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HEMATOLOGY 2 PRELIM EXAM

Total questions: 60

Worksheet time: 28mins

Name
Class
Date
1.

What intimal cell synthesizes and stores VWF?

a)

Smooth muscle cell

b)

Endothelial cell

c)

Fibroblast

d)

Platelet

2.

What subendothelial structural protein triggers coagulation through activation of factor VII?

a)

Thrombomodulin

b)

Nitric oxide

c)

Tissue factor

d)

Thrombin

3.

What coagulation plasma protein should be assayed when

platelets fail to aggregate properly?

a)

Factor VIII

b)

Fibrinogen

c)

Thrombin

d)

Factor X

4.

Coagulation factor VIII circulates bound to:

a)

VWF

b)

Factor IX

c)

Platelets

d)

Factor V

5.

Normal hemostasis depends on all of the following except

a)

an intact vascular system

b)

inadequate numbers of platelets

c)

appropriate coagulation factors

d)

fibrinolysis

6.

Which blood vessels have the thickest walls?

a)

Veins

b)

Arteries

c)

Capillaries

d)

Arterioles

7.

All blood and lymphatic vessels are lined with

a)

endothelium

b)

nerve endings

c)

stratified epithelial cells

d)

simple squamous epithelium

8.

Blood passes from the arterial to the venous system via

a)

arterioles

b)

capillaries

c)

veins

d)

arteries

9.

The initiating stimulus to blood coagulation following

injury to a blood vessel is

a)

contact activation with collagen

b)

vasoconstriction

c)

stenosis

d)

release of serotonin

10.

Endothelium is involved in the metabolism and clearance

of molecules such as

a)

serotonin

b)

angiotensin

c)

bradykinin

d)

all of the above

11.

Which of the following is not correct?

a)

Vasoconstriction reduces blood flow and promotes

contact activation of platelets and coagulation factors

b)

Platelets adhere to exposed endothelial connective

tissues

c)

Aggregation of platelets releases thromboxane A2

and vasoactive amines (serotonin and epinephrine)

d)

None of the above

e)

All of the above

12.

Which of the following is (are) true of thrombopoietin?

a)

Thought to stimulate the production and maturation

of megakaryocytes

b)

Is influenced by various cytokines, which increase

megakaryocyte size

c)

Is influenced by various cytokines, which impact

maturational stage and ploidy

d)

All of the above

e)

None of the above

13.

Which of the following is not a characteristic of

platelets?

a)

The presence of a nucleus

b)

Size of 2 to 4 mm

c)

Cytoplasm is light blue with fi ne red-purple granules

d)

A discoid shape as an inactive cell

14.

The cellular ultrastructural component(s) unique to the

platelet is (are)

a)

Cytoplasmic membrane

b)

Glycocalyx

c)

Mitochondria

d)

Microtubules

15.

Choose the incorrect statement regarding storage granules

related to hemostasis in the mature platelet.

a)

Alpha-granules contain platelet factor 4, beta-thromboglobulin,

and platelet-derived growth factor

b)

Alpha-granules contain platelet fi brinogen and von

Willebrand factor

c)

Dense bodies contain serotonin and ADP

d)

Lysosomes contain actomyosin, myosin, and fi lamin

16.

At all times, approximately _____ of the total number of

platelets are in the systemic circulation.

a)

one fourth

b)

one third

c)

one half

d)

two thirds

17.

The reference range of platelets in the systemic circulation is

a)

50 to 150 × 109/L

b)

100 to 200 × 109/L

c)

150 to 350 × 109/L

d)

150 to 450 × 109/L

18.

The functions of platelets in response to vascular damage

include

a)

maintenance of vascular integrity by sealing minor

defects of the endothelium

b)

formation of a platelet plug

c)

promotion of fibrinolysis

d)

all of the above

19.

If vascular injury exposes the endothelial surface and underlying collagen, platelets

_____ to the collagen fibers and _____.

a)

aggregate, adhere

b)

adhere, aggregate

20.

Agents that are capable of aggregating platelets include

a)

collagen

b)

thrombin

c)

serotonin

d)

All of the above

e)

None of the above

21.

Aspirin ingestion has the following hemostatic effect in

a normal person.

a)

Prolongs the bleeding time

b)

Prolongs the clotting time

c)

Inhibits factor VIII

d)

Has no effect

22.

The clot retraction test is

a)

a visible reaction to the activation of platelet actomyosin

(thrombosthenin)

b)

a reflection of the quantity and quality of platelets

and other factors

c)

a measurement of the ability of platelets to stick to

glass

d)

a measurement of the cloudiness of blood

23.

Arrange the four stages of coagulation

in their proper sequence.

a)

Fibrinolysis, Formation of thrombin from prothrombin, Generation of plasma thromboplastin, Formation of fibrin from fibrinogen

b)

Generation of plasma thromboplastin, Formation of thrombin from prothrombin, Formation of fibrin from fibrinogen, Fibrinolysis

c)

Formation of fibrin from fibrinogen , Formation of thrombin from prothrombin, Generation of plasma thromboplastin, Fibrinolysis

d)

None of the above

24.

Which of the following is a condition associated with

purpura?

a)

Direct endothelial damage

b)

Inherited disease of the connective tissue

c)

Mechanical disruption of small venules

d)

All of the above

e)

None of the above

25.

Wiskott-Aldrich syndrome

a)

Giant platelets

b)

Smallest platelets seen

c)

Large platelets

d)

None of the above

26.

Bernard-Soulier syndrome

a)

Giant platelets

b)

Smallest platelets seen

c)

Large platelets

d)

None of the above

27.

Laboratory results in acute DIC reflect abnormalities

in which of the following coagulation components?

a)

Platelet function

b)

Excessive clotting and fibrinolysis

c)

Accelerated thrombin formation

d)

Fibrin formation

28.

DIC is characterized by

a)

microvascular thrombosis

b)

fibrin deposition

c)

active fibrinolysis

d)

all of the above

29.

Which of the following factors can contribute to hypercoagulation?

a)

Vascular endothelial damage

b)

Increased blood flow

c)

Decreased platelets

d)

Decreased titers of clotting factors

30.

A protein that plays a role in both coagulation and

platelet aggregation is:

a)

Factor I

b)

Factor VIII

c)

Factor IX

d)

Factor XI

31.

Thrombotic thrombocytopenic purpura (TTP) is

characterized by

a)

Prolonged PT

b)

Increased platelet aggregation

c)

Thrombocytosis

d)

Prolonged APTT

32.

Thrombocytopenia may be associated with:

a)

Postsplenectomy

b)

Hypersplenism

c)

Acute blood loss

d)

Increased proliferation of pluripotential stem

cells

33.

Aspirin prevents platelet aggregation by inhibiting

the action of which enzyme?

a)

Phospholipase

b)

Cyclo-oxygenase

c)

Thromboxane A2 synthetase

d)

Prostacyclin synthetase

34.

Normal platelet adhesion depends upon:

a)

Fibrinogen

b)

Glycoprotein Ib

c)

Glycoprotein IIb, IIIa complex

d)

Calcium

35.

When performing platelet aggregation studies,

which set of platelet aggregation results would most

likely be associated with Bernard–Soulier syndrome?

a)

Normal platelet aggregation to collagen, ADP,

and ristocetin

b)

Normal platelet aggregation to collagen, ADP, and

epinephrine; decreased aggregation to ristocetin

c)

Normal platelet aggregation to epinephrine and

ristocetin; decreased aggregation to collagen

and ADP

d)

Normal platelet aggregation to epinephrine,

ristocetin, and collagen; decreased aggregation

to ADP

36.

Which set of platelet responses would be most

likely associated with Glanzmann’s thrombasthenia?

a)

Normal platelet aggregation to ADP and

ristocetin; decreased aggregation to collagen

b)

Normal platelet aggregation to collagen;

decreased aggregation to ADP and ristocetin

c)

Normal platelet aggregation to ristocetin;

decreased aggregation to collagen, ADP, and

epinephrine

d)

Normal platelet aggregation to ADP; decreased

aggregation to collagen and ristocetin

37.

Which of the following is a characteristic of acute

immune thrombocytopenic purpura?

a)

Spontaneous remission within a few weeks

b)

Predominantly seen in adults

c)

Nonimmune platelet destruction

d)

Insidious onset

38.

Hemolytic uremic syndrome (HUS) is

associated with:

a)

Fever, thrombocytosis, anemia, and renal failure

b)

Fever, granulocytosis, and thrombocytosis

c)

Escherichia coli 0157:H7

d)

Leukocytosis and thrombocytosis

39.

Storage pool deficiencies are defects of:

a)

Platelet adhesion

b)

Platelet aggregation

c)

Platelet granules

d)

Platelet production

40.

Hereditary hemorrhagic telangiectasia is a

disorder of:

a)

Platelets

b)

Clotting proteins

c)

Fibrinolysis

d)

Connective tissue

41.

Which of the following is correct regarding

acquired thrombotic thrombocytopenic purpura?

a)

Autoimmune disease

b)

Decreased VWF

c)

Decreased platelet aggregation

d)

Decreased platelet adhesion

42.

Which of the following prevents platelet

aggregation?

a)

Thromboxane A2

b)

Thromboxane B2

c)

Prostacyclin

d)

Antithrombin

43.

Which defect characterizes Gray’s syndrome?

a)

Platelet adhesion defect

b)

Dense granule defect

c)

Alpha granule defect

d)

Coagulation defect

44.

Which of the following is not a cause of thrombocytopenia?

a)

Splenomegaly

b)

Chemotherapy

c)

Increased thrombopoietin

d)

Aplastic anemia

45.

Platelets interacting with and binding to other platelets is referred to as

a)

Adhesion

b)

Aggregation

c)

Release

d)

Retraction

46.

A potent inhibitor of platelet aggregation released by endothelial cells is

a)

Epinephrine

b)

Prostacyclin

c)

Ristocetin

d)

Thromboxane A2

47.

The platelet parameter PDW refers to the

a)

Average platelet volume

b)

Cell weight versus density

c)

Capacity to adhere to foreign surfaces

d)

Variation in platelet cell size

48.

Which of the following enzymatically degrades the stabilized fibrin clot?

a)

Plasminogen

b)

Plasmin

c)

Prothrombin

d)

Thrombin

49.

A clot retraction defect is most likely due to

a)

Lack of platelet receptor glycoprotein Ib

b)

Lack of platelet receptor glycoprotein Ilb/IIIa

c)

Insufficient ADP in dense bodies

d)

Absence of von Willebrand factor

50.

von Willebrand factor is a

a)

Phospholipid required for multiple reactions in the coagulation sequence

b)

Plasma protein that binds platelets to exposed subendothelial collagen

c)

Plasma protein with procoagulant activity in the intrinsic coagulation system

d)

Platelet membrane glycoprotein that attaches the platelet to the injured vessel wall

51.

The process of stopping bleeding is known as:

a)

homeostasis

b)

hemostasis

c)

phagocytosis

d)

dermatographia

52.

Which of the following has the largest size in the bone marrow?

a)

Megakaryoblast

b)

Granular megakaryocyte

c)

Promegakaryocyte

d)

Mature Megakaryocyte

53.

All of the following are important platelet granules that belongs to alpha granules except?

a)

fibronectin

b)

5-hydroxytryptamine

c)

platelet albumin

d)

thrombospondin

e)

platelet derived growth factor

54.

1/3 of the circulating platelets are found in?

a)

Bone marrow

b)

Kidney

c)

Spleen

d)

Peripheral Blood

55.

These are the thinnest walled and most numerous blood vessels consisting of a single layer of squamous epithelium.

a)

Arteries

b)

Veins

c)

Venules

d)

Arterioles

e)

Cappillaries

56.

All of the following are characteristics of a mature platelet except?

a)

Light blue to pinkish red and very granular cytoplasm

b)

Size can be 1-4um

c)

Average lifespan is 9 days

d)

Development of platelets is via endomitosis

57.

which proteins serves as receptor of thrombin found in the plasma membrane of platelets?

a)

Glycoprotein Ib

b)

Glycoprotein IIb/IIIa

c)

Glycoprotein Va

d)

Glycoprotein IX

58.

This system serves as calcium sequestering pump that maintains platelet cytoplasmic calcium levels

a)

Dense Tubular System

b)

Open Canalicular System

c)

Dense Granules

d)

Alpha Granules

59.

This regulatory protein is produced by platelets that inhibits complement 1 of the classical pathway.

a)

Alpha2-antiplasmin

b)

C1 esterase inhibitor

c)

Plasmin

d)

Beta thrombogobulin

60.

When platelets reached their maximum shelf-life, they are removed by the:

a)

Microglial cells

b)

Kupffer cells

c)

Alveolar cells

d)

Hoff bauer cells

e)

Littoral cells

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