THROMBOTIC DISORDERS

Question 1

Is the inappropriate formation of a platelet or fibrin clot that obstructs a blood vessel

Answer 1

Thrombosis

Question 2

Is a multifaceted disorder resulting from circulatory stasis and abnormalities in the coagulation system, coagulation control mechanisms, platelet function, the blood vessel wall, or leukocyte activation molecules

Answer 2

Thrombosis

Question 3

Causes ischemia and necrosis

Answer 3

Thrombosis

Question 4

Also known as hypercoagulability

Answer 4

Thrombophilia

Question 5

Is the predisposition to thrombosis secondary
to a congenital or acquired condition

Answer 5

Thrombophilia

Question 6

Known causes of Thrombophilia

Answer 6

• Physical, chemical, or biological events.
• Uncontrolled platelet activation and blood coagulation system activation.
• Blood coagulation control protein deficiencies. • Uncontrolled suppression of fibrinolysis

Question 7

Confer a risk of venous/arterial thrombosis (a condition called

Answer 7

antiphospholipid syndrome or APS

Question 8

A cardinal sign of APML is DIC secondary to the release of procoagulant granule contents from malignant promyelocytes

Answer 8

Myeloproliferative neoplasms

Question 9

Caused by stem cell mutation that modifies membrane-anchored platelet activation suppressors

Answer 9

PNH

Question 10

most common inherited thrombosis risk factor

Answer 10

FVL gene mutation

Question 11

second most common inherited thrombophilia in patients with a personal and family history of deep vein thrombosis

Answer 11

Prothrombin G20210A gene mutation

Question 12

Thrombosis is often associated with a combination of genetic defect, disease, and lifestyle influences

Answer 12

Thrombosis Double Hit

Question 13

Laboratory Evaluation of Thrombophilia

Answer 13

1.
Antiphospholipid antibodies (LAC, ACL, and Anti-B2-GPI)
Activated protein C resistance and Factor V 2.
Leiden mutation Prothrombin G20210A 3.
4. Antithrombin
5. Protein C control pathway

Question 14

Comprise a family of immunoglobulins that bind protein-phospholipid complexes

Answer 14

Antiphospholipid Antibodies

Question 15

APLAs arise as what immunoglobulin

Answer 15

IgG or IgG

Question 16

Antiphospholipid Antibodies are sometimes called

Answer 16

Nonspecific inhibitors

Question 17

the plasma protein most often bound
to APLAs

Answer 17

B2-GPI

Question 18

Most APLAs arise in response to a bacterial, viral, fungal, or parasitic infection or to treatment with one of a variety of drugs

Answer 18

Transient alloimmune APLAs

Question 19

autoantibodies that arise in collagen vascular diseases, SLE, RA, scleroderma, and Sjogren’s syndrome

Answer 19

Aitoimmune APLA

Question 20

sign of occult adenocarcinoma such as cancer of the pancreas or colon.

Answer 20

Migratory thrombophlebitis, or Trousseau syndrome

Question 21

creates protein imbalances that lead to thrombosis through loss of plasma proteins such as antithrom- bin.

Answer 21

Nephrotic Syndrome

Question 22

throm- botic event occurs in young adults; occurs in unusual sites such as the mesenteric, renal, or axillary veins; is recurrent; or occurs in a patient with a family history of thrombosis (Table 39.3). Because thrombosis is multifactorial, however, even patients with congenital thrombophilia are most likely to experience thrombotic events because of a combination of constitutional and acquired conditions.

Answer 22

Congenital Thrombosis Risk Factors

Question 23

inadequate dietary folate, vitamin B6, or vitamin B12 levels and with polymorphisms affected the function of methylene tetrahydrofolate reductase (MTHFR) in the methionine metabolic pathway.

Answer 23

antithrombin

Question 24

may exist in the absence of the FVL mutation and is occasionally acquired in pregnancy or in association with oral contraceptive therapy

Answer 24

APC Resistance

Question 25

most common inherited thrombosis risk factor,

Answer 25

FVL gene mutation

Question 26

mutation is the second most common inherited thrombophilia in patients with a personal and family history of deep vein thrombosis.

Answer 26

prothrombin G20210A

Question 27

associated with a combination of genetic defect, disease, and lifestyle influences.

Answer 27

Thrombosis Double Hit

Question 28

Antiphospholipid antibodies

Answer 28

comprise a family of immuno- globulins that bind protein-phospholipid complexes.

Question 29

detected by clot-based profiles;

Answer 29

APLAs include LACs

Question 30

detected by immunoassay

Answer 30

ACL and anti-!2-GPI antibodies,

Question 31

nonspecific inhibitors

Answer 31

Because they may bind a variety of protein-phospholipid complexes, they are sometimes

Question 32

Clot-based screen employs PTT with factor V-depleted plasma.

Answer 32

APC RESISTANCE

Question 33

Measured by molecular assay

Answer 33

Factor V Leiden mutation* Prothrombin G20210A*

Question 34

Two clot based assays for LAC profile

Answer 34

DRVVT PTT

Question 35

Immunoassay for immunoglobulins of APL family. ACL depends on B2-GPI in reaction mix.

Answer 35

ACL antibody

Question 36

Immunoassay for an immunoglobulin of APL family. B2-GPI is key phospholipid-binding protein in family.

Answer 36

Anti-B2-GPI antibody*

Question 37

Digests VIIIa and Va. When consistently below reference limit, follow up with PC antigen assay.

Answer 37

PC ACTIVITY

Question 38

Serine protease inhibitor suppresses IIa (thrombin), IXa, Xa, XIa. When consistently below reference limit, follow up with AT antigen assay.

Answer 38

AT activity

Question 39

Digests VIIIa and Va. When consistently below reference limit, follow up with PC antigen assay.

Answer 39

PC activity

Question 40

PC cofactor. When consistently below reference limit, follow up with total and free PS antigen assay, C4b-binding protein assay.

Answer 40

PS activity

Question 41

includes a means for detecting unfraction- ated heparin (UFH),

Answer 41

MIXING STUDY

Question 42

heparinase

Answer 42

Neutralize heparin, although this may be unnecessary because many LAC detection reagents provide heparin-neutralizing poly- brene.

Question 43

In performing mixing studies, the laboratory professional employs only

Answer 43

PPP

Question 44

considered the more specific of the LAC assays

Answer 44

DRVVT

Question 45

Confirms LAC by mixing an aliquot of the patient specimen with the

Answer 45

RVVT high-phospholipid confirmatory reagent,

Answer 46

If the primary reagent result is prolonged over the DRVVT confirm reagent result by a prede- termined ratio or more, typically 1.2, LAC is confirmed.

Question 47

immunoassay that is not affected by anticoagulant therapy, current thrombosis, or factor deficiencies.

Answer 47

ACL TEST (anti)

Question 48

in performing mixing studies, the laboratory professional employ

Answer 48

PPP

Question 49

to detect APL antibodies specific for phosphatidylserine or prothrombin.

Answer 49

antiphosphatidylserine and anti- prothrombin immunoassays

Question 50

mutation in the factor V

Answer 50

substitutes glutamine for arginine at position 506 of the factor V molecule (FV R506Q)

Question 51

factor V R506Q mutation is named for the city

Answer 51

The Netherlands in which Bertina first described it, Leiden

Question 52

factor V Leiden [FVL] mutation,

Answer 52

APC RESISTANCE

Question 53

chromogenic substrate test

Answer 53

detects quantitative and qualitative AT deficiencies and detects mutations affecting the proteolytic site but not the heparin binding site.

Question 54

turbidometric micropar- ticle immunoassay

Answer 54

turbidometric micropar- ticle immunoassay

Question 55

uses a suspension of latex microbeads coated with antibody to antithrombin

Answer 55

Turbidometric micropar- ticle immunoassay

Question 56

AT concentration is directly proportional to the rate of light absorption change. I LOVE JHOPE

Question 57

detect both quantitative and qualitative PC deficiencies.

Answer 57

Clot-based or chromogenic functional assays

Question 58

protein c assay venom

Answer 58

Agkistrodon contortrix

Question 59

The interval to clot formation is proportional to PS activity ( i love jhope

Question 60

APC resistance, LAC, and the presence of the therapeutic direct thrombin in- hibitors

Answer 60

argatroban or dabigatran

Question 61

lipoprotein can be measured by

Answer 61

EIA

Question 62

Naturally occurring sulfur-containing amino acid intermediate in the metabolism of dietary methionine.

Answer 62

HOMOCYSTEINE

Question 63

Which comprises DVT and PE, is the third most common thrombotic disease,

Answer 63

Venous Thromboembolic Disease

Question 64

Often the sufferer first misidentifies DVT as

Answer 64

muscle strain or charles horse

Question 65

reference method for Pulmonary Embolism

Answer 65

multislice” or spiral chest computed tomography (CT) angiography

Question 66

generalized and uncontrolled hemostasis activation secondary to a systemic disorder.

Answer 66

DIC

Question 67

BLACK DEATH

Answer 67

DIC

Question 68

is the consequence of an immune response to UFH (standard intravenous heparin) and LMWH that is reflected in a reduced platelet count

Answer 68

heparin-induced thrombocytopenia

Question 69

heparin induced thrombocytopenia antibodies are specific for

Answer 69

platelet factor 4 complexed woth heparin

Question 70

hapten that triggers immune production of IgG isotype anti-H:PF4 anti- bodies that now bind the H:PF4, targeting a neoepitope on PF4 that is expressed with heparin binding.

Answer 70

H:PF4

Question 71

pF4 is a positively charged tetrameric protein stored in

Answer 71

alpha granules