WK9: Lab Monitoring of Secondary Hemostatic Disorders

Question 1

low PLTs
N or low fibrinogen
high D-dimer

Answer 1

DIC

Question 2

N or low PLTs
N INR
N aPTT

Answer 2

Pregnancy

Question 3

True or False:

PTT is used in alcoholic hepatitis and cirrhosis

Answer 3

True

Question 4

N or low PLTs

N D-dimer and Fibrinogen

Answer 4

vWF disease

Question 5

Clotting test can be abnormal due to either a _____ or ______

Answer 5

clotting factor deficiency

inhibitor or normal factor activity

Question 6

ratio of patients plasma and pooled normal plasma

Answer 6

1:1

Question 7

When a clotting test NORMALIZES the patient has a _______

Answer 7

factor deficiency

Question 8

When a clotting test DOES NOT NORMALIZE the patient has a _______

Answer 8

factor inhibitor

Question 9

True or False
If CT in the mixture is normalized when checked initially the test should be repeated and the mixed plasma is incubated at 30C

Answer 9

False (37C)

Question 10

____ and ____ have low sensitivity and specificity for bleeding disorders

Answer 10

INR

PTT

Question 11

True or False

Personal or family history of excessive bleeding is not as predictive or perioperative bleeding than coagulation tests

Answer 11

False (much more predictive)

Question 12

_______ are proteins that precipitate when plasma is diluted with water and acidified

Answer 12

Euglobulin

Question 13

Test in which inhibitors of fibrinolysis (antiplasmin and anti-plasminogen
activators) remains in the supernatant fluid

Answer 13

Euglobulin lysis time

Question 14

plasminogen in the euglobulin fraction is converted to

______

Answer 14

plasmin

Question 15

Action of thrombin on fibrinogen results in the formation of fibrin monomers that spontaneously polymerize to form a fibrin mesh

Answer 15

Protamine sulfate dilution test

Question 16

largest competitive inhibitor of thrombin

Answer 16

X

Question 17

detected in patients with DIC

Answer 17

D, E

Question 18

When ________ is added to plasma, it displaces the secondary (smaller) degradation products from fibrin monomers and primary (larger) FDP, which will polymerize spontaneously

Answer 18

protamine sulfate

Question 19

Normal result for protamine sulfate dilution test

Answer 19

no gel formation

Question 20

In the presence of 50% solution of ethanol, any soluble fibrin monomers complexes present will dissociate

Answer 20

Ethanol gelation test

Question 21

True or False

Ethanol gelation test is more sensitive and specific than protamine sulfate dilution test

Answer 21

False (less sensitive, more specific)

Question 22

Latex particles coated with antibody against either fibrin(ogen) fragments D and E or human fibrinogen are mixed with patients serum

Answer 22

Latex FDP Assay

Question 23

In latex FDP assay, If heparin is present in the sample ______ must be added to ensure complete clotting

Answer 23

snake venom

Question 24

Added when plasma from patients with excessive fibrinolytic activity

Answer 24

trypsin

Question 25

Whole blood is added to thrombin and soya bean enzyme

Answer 25

Thrombo-Wellcotest Method

Question 26

In the Thrombo-Wellcotest Method, when fibrin split products are present, ________ occurs

Answer 26

agglutination

Question 27

Fibrin split products are present in increased amounts with normal hepatic and renal function - it is assumed that _____ has taken place

Answer 27

fibrinolytic event

Question 28

Source of Error: Underfilling of citrate tube, Polycythemia, Sample from indwelling catheters (dilution or contamination with anticoagulants)

Answer 28

Falsely prolonged CT

Question 29

Source of Error: | Overfilling citrate tube

Answer 29

Falsely shortened CT

Question 30

Source of Error: | Elevated factor VIII

Answer 30

Falsely shortened aPTT in patients on heparin

Question 31

Source of Error: | Heparin-like anticoagulants (in malignancies)

Answer 31

Falsely prolonged TT

Question 32

Source of Error: | RF

Answer 32

Falsely high FDP and D-dimer

Question 33

Source of Error: | Heparin, Lepirudin, Danaparoid, Argatroban

Answer 33

Falsely low factor levels