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Hemostasis and Coagulation

Total questions: 30

Worksheet time: 2hrs 52mins

Name
Class
Date
1.

What is the final product of secondary hemostasis?

a)

Platelet plug

b)

Fibrin Clot

c)

ormal blood flow

d)

B and C

2.

It involves the response of the coagulation factors during vascular injury.

a)

Primary Hemostasis

b)

Secondary Hemostasis

c)

Megakaryopoiesis

d)

NOTA

3.

1. Hemostasis comes from Greek; "Hemo" means "Blood" and "Stasis" means ________.

a)

stopping

b)

motionlessness

c)

Either

d)

Neither

4.

In megakaryopoiesis, megakaryoblast contains cytoplasmic granules.

a)

True

b)

False

5.

Megakaryocytes have already visible thrombocytes.

a)

True

b)

False

6.

Metamegakaryocyte contains cytoplasmic tags or blunt protrusions of cytoplasm extending into its external environment.

a)

True

b)

False

7.

Circulating, inactive platelets have _____ shape.

a)

Irregular

b)

Discoid

c)

Protruding

d)

Blunt

8.

Hemostasis is:

a)

A process which occurs in 2 phases: primary and secondary hemostasis

b)

A production, maturation, and proliferation of thrombocytes

c)

A mechanism involving the interaction of blood vessels, platelets and coagulation factors

d)

Only 2 options are correct

e)

AOTA

9.

Megakaryocyte maturation series: Mature to Immature

I. Metamegakaryocytes II. Megakaryoblasts

III. Promegakaryocytes IV. Megakaryocytes

a)

I,II,III,IV

b)

IV,II,III,I

c)

I,IV,III,II

d)

II,III,IV,I

10.

Cytoplasmic Tags in Promegakaryocytes.

a)

Present

b)

Absent

c)

Usually Absent

d)

Any of the Above

11.

The stage of Megakaryopoiesis where Demarcating Membrane System (DMS) is first formed.

a)

Megakaryocytes

b)

Metamegakaryocytes

c)

Leukocytes

d)

Promegakaryocytes

12.

Substances involved in Primary Hemostasis.

I. Platelets

II. PK

III. Blood vessels

IV. Tissue Thromboplastin

a)

I and II

b)

II and III

c)

I and III

d)

II and IV

13.

Megakaryocytic Cell series or maturation is done at what site?

a)

Liver

b)

Peripheral Blood

c)

Bone Marrow

d)

NOTA

14.

What is the specimen of choice to visualize and study the different Megakaryocytic cells?

a)

Whole Blood

b)

Platelet Concentrate

c)

Bone Marrow Aspirate

d)

Any of the Three

15.

What is the nuclear feature of Promegakaryocytes?

a)

Single Nucleus

b)

Double Nuclei

c)

2 or more Nuclei

d)

4 or more Nuclei

16.

Which of the following is true?

a)

The extrinsic system is activated first, and then the intrinsic system is turned on later

b)

The intrinsic system is weak and short-lived

c)

The extrinsic system is only important in vitro

d)

Factors V and VII are only important in vitro

17.

Patients with which of the following diseases may have a normal PTT?

a)

von Willebrand’s disease

b)

Hemophilia A

c)

Hemophilia B

d)

Factor V Leiden

18.

A twenty-seven year-old woman complains of heavy menstrual periods, ease of bruising and excessive bleeding following a dental procedure. She has a normal platelet count, normal PT, but slightly prolonged aPTT. Of the following, the test that will most likely make the diagnosis is.

a)

Ristocetin cofactor

b)

Factor VII assay

c)

Test for anticardiolipin antibodies

d)

all of the above

19.

Features of the antiphosopholipid syndrome include all of the following except

a)

A prolonged PT

b)

A prolonged aPTT

c)

High incidence of venous thrombosis

d)

Placental infarction and fetal loss

20.

von Willebrand factor adheres platelets to exposed subendothelial collagen via

a)

glycoprotein Ib

b)

glycoprotein Ia

c)

glycoprotein 2b/3a

d)

glycoprotein x/v

21.

Platelets aggregate with each other with the help of fibrinogen that binds to

a)

glycoprotein Ia

b)

glycoprotein Ib

c)

glycoprotein IIb-IIIa

d)

glycoprotein x/v

22.

thrombin activates following factors, except

a)

5

b)

8

c)

12

d)

13

23.

clot retraction is mediated by

a)

gp1a

b)

gp1b

c)

gp2b/3a

d)

gpx/v

24.

antithrombin inhibits the following except

a)

protein c

b)

TF+VIIa

c)

factor Xa

d)

factor Va

25.

urokinase activates

a)

TPA

b)

plasminogen

c)

TFPI

d)

PAI

26.

A 7 year old girl requiring a tonsillectomy and adenoidectomy undergoes pre-operative laboratory testing by her surgeon revealing a prolonged activated partial thromboplastin time (PTT) of 150 seconds (normal range 22-36 seconds). Her prothrombin time (PT) is normal. She had previously had 2 dental extractions that were uneventful. She otherwise has no personal or family history of bleeding. Which of the following is most likely:

a)

Factor VIII activity of 2%

b)

Factor IX activity of 2%

c)

Factor VII activity of 2%

d)

Factor XI activity of 2%

e)

Factor XII activity of 2%

27.

A 1 year old male presents to the emergency room with irritability and vomiting, and a CT scan demonstrates a large intracranial parenchymal hemorrhage. The mother reports that his only other bleeding symptom was prolonged bleeding from the umbilical stump. The patient comes from a large pedigree with numerous male and female first and second degree relatives, however there is no history of excessive bleeding in any of them. Which of the laboratory test patterns are most consistent with this history?

a)

Normal PT and PTT

b)

Prolonged PT, normal PTT

c)

Normal PT, prolonged PTT

d)

Prolonged PT, prolonged PTT

28.

A 34-year-old man with limited medical history presents with recurrent epistaxis and prolonged bleeding following a dental extraction. He notes a history of easy bruising. His nose bleeds last for up to an hour and he has required medical intervention on several occasions to control the bleeding. A complete blood count (CBC) shows mild thrombocytopenia (134 x 109/L) but is otherwise normal. Prothrombin time (PT) and partial thromboplastin time (PTT) are normal. Review of the peripheral blood smear shows giant platelets. Which of the following is most likely to support the diagnosis?

a)

Von Willebrand factor activity, von Willebrand factor antigen, factor 8, multimer analysis

b)

Platelet function testing showing no aggregation with ristocetin

c)

Platelet function testing showing no aggregation to all agonists except ristocetin

d)

Platelet electron microscopy

29.

Which factor has shortest half-life?

a)

7

b)

8

c)

5

d)

13

30.

Joint hematoma (hemarthosis) can be seen in all, except

a)

Hemophilia A

b)

Hemophilia B

c)

Bernard Soulier syndrome

d)

Type III VWD