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Pediatric and Geriatric Hematology and Hemostasis

Total questions: 303

Worksheet time: 3hrs 44mins

Name
Class
Date
1.

PEDIATRIC HEMATOLOGY AND HEMOSTASIS

It is inappropriate to use the adult reference interval for the assessment of pediatric blood values.

a)

True

b)

False

2.

PEDIATRIC HEMATOLOGY AND HEMOSTASIS

Newborns, children, or adults primarily exhibit profound hematologic differences from one another.

a)

True

b)

False

3.

PEDIATRIC HEMATOLOGY AND HEMOSTASIS

The concentration cells in the blood of newborns differ as compared to an adult.

a)

True

b)

False

4.

PEDIATRIC HEMATOLOGY AND HEMOSTASIS

Dramatic changes may occur in the blood and bone marrow of the newborn infant especially during the

________________________

a)

first hours and days after birth.

b)

first hours and days before birth.

5.

PEDIATRIC HEMATOLOGY AND HEMOSTASIS

There are significant hematologic differences that are normally seen between the different types of blood of newborns such as:

a)

Term and Preterm

b)

Infants, young children, and older children

c)

All hematologic elements.

6.

PRENATAL HEMATOPOIESIS

Hematopoiesis or the formation of and development of blood cells begins from the

a)

HEMATOPOIETIC STEM CELLS.

b)

All hematologic elements.

7.

PRENATAL HEMATOPOIESIS

HEMATOPOIETIC STEM CELLS

Commences in the ____________________

a)

1ST WEEK OF EMBRYONIC DEVELOPMENT

b)

2ND WEEK OF EMBRYONIC DEVELOPMENT

8.

PRENATAL HEMATOPOIESIS

First cells produced in the developing embryo, we call it as your _________________

a)

PRIMITIVE ERYTHROBLAST

b)

HEMATOPOIETIC STEM CELLS

9.

PRENATAL HEMATOPOIESIS

PRIMITIVE ERYTHROBLAST

These cells appear to be ___________.

a)

MEGALOBLASTIC

b)

LARGE NUCLEATED CELLS SYNTHESIZING EMBRYONIC HEMOGLOBINS

10.

PRENATAL HEMATOPOIESIS

PRIMITIVE ERYTHROBLAST

They circulate as ___________.

a)

MEGALOBLASTIC

b)

LARGE NUCLEATED CELLS SYNTHESIZING EMBRYONIC HEMOGLOBINS

11.

PRENATAL HEMATOPOIESIS

A second wave of yolk sac-derived erythroid progenitor cells is called as the _____________

a)

MEGALOBLASTIC

b)

BFUE or the BURST- FORMING UNITS ERYTHROID

12.

PRENATAL HEMATOPOIESIS

A second wave of yolk sac-derived erythroid progenitor cells is called as the BFUE or the BURST-

FORMING UNITS ERYTHROID.

a)

Normally appear around 4 WEEKS.

b)

Normally appear around 5 WEEKS.

13.

PRENATAL HEMATOPOIESIS

A second wave of yolk sac-derived erythroid progenitor cells is called as the BFUE or the BURST-

FORMING UNITS ERYTHROID.

a)

Thought to seed the fetal liver.

b)

Thought to seed the fetal kidney.

14.

PRENATAL HEMATOPOIESIS

By the _________________hematopoiesis ceases in the yolk sac.

a)

2ND MONTH OF GESTATION,

b)

3RD MONTH OF GESTATION,

15.

PRENATAL HEMATOPOIESIS

By the 2ND MONTH OF GESTATION, hematopoiesis ceases in the yolk sac.

a)

And this is the time that the LIVER becomes the center for hematopoiesis.

b)

And this is the time that the KIDNEY becomes the center for hematopoiesis.

16.

PRENATAL HEMATOPOIESIS

By the 2ND MONTH OF GESTATION, hematopoiesis ceases in the yolk sac.

a)

it reaches its peak activity during the THIRD and FOURTH MONTH.

b)

it reaches its peak activity during the FIRST and SECOND MONTH.

17.

PRENATAL HEMATOPOIESIS

_____________________ of each cell type systematically make their appearance.

a)

MEGAKARYOCYTES

b)

LEUKOCYTES

c)

PLATELETS

18.

PRENATAL HEMATOPOIESIS

In the _____________________ can be detected in the region of the THYMUS.

a)

10TH WEEK OF GESTATION, LYMPHOCYTES

b)

9TH WEEK OF GESTATION, LYMPHOCYTES

19.

PRENATAL HEMATOPOIESIS

In the 9TH WEEK OF GESTATION, LYMPHOCYTES can be detected in the region of the _______.

a)

PANCREAS

b)

THYMUS

20.

PRENATAL HEMATOPOIESIS

The__________________ the BONE MARROW emerged as a major site of blood

production.

a)

4TH and 5TH GESTATIONAL MONTH,

b)

3RD and 4TH GESTATIONAL MONTH,

21.

PRENATAL HEMATOPOIESIS

The 4TH and 5TH GESTATIONAL MONTH, the___________emerged as a major site of blood

production

a)

BONE MARROW

b)

SPLEEN

22.

PRENATAL HEMATOPOIESIS

The 4TH and 5TH GESTATIONAL MONTH, the BONE MARROW emerged as a major site of blood

production

a)

Primarily on FLAT and on the END OF LONG BONES.

b)

Primarily on FLAT and on the END OF SHORT BONES.

23.

PRENATAL HEMATOPOIESIS

The bone marrow, particularly the _________, it is where your bone marrow is highly concentrated.

a)

RED MARROW

b)

YELLOW MARROW

24.

PRENATAL HEMATOPOIESIS

primary site by birth.

a)

RED MARROW

b)

YELLOW MARROW

25.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

During the FIRST FEW WEEKS, the YOLK SAC is the chief site of blood cells production.

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

26.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

As it proceeds, you may notice that from the yolk sac or the mesoblastic space, it will become the LIVER being the site of hematopoiesis during this period

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

27.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

And of course, your BONE MARROW or the myeloid organ being the primary site of hematopoiesis during this period.

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

28.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

YOLK SAC

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

29.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

LIVER

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

30.

PRENATAL HEMATOPOIESIS

Sites of Hematopoiesis:

BONE MARROW

a)

MESOBLASTIC

b)

HEPATIC

c)

MYELOID

31.

HEMATOPOIESIS OF THE NEONATE

With all the hematologic or hematopoietic cell lineage undergoing cellular differentiation and amplification

a)

True

b)

False

32.

HEMATOPOIESIS OF THE NEONATE

ACTIVE Bone Marrow

a)

RED Marrow

b)

YELLOW Marrow

c)

CORD BLOOD

33.

HEMATOPOIESIS OF THE NEONATE

INACTIVE Bone Marrow

a)

RED Marrow

b)

YELLOW Marrow

c)

CORD BLOOD

34.

HEMATOPOIESIS OF THE NEONATE

PROGENITOR CELLS in __________

a)

RED Marrow

b)

YELLOW Marrow

c)

CORD BLOOD

35.

HEMATOPOIESIS OF THE NEONATE

At the time of (a)   , you all know that the bone marrow is fully active and almost completely cellular.

36.

HEMATOPOIESIS OF THE NEONATE

____________________may be seen in times of STRESS.

a)

EXTRA-MEDULLARY HEMATOPOIESIS

b)

MEDULLARY HEMATOPOIESIS

37.

HEMATOPOIESIS OF THE NEONATE

EXTRA-MEDULLARY HEMATOPOIESIS may be seen in times of ______.

a)

STRESS

b)

SLEEP

38.

HEMATOPOIESIS OF THE NEONATE

EXTRA-MEDULLARY HEMATOPOIESIS may be seen in times of STRESS

a)

Most commonly in the LIVER, SPLEEN, LYMPH NODES, or even in the PARAVERTEBRAL

regions.

b)

Most commonly in the KIDNEY, SPLEEN, LYMPH NODES, or even in the PARAVERTEBRAL

regions.

39.

PEDIATRIC DEVELOPMENT STAGES

Pediatric population can be categorized with reference to 3 different developmental stages:

FIRST 4-WEEKS of Life

a)

NEONATAL PERIOD

b)

INFANCY

c)

CHILDHOOD

40.

PEDIATRIC DEVELOPMENT STAGES

Pediatric population can be categorized with reference to 3 different developmental stages:

FIRST YEAR of Life

a)

NEONATAL PERIOD

b)

INFANCY

c)

CHILDHOOD

41.

PEDIATRIC DEVELOPMENT STAGES

Pediatric population can be categorized with reference to 3 different developmental stages:

1 to Puberty (Ages 8-12 years)

a)

NEONATAL PERIOD

b)

INFANCY

c)

CHILDHOOD

42.

PEDIATRIC DEVELOPMENT STAGES

Pediatric hematologic values change markedly:

a)

Ideally in the first weeks and months of life.

b)

Many variables influence the interpretation of what might be considered healthy at the time of birth.

c)

Very important to provide age-appropriate pediatric hematologic reference value that

extend from the neonatal life through the adolescence.

43.

GESTATIONAL AGE AND BIRTH WEIGHT

Hematologic values obtained from a___________generally do not apply to preterm.

a)

Full-term infant

b)

Premature or Preterm

c)

Post-term infant

44.

GESTATIONAL AGE AND BIRTH WEIGHT

Laboratory values for low-birth-weight ___________ infants differ from values for extremely low birth

weight infants

a)

Full-term infant

b)

Premature or Preterm

c)

Post-term infant

45.

GESTATIONAL AGE AND BIRTH WEIGHT

Infant who has completed 37 to 42 weeks of gestation

a)

Full-term infant

b)

Premature or Preterm

c)

Post-term infant

46.

GESTATIONAL AGE AND BIRTH WEIGHT

Infant born before 37 weeks gestation

a)

Full-term infant

b)

Premature or Preterm

c)

Post-term infant

47.

GESTATIONAL AGE AND BIRTH WEIGHT

Delivered after 42 weeks

a)

Full-term infant

b)

Premature or Preterm

c)

Post-term infant

48.

GESTATIONAL AGE AND BIRTH WEIGHT

Infants can be subcategorized further by birth weight as described by the following:

a)

Appropriate size for gestational age

b)

Small for gestational age, including low-birth- weight infants

c)

Very low-birth-weight infants

d)

Extremely low-birth-weight micropreemies

e)

Large for gestational age

49.

GESTATIONAL AGE AND BIRTH WEIGHT

Birth weight:

Small for gestational age, including low-birth-weight infants

a)

2500 g or less

b)

1500 g or less

c)

1000 g (1kg)

d)

More than 4000 g (>4000 g)

50.

GESTATIONAL AGE AND BIRTH WEIGHT

Birth weight:

Very low-birth-weight infants

a)

2500 g or less

b)

1500 g or less

c)

1000 g (1kg)

d)

More than 4000 g (>4000 g)

51.

GESTATIONAL AGE AND BIRTH WEIGHT

Birth weight:

Extremely low-birth-weight micropreemies

a)

2500 g or less

b)

1500 g or less

c)

1000 g (1kg)

d)

More than 4000 g (>4000 g)

52.

GESTATIONAL AGE AND BIRTH WEIGHT

Birth weight:

Large for gestational age

a)

2500 g or less

b)

1500 g or less

c)

1000 g (1kg)

d)

More than 4000 g (>4000 g)

53.

SPECIMEN COLLECTION FOR THE NEONATE

Neonatal hematologic values are affected by gestational age particularly of ____________

____, _________, ____________, and also by the _______________

a)

infant birth weight,

b)

age

c)

hours after delivery

d)

presence of illness

e)

level of support required.

54.

SPECIMEN COLLECTION FOR THE NEONATE

Other important variable to be considered when evaluating laboratory data include the following:

a)

Site of sampling and technique

b)

Timing of sampling

c)

Course of labor

d)

Treatment of the umbilical vessels and maternal drug use

55.

SPECIMEN COLLECTION FOR THE NEONATE

The presence of fetal hemoglobin such as ___________ including _______ and _____ in newborn can also interfere with the hematology laboratory testing.

a)

Hemoglobin F

b)

bilirubin

c)

lipids

56.

SPECIMEN COLLECTION FOR THE NEONATE

As with all laboratory testing, it is important to know that each laboratory should establish reference

intervals base on the methods that they are using, the instrumentation, and the patient population

a)

It depends on the race of the patient (whit, black, asian)

b)

It may vary depending on their characteristics

57.

RED BLOOD CELL VALUES IN THE NEONATE

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

58.

RED BLOOD CELL VALUES IN THE NEONATE

It remains in this plateau for about 2 weeks and then it will turn to slowly decline

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

59.

RED BLOOD CELL VALUES IN THE NEONATE

the trigger for increased section of EPO

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

60.

RED BLOOD CELL VALUES IN THE NEONATE

This polycythemia of the newborn may be explained by utero hypoxia, in which it becomes more pronounced as the fetus grows

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

61.

RED BLOOD CELL VALUES IN THE NEONATE

In the event of hypoxia, it is the trigger for increased secretion of erythropoietin

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

62.

RED BLOOD CELL VALUES IN THE NEONATE

At birth, the physiologic environment changes. The fetus makes the transition from the placenta

dependent oxygenation to the increased tissue oxygenation by the lungs

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

63.

RED BLOOD CELL VALUES IN THE NEONATE

Early normoblasts are MEGALOBLASTIC, hypochromic, and irregularly shaped

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

64.

RED BLOOD CELL VALUES IN THE NEONATE

During hepatic hematopoiesis, normoblasts (immature RBCs) are smaller than the

megaloblasts of the yolk sac but are still MACROCYTIC

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

65.

RED BLOOD CELL VALUES IN THE NEONATE

It gradually changes its characteristic (normocytic,normochromic morphology)

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

66.

RED BLOOD CELL VALUES IN THE NEONATE

You may also observe the presence of orthochromic normoblasts because these cells are identified in the full-term infant, particularly on the first day of life

  • -Take note! It actually disappears within postnatal days (3-5 days).

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

67.

RED BLOOD CELL VALUES IN THE NEONATE

Average no. of ranges is from…

3-10 per 100 WBCs for full-term infant

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

68.

RED BLOOD CELL VALUES IN THE NEONATE

Average no. of ranges is from…

25 NRBCs in a premature infant

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

69.

RED BLOOD CELL VALUES IN THE NEONATE

Nucleated RBCs

Average no. of ranges is from…

25 NRBCs in a ______

a)

premature infant

b)

full-term infant

70.

RED BLOOD CELL VALUES IN THE NEONATE

Nucleated RBCs

Average no. of ranges is from…

3-10 per 100 WBCs for ______

a)

premature infant

b)

full-term infant

71.

RED BLOOD CELL VALUES IN THE NEONATE

____________or orthochromic normoblasts may persist longer than a week in immature infants

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

72.

RED BLOOD CELL VALUES IN THE NEONATE

The presence of _______ for more than 5 days suggests hemolysis, hypoxic stress, and may be dueto acute infection

a)

RBC count increases during the first 24 hours of life

b)

Hypoxia

c)

Erythrocyte Morphology of the neonate

d)

Nucleated RBCs

73.

RED BLOOD CELL VALUES IN THE NEONATE

The ________ of newborns actually show additional morphological differences because you

know that the number of biconcave discs relative to stomatocytes is actually reduced in neonates

compared with adults

a)

erythrocytes

b)

Nucleated RBCs

74.

RED BLOOD CELL VALUES IN THE NEONATE

The increase number of the __________ including stomatocytes, burr cells, spherocytes, and

other abnormally shaped erythrocytes are normally seen in neonates.

a)

erythrocytes

b)

pitted blood cells

75.

RED BLOOD CELL VALUES IN THE NEONATE

The presence of______________ is even higher in premature infants and other types of poikilocytes.

a)

erythrocytes

b)

pitted blood cells

c)

morphic cells

76.

RED BLOOD CELL VALUES IN THE NEONATE

Presence of NRBCs for more than 5 days

a)

Hemolysis

b)

Hypoxic stress

c)

May be due to acute infection

77.

RETICULOCYTE COUNT

An apparent reticulocytosis actually exists during _______

a)

gestation

b)

3 days after birth.

78.

RETICULOCYTE COUNT

Reticulocytosis persists for about _______

a)

gestation

b)

3 days after birth.

79.

RETICULOCYTE COUNT

An apparent reticulocytosis actually exists during gestation.

a)

It is actually decreasing from 90% reticulocytes at 12 weeks gestation to 15% at 6 months gestation and ultimately, at 4-6% at birth

b)

And then, it declines abruptly to 0.8 reticulocyte on postnatal days (4-7)

80.

RETICULOCYTE COUNT

Reticulocytosis persists for about 3 days after birth.

a)

It is actually decreasing from 90% reticulocytes at 12 weeks gestation to 15% at 6 months gestation and ultimately, at 4-6% at birth

b)

And then, it declines abruptly to 0.8 reticulocyte on postnatal days (4-7)

81.

RETICULOCYTE COUNT

At ________, the number of reticulocytes increases slightly

a)

3 months

b)

2 months

82.

RETICULOCYTE COUNT

Reticulocyte count of premature is _________of term infants

a)

low than

b)

higher than

83.

RETICULOCYTE COUNT

_____ Reticulocytes

a)

Prenatal

b)

Postnatal

84.

RETICULOCYTE COUNT

Followed by a slight decline from 3 months to 3 years when adult levels reach the concentration of 0.5% to 2.5%

a)

At 2 months, the number of reticulocytes increases slightly

b)

Reticulocyte count of premature is higher than of term infants

c)

Postnatal Reticulocytes

85.

RETICULOCYTE COUNT

However, the count can be vary dramatically because it actually depends on the extent of illness in the newborns, especially if they are suffering from certain abnormalities

a)

At 2 months, the number of reticulocytes increases slightly

b)

Reticulocyte count of premature is higher than of term infants

c)

Postnatal Reticulocytes

86.

RETICULOCYTE COUNT

Condition associated with significant polychromasia seen on a Wright-stained blood film

a)

At 2 months, the number of reticulocytes increases slightly

b)

Reticulocyte count of premature is higher than of term infants

c)

Postnatal Reticulocytes

87.

PERIPHERAL BLOOD FILM FROM A PREMATURE INFANT

The appearance of the RBCs, there are:

a)

Spherocytic cells

b)

Burst cells

c)

Echinocytes

d)

Nucleated RBCs

e)

Lymphocytes

88.

PERIPHERAL BLOOD FILM FROM A PREMATURE INFANT

Don’t be confused with their appearance (NRBCs and lymphocytes) they resemble each other but

lymphocytes are slightly larger than NRBCs

a)

True

b)

False

89.

HEMOGLOBIN

Hemoglobin synthesis results from an orderly evolution of a series of embryonic, fetal, and adult

hemoglobin.

a)

True

b)

False

90.

HEMOGLOBIN

Hb F is 53% to 95% of the total population of hemoglobin

a)

At birth

b)

30 weeks of gestation

c)

12 weeks after birth

d)

6 months of age

91.

HEMOGLOBIN

Hb F declines from 90% to 95%

a)

At birth

b)

30 weeks of gestation

c)

12 weeks after birth

d)

6 months of age

92.

HEMOGLOBIN

Hb F is approximately 7%

a)

At birth

b)

30 weeks of gestation

c)

12 weeks after birth

d)

6 months of age

93.

HEMOGLOBIN

Hb F stabilizes at 2% to 3%

a)

At birth

b)

30 weeks of gestation

c)

12 weeks after birth

d)

6 months of age

94.

HEMOGLOBIN

As an individual grow along, the levels of Hb F ________

a)

decreases

b)

increases

95.

HEMOGLOBIN

The switch from Hb F to Hb A is genetically controlled and determined by gestational age;

a)

It does not appear to be influenced by the age at which birth occurs.

b)

It does appear to be influenced by the age at which birth occurs.

96.

HEMOGLOBIN

Factors influence the hemoglobin level in newborn infants:

a)

Site of sampling

b)

Gestational age

c)

Time interval between delivery

d)

Clamping of the umbilical cord

e)

Number of RBCs

97.

HEMOGLOBIN

In addition, there are significant differences between Capillary and Venous blood hemoglobin levels

a)

True

b)

False

98.

HEMOGLOBIN

Capillary specimens in newborns generally has a_________concentration than venous

specimens, which can be attributed to circulatory factors

a)

higher hemoglobin

b)

low hemoglobin

99.

HEMOGLOBIN

Capillary is greater than venous specimen, in terms of concentration.

a)

True

b)

False

100.

HEMOGLOBIN

Racial differences must also be considered when evaluating hemoglobin levels in children

a)

True

b)

False

101.

HEMOGLOBIN

Black children have hemoglobin levels averaging __________those in white children

a)

0.5 g/dL lower than

b)

0.5 g/dL more than

102.

HEMOGLOBIN

Racial Differences

16.5 to 21.5 g/dL

a)

Reference interval for a full-term infant at birth

b)

Average Hgb value for preterm infant

103.

HEMOGLOBIN

Racial Differences

17.1 g/dL

a)

Reference interval for a full-term infant at birth

b)

Average Hgb value for preterm infant

104.

HEMOGLOBIN

Racial Differences

Less than 14g/dL is considered to be abnormal

a)

Reference interval for a full-term infant at birth

b)

Average Hgb value for preterm infant

105.

HEMOGLOBIN

Racial Differences

Less than 13.7g/dL is considered to be abnormal

a)

Reference interval for a full-term infant at birth

b)

Average Hgb value for preterm infant

106.

PHYSIOLOGIC ANEMIA OF THE NEONATE

The hemoglobin concentration of term infants decreases during the __________, a condition known as physiologic anemia of neonate/infants

a)

first 4 to 8 weeks of life

b)

first 5 to 8 weeks of life

107.

PHYSIOLOGIC ANEMIA OF THE NEONATE

Physiologic Anemia of Prematurity

a)

Infants born prematurely also experience a decrease in hemoglobin concentration

b)

Infants born prematurely also experience a increase in hemoglobin concentration

108.

PHYSIOLOGIC ANEMIA OF THE NEONATE

There is a reduction of the following parameters:

a)

Number of RBCs

b)

Reticulocyte percentage

c)

Undetectable levels of EPO associated with the transition from the placenta to the lungs as a source of oxygen

109.

PHYSIOLOGIC ANEMIA OF THE NEONATE

When the hemoglobin concentration ___________, erythropoietic activity increases until it reaches its adult levels by age 14 years.

a)

decreases to approximately 11 g/dL

b)

increases to approximately 11 g/dL

110.

PHYSIOLOGIC ANEMIA OF THE NEONATE

WhAlso contributing to the physiologic anemia is the ______ life span of the fetal RBC.

a)

shortened

b)

longer

111.

PHYSIOLOGIC ANEMIA OF THE NEONATE

The lifespan of erythrocytes in term:

60 to 70 days

a)

Neonates

b)

Premature Neonates

112.

PHYSIOLOGIC ANEMIA OF THE NEONATE

The lifespan of erythrocytes in term:

35 to 50 days

a)

Neonates

b)

Premature Neonates

113.

PHYSIOLOGIC ANEMIA OF THE NEONATE

The more immature the infant, the shorter the lifespan

a)

True

b)

False

114.

PHYSIOLOGIC ANEMIA OF THE NEONATE

This physiologic anemia is not known to be associated with any abnormalities in the infant.

a)

True

b)

False

115.

PHYSIOLOGIC ANEMIA OF THE NEONATE

The hemoglobin levels of premature infants are typically ____________________

a)

1 g/dL or more below the values of full-term infants.

b)

2 g/dL or more below the values of full-term infants.

116.

PHYSIOLOGIC ANEMIA OF THE NEONATE

Very low-birth-weight infants, ideally those infant who has a weight of less than 1500g, they actually

show a progressive decline in:

a)

Hemoglobin

b)

RBC count

c)

Mean cell volume (MCV)

d)

Mean cell hemoglobin concentration (MCHC)

e)

And as slower recovery than other preterm and term infants

117.

HEMATOCRIT (HCT)

61% (Normal value: 48-68%)

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

118.

HEMATOCRIT (HCT)

It is high compared to adult individuals

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

119.

HEMATOCRIT (HCT)

Associated with increased hematocrit with values > 65%

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

120.

HEMATOCRIT (HCT)

This can cause problems in producing a high- quality peripheral blood film

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

121.

HEMATOCRIT (HCT)

Male: 47%

Female: 42%

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

122.

HEMATOCRIT (HCT)

Many require transfusions or erythropoietin injections or both

a)

Average Capillary Hematocrit for Full-term infants

b)

Hyperviscosity

c)

Adolescence

d)

Very low-birth-weight preterm infants are often anemic at birth.

123.

HEMATOCRIT (HCT)

The HCT usually increases approximately ___________

a)

5% during the first 48 postnatal hours

b)

10% during the first 48 postnatal hours

124.

HEMATOCRIT (HCT)

HCT usually increases approx. 5%

a)

First postnatal hours

b)

2 weeks

c)

Between the 2nd and 4th months

125.

HEMATOCRIT (HCT)

Show linear decline to 46% to 62%

a)

First postnatal hours

b)

2 weeks

c)

Between the 2nd and 4th months

126.

HEMATOCRIT (HCT)

32% to 40%

a)

First postnatal hours

b)

2 weeks

c)

Between the 2nd and 4th months

127.

RED BLOOD INDICES

The RBC indices and RBC distribution width provide as on of the indicator for assessing the type of anemia

a)

True

b)

False

128.

RED BLOOD INDICES

Full-term infants - 119 ± 9.4fL

o However, there is a sharp decrease that occurs during the first 24 hours of life

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

129.

RED BLOOD INDICES

3 - 4 months – decrease to 90 ± 12 fL

o The more premature the infant, the higher the MCV

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

130.

RED BLOOD INDICES

MCV of < 94 fL – should be evaluated for ɑ-thalassemia or iron deficiency

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

131.

RED BLOOD INDICES

Healthy neonates: 30 – 42 pg

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

132.

RED BLOOD INDICES

Premature infants: 27 – 41 pg

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

133.

RED BLOOD INDICES

Approximately 33 g/dL

o Same for full-term infants, in premature infants and adults

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

134.

RED BLOOD INDICES

Reference value: 14.2% to 17.8%

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

135.

RED BLOOD INDICES

Elevated in newborns

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

136.

RED BLOOD INDICES

The first 30 days of life. After these it may gradually decrease and until it reaches the adult reference interval by 6 months of age.

a)

Mean Cell Volume

b)

Mean Cell Hemoglobin

c)

Mean Cell Hemoglobin Concentration

d)

Red Blood Cell Distribution Width

137.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 15.6

Age of Infant Days 12-14: 14.4

Age of Infant Days 24-26: 12.4

Age of Infant Days 40-42: 10.6

a)

Hemoglobin (g/dL)

b)

Hematocrit (%)

c)

Red blood cells (x10^12/L)

d)

Reticulocytes (%)

e)

Platelets (x10^9/L)

138.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 47

Age of Infant Days 12-14: 44

Age of Infant Days 24-26: 39

Age of Infant Days 40-42: 33

a)

Hemoglobin (g/dL)

b)

Hematocrit (%)

c)

Red blood cells (x10^12/L)

d)

Reticulocytes (%)

e)

Platelets (x10^9/L)

139.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 4.2

Age of Infant Days 12-14: 4.1

Age of Infant Days 24-26: 3.8

Age of Infant Days 40-42: 3.4

a)

Hemoglobin (g/dL)

b)

Hematocrit (%)

c)

Red blood cells (x10^12/L)

d)

Reticulocytes (%)

e)

Platelets (x10^9/L)

140.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 7.1

Age of Infant Days 12-14: 1.7

Age of Infant Days 24-26: 1.5

Age of Infant Days 40-42: 1.8

a)

White blood cells (x10^9/L)

b)

Red blood cells (x10^12/L)

c)

Reticulocytes (%)

d)

Platelets (x10^9/L)

141.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 203.5

Age of Infant Days 12-14: 318

Age of Infant Days 24-26: 338

Age of Infant Days 40-42: 357

a)

White blood cells (x10^9/L)

b)

Red blood cells (x10^12/L)

c)

Reticulocytes (%)

d)

Platelets (x10^9/L)

142.

RED BLOOD INDICES

Hematologic Values for Very Low-Birth-Weight Infants During the First 6 Weeks of Life

Age of Infant Days 3: 9.5

Age of Infant Days 12-14: 12.3

Age of Infant Days 24-26: 10.4

Age of Infant Days 40-42: 9.1

a)

White blood cells (x10^9/L)

b)

Red blood cells (x10^12/L)

c)

Reticulocytes (%)

d)

Platelets (x10^9/L)

143.

RED BLOOD INDICES

Hemoglobin, Hematocrit, RBCs, and Reticulocytes

o Tend to decrease as the infant grows.

a)

True

b)

False

144.

RED BLOOD INDICES

Platelets

o There is a decreased level in the number of platelets in infants, but it increases as it reaches its full maturity.

a)

True

b)

False

145.

RED BLOOD INDICES

WBCs

o It varies.

a)

True

b)

False

146.

ANEMIA IN INFANTS AND CHILDREN

Nutritional deficiencies in infants and children can result in:

a)

Iron deficiency anemia

b)

Rarely, in megaloblastic anemia, particularly in low-birthweight and premature infants.

147.

ANEMIA IN INFANTS AND CHILDREN

These anemias are associated with abnormal psychomotor development.

a)

True

b)

False

148.

ANEMIA IN INFANTS AND CHILDREN

However, they can easily be treated with dietary fortification.

▪ The food that they eat must contain a significant amount of iron, Vit B12, or folate.

a)

True

b)

False

149.

IRON DEFICIENCY ANEMIA

most common pediatric hematologic disorder

a)

True

b)

False

150.

IRON DEFICIENCY ANEMIA

most common cause of anemia in childhood

a)

True

b)

False

151.

IRON DEFICIENCY ANEMIA

More prevalent in premature infant

▪ because the majority of the placental transfer of maternal iron occurs late in the third trimester

a)

True

b)

False

152.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Can be used to assess the status of the patient

a)

True

b)

False

153.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Tend to decrease as to be undetectable in neonates, which makes it unreliable as a marker of infant hemolysis.

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

154.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Also lower in neonates

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

155.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

But will increase rapidly after birth and until reaching adult levels at 6 months

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

156.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

High at birth

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

157.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Rise during the first month.

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

158.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Drop to their lowest level between 6 months and 4 years of age

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

159.

ANCILLARY TESTS FOR ANEMIA IN INFANTS AND CHILDREN

Remain low throughout childhood

a)

Haptoglobin Levels

b)

Transferrin Levels

c)

Serum Ferritin and Serum Iron

160.

NEUTROPHILIC LEUKOCYTE

is higher in term and premature infants than in OLDER CHILDREN

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

161.

NEUTROPHILIC LEUKOCYTE

Characteristically maintains a predominance of lymphocytes

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

162.

NEUTROPHILIC LEUKOCYTE

_____higher than their neutrophils. But when they become adult, neutrophils become dominant instead of the lymphocytes.

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

163.

NEUTROPHILIC LEUKOCYTE

_____are also higher for the first 3-4 days after birth.

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

164.

NEUTROPHILIC LEUKOCYTE

Exhibit a left shift

o Promyelocyte and myelocytes are commonly observed.

o The trend to lymphocytes predominance occurs later than in full term infants.

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

165.

NEUTROPHILIC LEUKOCYTE

Neutrophil count in premature infants are similar to or slightly lower than the neutrophil counts in full-term during the first 5 days of life.

o However, the count gradually declines until it reaches 4 weeks.

o There is no significant difference in absolute neutrophil count of infants by birth weight or gestational age.

 However, when the infants have a very low birth weight, they have significantly lower limit compared to larger infants

 Kapag maliit ang size mo, expected na mas mababa ang counts ng cells compared to larger infants

a)

ABSOLUTE NEUTROPHIL COUNT

b)

Lymphocytes

c)

Band forms

d)

Premature Infants

166.

WHITE BLOOD CELL VALUES IN NEONATE

Typical at birth for full-term and preterm infants, with a wide reference interval.

(a)  

167.

WHITE BLOOD CELL VALUES IN NEONATE

You may notice there are segmented neutrophils and bands and an occasional metamyelocyte, with no evidence of disease.

(a)  

168.

WHITE BLOOD CELL VALUES IN NEONATE

Absolute neutrophil count rises within the first 8 to 12 hours after birth and then declines by 12 hours to a constant level

(a)  

169.

WHITE BLOOD CELL VALUES IN NEONATE

Absolute neutrophil count rises within the first 8 to 12 hours after birth and then declines by 12 hours to a constant level

(a)  

170.

NEUTROPHILIC LEUKOCYTE

Have an absolute neutrophil count averaging 2,000 cells /mL higher of those of boys.

a)

Newborn girls

b)

Neonates

171.

NEUTROPHILIC LEUKOCYTE

_______ whose mothers who have undergone labor have higher counts than those neonates delivered by cesarean section which with no preceding maternal labor.

a)

Newborn girls

b)

Neonates

172.

NEUTROPHILIC LEUKOCYTE

There is some evidence that absolute neutrophil count is lower in black children than the white children.

a)

False

b)

True

173.

NEUTROPHILIC LEUKOCYTE

Reduction in the number of circulating neutrophils to less than 1.5 x 109/L

a)

NEUTROPENIA

b)

NEUTROPHILIA

174.

NEUTROPHILIC LEUKOCYTE

__________ accompanied by the bands and metamyelocytes is often associated with infection,

particularly in preterm neonates

a)

NEUTROPENIA

b)

NEUTROPHILIA

175.

NEUTROPHILIC LEUKOCYTE

__________ represents a decrease in the neutrophil production or increase in consumption

a)

NEUTROPENIA

b)

NEUTROPHILIA

176.

NEUTROPHILIC LEUKOCYTE

Increase in the absolute number of neutrophils to greater than 8.0 x 109/L

a)

NEUTROPENIA

b)

NEUTROPHILIA

177.

NEUTROPHILIC LEUKOCYTE

Morphologic changes associated with infection include:

 Dohle bodies

 Vacuoles

 Toxic granulation

a)

NEUTROPENIA

b)

NEUTROPHILIA

178.

WHITE BLOOD CELL VALUES IN NEONATE

Remain consistent throughout infancy and childhood

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

179.

WHITE BLOOD CELL VALUES IN NEONATE

Tend to decrease to…

▪ 50% by 4 years,

▪ 40% by 6 years, and

▪ 30% by 8 years

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

180.

WHITE BLOOD CELL VALUES IN NEONATE

Constitute about 40% of the leukocytes at birth and increase to 60% at 4-6 months

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

181.

WHITE BLOOD CELL VALUES IN NEONATE

_______primarily the midstage B cells.

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

182.

WHITE BLOOD CELL VALUES IN NEONATE

They vary in diameter: 10 to 20 um

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

183.

WHITE BLOOD CELL VALUES IN NEONATE

Have scant cytoplasm and condensed but homogenous nuclear chromatin

▪ They have small indistinct nucleoli

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

184.

WHITE BLOOD CELL VALUES IN NEONATE

Although these _______ may be similar in appearance to the malignant cells that seen in childhood acute lymphoblastic leukemia (ALL).

▪ These benign cells lack the asynchronous or the aberrant antigen expression, which is seen in ALL.

▪ Halos kamukha ng midstage B cell with the cell with childhood ALL.

▪ Therefore, it can be differentiated by the method immunophenotyping.

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

185.

WHITE BLOOD CELL VALUES IN NEONATE

Higher in neonates than in adult

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

186.

WHITE BLOOD CELL VALUES IN NEONATE

Average proportion of 6%

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

187.

WHITE BLOOD CELL VALUES IN NEONATE

Average of 5% is maintained during infancy and childhood except in the 2nd and 3rd week

▪ When the proportion increases around 9%.

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

188.

WHITE BLOOD CELL VALUES IN NEONATE

The count reaches adult levels at 3-5 months

a)

EOSINOPHILS

b)

BASOPHILS

c)

LYMPHOCYTES

d)

MONOCYTE

189.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

The immune response of the newborn is considered immature.

a)

With decrease response to agonists? avenues?

b)

This distinct immune response is postulated to be related to the demand of the fetal environment and the need to avoid response to maternal antigen

190.

Common cause of morbidity in premature and low birth weight infants.

(a)  

191.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

The following are the markers of sepsis:

a)

Band Counts

b)

CD64 index

c)

C-reactive protein (CRP)

d)

Procalcitonin

192.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

The following are the markers of sepsis:

Increase level is related to sepsis

a)

Band Counts

b)

CD64 index

c)

C-reactive protein (CRP)

d)

Procalcitonin

193.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

The following are the markers of sepsis:

Marker of inflammation

a)

Band Counts

b)

CD64 index

c)

C-reactive protein (CRP)

d)

Procalcitonin

194.

PLATELET VALUES IN THE NEONATE

Platelet of a newborn/infant has great variation in terms of size and shape.

▪ Characterized as hypofunctional compared with adult platelets.

a)

True

b)

False

195.

PLATELET VALUES IN THE NEONATE

Your cord blood derived platelet have impaired calcium mobilization.

▪ GPIIbIIIa activation, dense granule secretion, and alpha granule release compared with adult platelet.

▪ However, bleeding time, platelet function analyzer 100 closure time, and thromboelastogram have a superior functionality.

▪ Although your neonatal platelet function differently from adult platelet, they are effective in their role in primary hemostasis.

a)

True

b)

False

196.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

Because in the case of transient neutrophilia which occurs during the 1st 24 hour after birth, followed by rapid decline. This neutrophil count is not a satisfactory index of infection in the newborn.

▪ If the newborn has bacterial infection, the neutrophil are within or less than to normal value, with a shift to the left.

▪ That is why there is an increase level in the band count. Therefore, many practitioners depends on the concentration B cells that is derived from the immature to the total neutrophil ratio as an indicator of (a)   .

197.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

Although, the CD64, CRP, and Procalcitonin are more sensitive marker for sepsis in infants

(a)  

198.

NEONATAL HEMATOLOGIC RESPONSE TO INFECTION

Although, the CD64, CRP, and Procalcitonin are more sensitive marker for sepsis in infants

(a)  

199.

PLATELET VALUES IN THE NEONATE

For full-term and pre-term infants

a)

150 – 400 x10^9/L

b)

100x10^9/L

200.

PLATELET VALUES IN THE NEONATE

Seen in high-risk infants with sepsis or respiratory distress

a)

150 – 400 x10^9/L

b)

100x10^9/L

201.

NEONATAL HEMOSTASIS

Skin puncture

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

202.

NEONATAL HEMOSTASIS

Heel stick specimen

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

203.

NEONATAL HEMOSTASIS

Vitamin K-dependent coagulation factors (2, 7, 9, 10) - 30% of adult values at birth

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

204.

NEONATAL HEMOSTASIS

They reach adult values after 3-6 months. Although, the mean values remain lower in children than in adults.

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

205.

NEONATAL HEMOSTASIS

It is changing in concentration particularly, at the 1-2 weeks of life but their values is dependent of

the gestational age of the child. Because premature infants and in term infants have different values at birth.

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

206.

NEONATAL HEMOSTASIS

Both test are prolong or longer

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

207.

NEONATAL HEMOSTASIS

Most coagulation factor assay measure lower values.

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

208.

NEONATAL HEMOSTASIS

Control proteins are lower in healthy pre term infants than in term infants.

a)

Specimen Collection and Management

b)

Hemostatic Components

c)

PT and aPTT

d)

SIMILAR to adult values

209.

NEONATAL HEMOSTASIS

Levels of Fibrinogen

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

210.

NEONATAL HEMOSTASIS

Factor VIII

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

211.

NEONATAL HEMOSTASIS

von Willebrand factor (VWF)

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

212.

NEONATAL HEMOSTASIS

Plasminogen

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

213.

NEONATAL HEMOSTASIS

a2 – antiplasmin

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

214.

NEONATAL HEMOSTASIS

FV

o Which decreases during childhood, and lower levels in teen years compared to adults.

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

215.

NEONATAL HEMOSTASIS

Tissue plasminogen Activator (TPA)

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

216.

NEONATAL HEMOSTASIS

Plasminogen Activator Inhibitor 1 (PAI-1)

a)

INCREASED in neonates

b)

DECREASED in neonates

c)

SIMILAR to adult values

217.

BLEEDING & THROMBOSIS

Risk of bleeding is _______in a healthy newborn despite the decrease level of Vit K

dependent factors.

a)

NOT INCREASED

b)

INCREASED

218.

BLEEDING & THROMBOSIS

Primarily related to the reduced level of the physiologic anticoagulant of Protein C and S. However, 2 age related peaks infrequently occur.

o NEONATAL PERIOD

o POST PUBERTY ADOLOSCENCE

a)

Risk of bleeding is NOT INCREASED in a healthy newborn despite the decrease level of Vit K

dependent factors.

b)

Risk of bleeding is INCREASED in a healthy newborn despite the decrease level of Vit K

dependent factors.

219.

BLEEDING & THROMBOSIS

Risk of thrombosis is considerably ____________ than in adults

a)

REDUCED in neonates and children

b)

ELEVATED in neonates and children

220.

GERIATRIC HEMATOLOGY AND HEMOSTASIS

Elderly adults can be roughly divided into three age categories:

aged 65 – 74

a)

YOUNG-OLD:

b)

OLD-OLD:

c)

VERY OLD:

221.

GERIATRIC HEMATOLOGY AND HEMOSTASIS

Elderly adults can be roughly divided into three age categories:

aged 74 – 84

a)

YOUNG-OLD:

b)

OLD-OLD:

c)

VERY OLD:

222.

GERIATRIC HEMATOLOGY AND HEMOSTASIS

Elderly adults can be roughly divided into three age categories:

aged 85 and older

a)

YOUNG-OLD:

b)

OLD-OLD:

c)

VERY OLD:

223.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Do not show significant deviations from those for younger adults.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

224.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Starts to decline at middle age.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

225.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Men older than 60 years have average hemoglobin levels of 12.4 to 15.3 g/dL.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

226.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Hgb levels in women may INCREASE slightly with age or remain unchanged.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

227.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Elderly women have a Hgb conc. of 11.7 to 13.8 g/dL

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

228.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Men have higher hemoglobin levels than woman because of the stimulating effects to the

hormones such as androgens during hematopoiesis.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

229.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

There are no statistically significant differences between the total leukocyte count and WBC

differential for the young-old and old-old and those for middle-aged adults

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

230.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Some investigators have reported a lower leukocyte count in the elder adults due to the decrease of lymphocyte count.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

231.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Other studies also have found that there are no change in the WBC with age.

a)

Red Blood Cells

b)

Hemoglobin

c)

Leukocytes

232.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Immunosenescence

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

233.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

T cells are most susceptible

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

234.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Does not significantly affect the number.

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

235.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Does not significantly change with age.

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

236.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Thrombocytopenia may be drug induced or secondary to marrow infiltration of metastatic cancer, lymphoma, or leukemia.

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

237.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Primary thrombocytosis can also be seen in chronic myeloid leukemia.

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

238.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Essential thrombocythemia is a myeloproliferative neoplasm characterized by sustained proliferation of megakaryocytes.

a)

Immune Response in Elderly Adults

b)

Monocytes and Macrophages

c)

Platelets

239.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Immune Response in Elderly Adults

This is the adverse changes that occurs in the function of the immune system with age

a)

Immunosenescence

b)

T cells

240.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Immune Response in Elderly Adults

Thymus disappears at early middle aged and adult must depend on the T lymphocyte pool in the secondary tissues to mediate T cell dependent immune responses.

a)

Immunosenescence

b)

T cells

241.

HEMATOLOGICAL PARAMETERS IN ELDERLY ADULTS

Immune Response in Elderly Adults

The number of B cells decreases in elderly adults which increases the dependence on memory T cells.

a)

Immunosenescence

b)

T cells

242.

ANEMIA AND ELDERLY ADULTS

Factors contributing to anemia include:

a)

Decrease in bone marrow function

b)

Decline in physical activity

c)

Nutritional deficiencies

d)

Cardiovascular diseases

e)

Chronic inflammatory disorders

243.

ANEMIA AND ELDERLY ADULTS

Ineffective erythropoiesis and hyperproliferation are also seen in elderly adults.

a)

Vitamin B12 or folate deficiency

b)

Myelodysplastic syndrome

c)

Sideroblastic anemia

d)

Thalassemia

e)

Chronic inflammatory disorders

244.

ANEMIA AND ELDERLY ADULTS

Elderly adults are at risk for anemia such as:

a)

aplastic anemia

b)

hemolytic anemia

c)

myelophthisic anemia

d)

anemia caused by protein calorie malnutrition

e)

Chronic inflammatory disorders

245.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Anemia of chronic inflammation (some)

Hemorrhagic anemia

Leukemia-associated anemia

a)

MCV: Normal

RDW: Normal

b)

MCV: Normal

RDW: High

c)

MCV: Low

RDW: Normal

d)

MCV: Low

RDW: High

246.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Early iron deficiency anemia

Mixed deficiency anemia (e.g., Vit. B12 and iron)

Sideroblastic anemia

a)

MCV: Normal

RDW: Normal

b)

MCV: Normal

RDW: High

c)

MCV: Low

RDW: Normal

d)

MCV: Low

RDW: High

247.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Anemia of chronic inflammation (some)

a)

MCV: Normal

RDW: Normal

b)

MCV: Normal

RDW: High

c)

MCV: Low

RDW: Normal

d)

MCV: Low

RDW: High

248.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Iron deficiency anemia

a)

MCV: Normal

RDW: Normal

b)

MCV: Normal

RDW: High

c)

MCV: Low

RDW: Normal

d)

MCV: Low

RDW: High

249.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Anemia associated with myelodysplastic syndrome

a)

MCV: High

RDW: Normal

b)

MCV: High

RDW: High

250.

ANEMIA AND ELDERLY ADULTS

Classification of Geriatric Anemia According to MCV and RDW

Vit. B12 deficiency anemia

Folate deficiency anemia

Hemolytic anemia

a)

MCV: High

RDW: Normal

b)

MCV: High

RDW: High

251.

CLASSIFICATION OF GERIATRIC ANEMIA BASED ON TYPICAL MEAN CELL VOLUME (MCV) AND RED CELL DISTRIBUTION (RDW)

Initial laboratory evaluation of anemia should include:

a)

CBC

b)

Reticulocyte count

c)

PBS

d)

Iron studies (ferritin, vitamin b12, folate levels)

252.

CLASSIFICATION OF GERIATRIC ANEMIA BASED ON TYPICAL MEAN CELL VOLUME (MCV) AND RED CELL DISTRIBUTION (RDW)

Assessment for signs of gastrointestinal blood loss can also be observed such as:

a)

Presence of hemolysis

b)

Nutritional deficiency

c)

Malignancy

d)

Chronic infection

e)

Renal hepatic disease

o All of these can provide an important information for the evaluation of anemia in elderly adults.

253.

ANEMIA OF CHRONIC INFLAMMATION

Assessment for signs of gastrointestinal blood loss can also be observed such as:

a)

Anemia of Chronic Inflammation

b)

Often occurs with chronic inflammatory disorders and malignant diseases

c)

Most common form of anemia in the hospitalized geriatric population.

d)

Ex: Rheumatoid arthritis, live disease etc

e)

Renal hepatic disease

o All of these can provide an important information for the evaluation of anemia in elderly adults.

254.

ANEMIA OF CHRONIC INFLAMMATION

Malignant diseases such as hodgkin lymphoma, leukemia, and plasma cell myeloma.

a)

Anemia of Chronic Inflammation

b)

Often occurs with chronic inflammatory disorders and malignant diseases

c)

Most common form of anemia in the hospitalized geriatric population.

d)

Ex: Rheumatoid arthritis, live disease etc

e)

Renal hepatic disease

o All of these can provide an important information for the evaluation of anemia in elderly adults.

255.

IRON DEFICIENCY ANEMIA

Common cause of anemia in elderly adults with a prevalence of 25%.

a)

Iron Deficiency Anemia

b)

Iron deficiency in elderly adults most often results from conditions leading to:

256.

IRON DEFICIENCY ANEMIA

The serum iron level decreases progressively with each decade.

a)

Iron Deficiency Anemia

b)

Iron deficiency in elderly adults most often results from conditions leading to:

257.

IRON DEFICIENCY ANEMIA

Iron deficiency in elderly adults most often results from conditions leading to:

a)

Chronic gastrointestinal blood loss

b)

Long-term use of nonsteroidal anti-inflammatory medications

c)

Gastritis

d)

Peptic ulcer disease

e)

Gastroesophageal reflux disease with esophagus

258.

IRON DEFICIENCY ANEMIA

Iron deficiency in elderly adults most often results from conditions leading to:

a)

Colon cancer

b)

Angiodysplasia

259.

IRON DEFICIENCY ANEMIA

Iron deficiency anemia does not only affect the erythrocytes but also the metabolic pathways of iron dependent tissues enzymes

a)

True

b)

False

260.

UNEXPLAINED ANEMIA OF THE ELDERLY

Responsible for approximately 30% of anemia in elderly adults.

a)

True

b)

False

261.

UNEXPLAINED ANEMIA OF THE ELDERLY

Anemia is typically mild and normocytic with hemoglobin levels between 10 to 12 g/dL.

a)

True

b)

False

262.

UNEXPLAINED ANEMIA OF THE ELDERLY

Occurs as result of a failure of a normal erythropoietin response to anemia

a)

True

b)

False

263.

UNEXPLAINED ANEMIA OF THE ELDERLY

Unexplained anemia of elderly is actually a hypoproliferative anemia that is not caused by nutritional deficiency nor kidney disease or other type of inflammatory disease.

a)

True

b)

False

264.

UNEXPLAINED ANEMIA OF THE ELDERLY

It is hypothesized that unexplained anemia of elderly is related to declining levels of testosterone.

▪ Testosterone directly stimulates the EPO.

a)

True

b)

False

265.

UNEXPLAINED ANEMIA OF THE ELDERLY

Low production of testosterone can affect the red blood cells.

a)

True

b)

False

266.

UNEXPLAINED ANEMIA OF THE ELDERLY

Underlying stem cell disorder or increase proinflammatory cytokines that are expressed in the

aging population.

a)

True

b)

False

267.

INEFFECTIVE ERYTHROPOEISIS

Attributed not to only to maturation disorders, such as Vitamin B12 and Folic Acid Deficiency, but also to the following conditions:

a)

Sideroblastic anemia

b)

Thalassemia

c)

Myelodysplastic syndrome

268.

INEFFECTIVE ERYTHROPOEISIS

Results in ineffective hematopoiesis because of mutations in hematopoietic stem cells and progenitor cells

a)

Sideroblastic anemia

b)

Thalassemia

c)

Myelodysplastic syndrome

269.

Results from defective synthesis of DNA with compromised division but normal cytoplasmic development, called it as Asynchrony.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

270.

These megaloblastic cells are more prone to destruction in the bone marrow which results in

ineffective electrophoresis.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

271.

There are two (2) causes of __________:

▪ Vitamin B12 deficiency

▪ Folate deficiency.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

272.

Due to INADEQUATE INTESTINAL ABSORPTION of food-bound vitamin B12.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

273.

If it is due to Vitamin B deficiency in the elderly, it has been attributed to an inadequate intestinal

absorption of food-bound vitamin B12 rather than pernicious anemia or in additive intake.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

274.

Many elderly individuals have atrophic gastritis resulting in decreased gastric production of acid.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

275.

In this condition, there is a low Vitamin B12 absorption because protein-bound vitamin B12 is not dissociated from food proteins.

▪ Therefore, it cannot bind to intrinsic factors for absorption.

▪ In addition, the loss of gastric acid can result in bacterial overgrowth, particularly if the patient has helicobacter pylori infections.

o because it can interfere with vitamin B12 absorption.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

276.

Inadequate vitamin B12 absorption in elderly adults has also been reported as in other uncommon

conditions.

▪ small bowel disorder

▪ pancreatic insufficiency,

▪ resection of the terminal ileum, or tropical sprue.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

277.

Due to INADEQUATE DIETARY INTAKE

▪ because the body stores little for it.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

278.

Alcoholic elderly patients are particularly at risk for folic acid deficiency.

▪ Mainly as a consequence of a poor diet.

▪ Take note that alcohol may also interfere with folate absorption and the induction of enzymes involved in folic metabolism.

a)

MEGALOBLASTIC ANEMIA

b)

VITAMIN B12 DEFICIENCY

c)

FOLATE DEFICIENCY

279.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

a)

Myeloproliferative Neoplasms (MPNs)

b)

Myeloid/ Lymphoid with eosinophilia and rearrangement of PDGFRA, PDGFRB, or with PCM1-

JAK2

c)

Myelodysplastic syndrome/ Myeloproliferative neoplasms (MDS/MPNs)

d)

Myelodysplastic syndrome

e)

Acute myeloid leukemia (AML) and related neoplasms

280.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

a)

Blastic plasmacytoid dendritic cell neoplasm

b)

Acute leukemias of ambiguous lineage

c)

B-lymphoblastic leukemia/ lymphoma

d)

T-lymphoblastic leukemia/ lymphoma

281.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Represents a heterogenous group of clonal bone marrow disorders that may affect multiple cell

lineages.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

282.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Most common hematologic malignancy in elderly adults.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

283.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Typical features include:

• progressive CYTOPENIAS

• DYSPOIESIS in one or more cell lines, and

• an increase in BLASTS in the peripheral blood and bone marrow.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

284.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Incidence of MDS increases from a total annual incidence of 4 cases in 100,000 individuals.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

285.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

If the individuals reach the age of 70 years old, MDS will occur from 4 to 40 cases per 100,000

individuals.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

286.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

If 80 years old, from 14 to 15 individuals acquired MDS.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

287.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Monoclonal proliferations of hematopoietic stem cells with overaccumulation of RBCs, WBCs, or platelets in various combinations.

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

288.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

• Chronic myeloid leukemia

• Polycythemia vera

• Essential thrombocythemia

• Primary myelofibrosis

• Chronic eosinophilic leukemia

• Mastocytosis

• Chronic neutrophilic leukemia

• Unclassifiable myeloproliferative neoplasms

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

289.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

Elderly individuals increase the cases of

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

290.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

It is a neoplastic disease characterized by a malignant proliferation of hematopoietic stem (in the bone

marrow, peripheral blood, and other organs)

a)

MYELODYSPLASTIC SYNDROME

b)

MYELOPROLIFERATIVE NEOPLASMS

c)

LEUKEMIA

291.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

LEUKEMIA

Lymphoid or Myeloid

a)

Basis of the Cell Type

b)

Stage of Maturity

292.

HEMATOLOGIC NEOPLASIA IN ELDERLY ADULTS

CHRONIC MYELOID NEOPLASMS

LEUKEMIA

Acute or Chronic

a)

Basis of the Cell Type

b)

Stage of Maturity

293.

GERIATRIC HEMOSTASIS

a)

Increased incidence of thrombosis in elderly adults.

b)

Approximately 60% of venous thrombosis events occur in those aged 70 years and older

c)

Factor 5, 7, 8, 9, 13, vWF, HMWK, and Prekallikrein are actually increased in healthy individuals as they

age.

d)

Increased platelet activity with age

294.

GERIATRIC HEMOSTASIS

Age-related changes occur in the vascular and hemostatic system, particularly in the platelets,

coagulation, and fibrinolytic factors

a)

Increased incidence of thrombosis in elderly adults.

b)

Approximately 60% of venous thrombosis events occur in those aged 70 years and older

c)

Factor 5, 7, 8, 9, 13, vWF, HMWK, and Prekallikrein are actually increased in healthy individuals as they

age.

d)

Increased platelet activity with age

295.

GERIATRIC HEMOSTASIS

For example: from 1 per 10,000 in the young individuals (age of 25 to 30 years old). From 1

to 8 per 1,000 elderly adults.

a)

Increased incidence of thrombosis in elderly adults.

b)

Approximately 60% of venous thrombosis events occur in those aged 70 years and older

c)

Factor 5, 7, 8, 9, 13, vWF, HMWK, and Prekallikrein are actually increased in healthy individuals as they

age.

d)

Increased platelet activity with age

296.

GERIATRIC HEMOSTASIS

▪ Demonstrate a shift in the hemostatic balance

• INCREASED coagulation

• DECREASED fibrinolysis

a)

Increased incidence of thrombosis in elderly adults.

b)

Approximately 60% of venous thrombosis events occur in those aged 70 years and older

c)

Factor 5, 7, 8, 9, 13, vWF, HMWK, and Prekallikrein are actually increased in healthy individuals as they

age.

d)

Increased platelet activity with age

297.

GERIATRIC HEMOSTASIS

As evidenced by a decrease in bleeding time in elderly adults and an increase in markers of

platelet activation such as beta thrombomodulin and platelet factor 4

a)

Increased incidence of thrombosis in elderly adults.

b)

Approximately 60% of venous thrombosis events occur in those aged 70 years and older

c)

Factor 5, 7, 8, 9, 13, vWF, HMWK, and Prekallikrein are actually increased in healthy individuals as they

age.

d)

Increased platelet activity with age

298.

GERIATRIC HEMOSTASIS

FIBRINOGEN

a)

INCREASES approx. 10 mg/dL per decade in elderly adults (65 – 79 years)

b)

From 280 mg/dL to more than 300 mg/dL

c)

Fibrinolysis is impaired in elderly adults

d)

Increased platelet activity in age as evidence by a decrease in bleeding time in elderly adults and an

increased markers of platelet activation such as your beta thrombomodulin and platelet factor 4

299.

GERIATRIC HEMOSTASIS

FIBRINOGEN

Has been implicated as a primary risk factor for thrombotic disorders, including ischemic heart

attack or heart disease.

a)

INCREASES approx. 10 mg/dL per decade in elderly adults (65 – 79 years)

b)

From 280 mg/dL to more than 300 mg/dL

c)

Fibrinolysis is impaired in elderly adults

d)

Increased platelet activity in age as evidence by a decrease in bleeding time in elderly adults and an

increased markers of platelet activation such as your beta thrombomodulin and platelet factor 4

300.

GERIATRIC HEMOSTASIS

FIBRINOGEN

It increases by approximately 10 mg per dL per decade.

a)

INCREASES approx. 10 mg/dL per decade in elderly adults (65 – 79 years)

b)

From 280 mg/dL to more than 300 mg/dL

c)

Fibrinolysis is impaired in elderly adults

d)

Increased platelet activity in age as evidence by a decrease in bleeding time in elderly adults and an

increased markers of platelet activation such as your beta thrombomodulin and platelet factor 4

301.

GERIATRIC HEMOSTASIS

FIBRINOGEN

Due to INCREASED in PAI-1

• (Plasminogen Activator Inhibitor -1)

a)

INCREASES approx. 10 mg/dL per decade in elderly adults (65 – 79 years)

b)

From 280 mg/dL to more than 300 mg/dL

c)

Fibrinolysis is impaired in elderly adults

d)

Increased platelet activity in age as evidence by a decrease in bleeding time in elderly adults and an

increased markers of platelet activation such as your beta thrombomodulin and platelet factor 4

302.

GERIATRIC HEMOSTASIS

FIBRINOGEN

a)

In addition, there are seasonal variations in fibrinogen in elderly adults, particularly in cold

weathers, it increases the levels of plasma fibrinogen.

b)

Elevated levels of factor 8 also have been associated with an increased risk for Venous

thrombosis

c)

There is a positive correlation or relationship has been found between vWF and atherosclerosis in the

elderly.

303.

GERIATRIC HEMOSTASIS

FIBRINOGEN

Risk Factors Associated with Venous Thrombosis

a)

Immobility

b)

Malignant disease

c)

Comorbidities

d)

Prescription drugs that influence coagulation or platelet function