale and Laidlaw’s Method)

Question 8

Clotting Time

NV:

Time consuming and needs 3 test tubes

Answer 8

Whole blood (Lee and
White Method)

7-15 minutes

Question 9

Whole blood (Lee and
White Method)

Procedure:
1. 3 test tubes (labeled as 1,2, and 3) in____ water bath
2._____ of blood into each of the test tubes
3. Start the timer as soon as blood enters____
4. Gently tilt the tube 3 every____ and observe for clotting
5. After clotting is observed in tube___, observe tube____ - When clotting is observed in tube 2 observe tube___

Answer 9

37°C

1 mL

tube 1

30 seconds

3, 2, 1

Question 9

Clotting Time

NV:

Time consuming and needs 3 test tubes

Answer 9

Whole blood (Lee and
White Method)

7-15 minutes

Question 10

Requested before an operation
(pre-operation)

• to test if the patient is capable of healing a large wound during surgery

Answer 10

Prothrombin Time (PT)

Activated Partial Thromboplastin Time (aPTT)

Question 11

Monitors the coagulation factors of the EXTRINSIC and of the COMMON pathways

Answer 11

Prothrombin Time (PT)

Question 12

Used to monitor COUMARIN/COUMADIN/WARFARIN therapy

Answer 12

PT

Question 13

PT

Used to monitor (3) therapy

Answer 13

COUMARIN
COUMADIN
WARFARIN

Question 14

Prothrombin Time

Uses a machine

WHAT TUBE??

Answer 14

Citrated Blood sample
(Light Blue Top)

Question 15

PT

NORMAL VALUE:

Answer 15

10-13 seconds

Question 16

PT

_______ + _______= addition of______ (begin timing for clot formation)
______ will activate your clotting

Answer 16

Platelet poor plasma (PPP) +Thromboplastin = + CaCl2

Question 17

Standardized way of reporting PT

Introduced to minimize the difference in PT results due to different reagent-instrument combinations

ISR=International Sensitivity Index

Answer 17

INR (International Normalized Ratio)

Question 18

INR FORMULA

Answer 18

PT Px
———-
PT Mean Normal

Question 19

PT

INR of ______ must be achieved

Answer 19

2.0-3.0

Question 20

Used to monitor HEPARIN therapy

Answer 20

Activated Partial Thromboplastin Time (aPTT)

Question 21

• Monitors the coagulation factors of the INTRINSIC and of the COMMON
pathways

Answer 21

Activated Partial Thromboplastin Time (aPTT)

Question 22

aPTT

NORMAL VALUE:

Answer 22

< 35 seconds

Question 23

aPTT
_______ +_______

Answer 23

Platelet poor plasma (PPP) + aPTT reagent

Question 24

aPTT Activator: (4) MECK _______: substance for platelet _______: initiate clotting (begin timing for clot formation on addition of this)

Answer 24

Micronized silica Ellagic acid Cellite Kaolin Phospholipid CaCl2

Question 25

Detects coagulation deficiencies in COMMON Pathway

Answer 25

Stypven Time (Russel Viper Venom Time)

Question 26

Used to detect deficiencies in fibrinogen, prothrombin, and factor V and X Differs from the PT in that ***deficiencies in factor VII are not detected***

Answer 26

Stypven Time (Russel Viper Venom Time)

Question 26

Stypven Time (Russel Viper Venom Time) Differs from the PT in that deficiencies in factor____ are not detected

Answer 26

VII

Question 27

Stypven Time (Russel Viper Venom Time) NORMAL VALUE:

Answer 27

6-10 seconds

Question 28

Stypven Time Reagent:

Answer 28

East Indian Viper (Viperarusselli)

Question 29

Stypven time is NORMAL and PT is ABNORMAL = Deficient______???

Answer 29

Factor VII

Question 30

Test for fibrinogen deficiency (2)

Answer 30

Thrombin Time Reptilase Time

Question 31

Detects fibrinogen deficiency Sensitive test in detecting Heparin inhibition Affected by heparin

Answer 31

Thrombin Time

Question 32

Thrombin Time & Reptilase Time Prolonged in:

Answer 32

Fibrinogen Deficiency Presence of thrombolytic agent Presence of FDP and FSP Presence of Heparin (Thrombin time only)

Question 33

Thrombin time NV

Answer 33

10-14 seconds

Question 34

Reptilase Time NV

Answer 34

10-15 seconds

Question 35

Detects ***Factor XIlI deficiency***

Answer 35

Duckert's Test/5M Urea Solubility test

Question 36

Duckert's Test/5M Urea Solubility test Reagent: 5M urea 1% monochloroacetic acid 2% acetic acid Factor XIII deficiency:________???

Answer 36

solubility to 5M urea at room temperature

Question 37

Used to identiy factor deficiency by mixing correction reagents with patient's plasma and then performing PT and aPTT

Answer 37

Substitution studies