WorksheetsMEDL 279 Hemostasis Review
Total questions: 70
Worksheet time: 35mins
Platelets are produced from which type of cell?
Megakaryocytes
Erythrocytes
Lymphocytes
Monocytes
What percentage of platelets are found in the spleen?
10%
30%
50%
70%
What is the basic reference range for platelet count per mm3?
150-450,000/mm3
50-100,000/mm3
500-1,000,000/mm3
10,000-50,000/mm3
What is the typical lifespan of platelets?
9-12 days
1-2 days
20-25 days
30-40 days
Which glycoprotein binds to exposed collagen during platelet adhesion?
Glycoprotein Ib
Glycoprotein IIb/IIIa
Glycoprotein VI
Glycoprotein Ia/IIa
Von Willebrands factor is required for which process in hemostasis?
Adhesion of platelets
Activation of fibrinogen
Synthesis of thrombin
Degradation of clot
What is the first phase of platelet aggregation?
Fibrinogen binding links the platelets
Platelets release serotonin
Platelets contract to form a plug
Thrombin converts fibrinogen to fibrin
Secreting platelets release arachidonic acid, which converts to what in the platelet?
Prostaglandin
Serotonin
Histamine
Dopamine
Which components are included in platelet release during the assembly and localization of the fibrin clot?
Fibrinogen, Factor V, Factor VIII
Collagen, ADP, Thrombin
Prostaglandin, Arachidonic acid, ADP
Glycoprotein Ib, Fibrinogen, Collagen
Which factor is the substrate in the plasma coagulation process?
Factor I (fibrinogen)
Factor II
Factor V
Factor VIII
Which of the following are cofactors that accelerate enzymatic reactions in plasma coagulation?
Factors III, V, and VII
Factors I, II, and IV
Factors IX, X, and XI
Factors VIII, IX, and XIII
Which enzyme cleaves peptide bonds in plasma coagulation?
Serine proteases
Transamidase
Factor HMWK
Prekallikrein
Fill in the blank: Transamidase acts on ______ only during plasma coagulation.
Factor XIII
Factor IX
Factor VII
Factor X
Which of the following are contact proteins involved in coagulation?
Factors XII, XI, PK & HMWK
Factors I, V, VIII, XIII
Factors II, VII, IX, X
Prekallikrein and HMWK
Which proteins are vitamin K dependent and are not consumed during clotting except for Factor II?
Prothrombin proteins (Factors II, VII, IX, X)
Fibrinogen proteins (Factors I, V, VIII, XIII)
Contact proteins (Factors XII, XI, PK & HMWK)
Enzymes
Fill in the blank: Fibrinogen proteins are consumed during the ______ process and increased in the ______ phase.
clotting, acute
healing, chronic
digestion, latent
respiratory, recovery
How are factor names denoted in plasma coagulation?
By Roman Numerals
By Greek Letters
By Arabic Numbers
By Colors
Which of the following is an exception to the factor naming system in plasma coagulation?
Prekallikrein
Factor I
Factor VII
Factor XIII
What factor is activated extrinsically by disrupted endothelial cell membrane complex with factor VII to directly activate it?
Factor X
Factor IX
Factor VIII
Factor XI
Which cofactor is bound with activated factor IX by calcium to the platelet phospholipid membrane (PL)?
Factor VIII
Factor V
Factor X
Factor XII
What does the prothrombinase complex convert prothrombin to?
Active thrombin
Inactive fibrin
Plasminogen
Fibrinogen
Thrombin cleaves peptides off of the fibrinogen molecule to form ______, which polymerizes to form insoluble fibrin strands.
fibrin
albumin
collagen
elastin
What factor does thrombin activate, which crosslinks the fibrin strands at the 'D' region?
Factor XIII
Factor VII
Factor IX
Factor X
Heparan sulfate on the endothelial cell binds to which molecule to inactivate the activated serine proteases?
Antithrombin (AT)
Protein C
Fibrinogen
Plasminogen
What does activated Protein C and its cofactor Protein S inactivate?
Factors VIII and V
Factors II and VII
Factors IX and X
Factors XI and XII
The fibrinolytic system is activated intrinsically by collagen via which factor?
Factor XII
Factor IX
Factor VII
Factor V
What does plasmin cleave fibrin strands to?
Soluble fragments of fibrin
Insoluble fibrin clots
Platelet aggregates
Activated thrombin
What is the recommended percentage of sodium citrate for specimen collection in coagulation studies?
3.2%
2.2%
5.0%
1.5%
What is the basic reference range for Prothrombin Time (PT)?
<= 13 seconds
15-20 seconds
20-25 seconds
30-35 seconds
Which factors are measured by Prothrombin Time (PT)?
A) I, II, V, VII, X
B) All factors except VII & XIII
C) Only factor I
D) None of the above
What is the therapeutic goal for the International Normalized Ratio (INR) in Prothrombin Time (PT)?
2.0-3.5
0.5-1.0
4.0-5.0
1.0-1.5
Activated Partial Thromboplastin Time (APTT) is used to monitor which therapy?
Warfarin
Heparin
Aspirin
None of the above
What is the basic reference range for Activated Partial Thromboplastin Time (APTT)?
20-40 seconds
10-20 seconds
40-60 seconds
60-80 seconds
Which test is a quantitative measure of factor I?
Fibrinogen assay
Prothrombin time
Activated partial thromboplastin time
D-dimer test
Thrombin Time (TT) is affected by decreased levels of ______ and presence of heparin and other antithrombins.
fibrinogen
prothrombin
calcium
vitamin K
What is the normal range for Bleeding Time (forearm)?
2-9 minutes
10-15 minutes
0.5-1 minute
15-20 minutes
Which of the following is NOT an in vivo aggregation agent for platelet aggregation?
ADP
Collagen
Calcium
Thrombin
Which of the following are agents that induce platelet aggregation?
ADP, Collagen, Ristocetin, Epinephrine, Thrombin, Arachidonic acid
Insulin, Glucose, Calcium, Potassium
Heparin, Warfarin, Aspirin, Ibuprofen
Vitamin K, Vitamin D, Iron, Zinc
As platelets aggregate, the turbidity of the platelet rich plasma _________?
decreases
increases
remains unchanged
fluctuates
Samples for platelet aggregation testing are kept at what temperature prior to testing?
Room temperature (RT), heated to 37°C
Refrigerated at 2-8°C
Frozen at -20°C
Incubated at 56°C
Aspirin inhibits the secondary wave of aggregation because ________ is destroyed.
Cyclooxygenase
Thrombin
Fibrinogen
Collagen
Abnormal ristocetin-induced aggregation is seen in which of the following disorders?
A) Bernard-Soulier and Von Willebrand's
B) Hemophilia A and B
C) Sickle cell anemia and Thalassemia
D) Iron deficiency anemia and Megaloblastic anemia
PT & APTT tests are performed with what type of plasma for factor assays?
Normal plasma
Specific factor deficient plasma
Platelet rich plasma
Serum
The normal range for % activity and amount of correction with normal plasma in factor assays is _________.
40-150%
10-30%
60-200%
25-75%
The APTT is insensitive to which anticoagulant?
LMWH (Low Molecular Weight Heparin)
Unfractionated Heparin
Warfarin
Direct Thrombin Inhibitors
Reptilase time is a test similar to thrombin time, but is not inhibited by ________.
heparin
warfarin
aspirin
clopidogrel
What is the deficiency in Hemophilia A?
Factor IX
Factor XI
Factor VIII
vWF
Hemophilia B is treated with _________.
factor IX concentrates
factor VIII concentrates
vitamin K
desmopressin
Which of the following is almost exclusively seen in men and is sex-linked recessive?
Hemophilia A
Hemophilia B
Both A and B
Hemophilia C
Hemophilia C is most commonly seen in which population?
A) Ashkenazi Jews
B) African Americans
C) Asians
D) Hispanics
Von Willebrand’s Disease is characterized by a primary defect in the ________.
vWF (von Willebrand factor)
platelet membrane glycoprotein IIb/IIIa
fibrinogen
prothrombin
Which test detects Factor XIII deficiency?
5M urea test
Bleeding time
Platelet count
PT/INR
Lupus anticoagulant (LA) is directed against _________?
phospholipids
immunoglobulins
red blood cells
platelets
Vitamin K deficiency results in functional deficiency of which clotting factors?
Factors II, VII, IX, and X
Factors I, V, VIII, and XIII
Factors III, V, VII, and XII
Factors I, II, V, and VIII
Which molecule is present but not functional in Vitamin K deficiency?
PIVKA molecules
Albumin
Transferrin
Hemoglobin
Vitamin K originates from the diet and which other source?
Gut bacteria
Skin cells
Liver enzymes
Pancreatic juice
Deficiency of which factors is seen in liver diseases?
Factors I, II, V, VII, IX, and X
Factors VIII and XIII only
Factors III, IV, and VI
Factors XI and XII
Which factor deficiency is most pronounced in liver diseases?
Factor VII deficiency
Factor IX deficiency
Factor VIII deficiency
Factor XII deficiency
What is increased due to fibrinolysis in liver diseases?
FDP (Fibrin Degradation Products)
Albumin
Prothrombin
Bilirubin
DIC is secondary to which conditions?
Sepsis or obstetric complications
Diabetes mellitus
Hypertension
Asthma
Which of the following is a principal antagonist of active coagulation proteases?
Protein C
Antithrombin
Fibrinogen
Plasminogen
Thrombotic diseases can be divided into which two main types of events?
Arterial Events and Venous Events
Pulmonary Events and Cardiac Events
Hepatic Events and Renal Events
Neurological Events and Gastrointestinal Events
Protein S is a ______ dependent protein that acts as a co-factor for protein C.
Vitamin K
Calcium
Iron
Magnesium
Which of the following states is functional for protein S?
Bound
Free
Both bound and free
None of the above
Factor V Leiden is a ______ Factor V that resists the action of protein C/S.
Mutant
Normal
Inactive
Deficient
The activated Protein C Resistance test is used to detect which condition?
Protein S deficiency
Factor V Leiden
Antiphospholipid syndrome
Prothrombin mutation
Antiphospholipid syndrome can be associated with which of the following antibodies?
Anticardiolipin antibodies
Lupus anticoagulant
Beta 2-glycoprotein antibodies
All of the above
1-2% of the general population are ______ for the prothrombin mutation.
heterozygotes
homozygotes
hemizygotes
carriers of sickle cell trait
Prothrombin mutation results in increased ______ formation.
thrombin
fibrinogen
platelet
plasmin
Prothrombin mutation increases the risk of what type of event?
thrombotic event
hemorrhagic event
allergic reaction
infectious disease
