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FINAL REVIEW

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HEML240 Quiz on FINAL REVIEW , created by Nadia Persaud on 05/12/2017.
Nadia Persaud
Quiz by Nadia Persaud, updated more than 1 year ago
Nadia Persaud
Created by Nadia Persaud about 7 years ago
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Resource summary

Question 1

Question
Which of the following is NOT indicative of accelerated red cell destruction?
Answer
  • decreased RBC, Hgb, Hct
  • increased unconjugated bilirubin, increased LDH
  • increase hemopexin
  • erythoid hyperplasia
  • URINE: increased urobilinogen, free hemoglobin, methemoglobin, hemosiderin

Question 2

Question
Which feature is present in BOTH intra- and extravascular hemolysis?
Answer
  • increased retics
  • spherocytes/schistocytes
  • increased unconjugated bilirubin
  • decreased poikilocytosis
  • A, B, and C
  • All of the above.

Question 3

Question
Select all that apply for INTRAVASCULAR hemolysis:
Answer
  • significant increase in LDH
  • hemoglobinemia
  • hemosiderinuria
  • IgG antibodies
  • decreased hemopexin
  • spherocytes

Question 4

Question
Select all that apply for EXTRAVASCULAR hemolysis:
Answer
  • IgG antibodies
  • presence of gall stones
  • splenomegaly
  • spherocytes
  • fragments

Question 5

Question
Normal adult hemoglobin consists of: 95% - 100% HbA 0% - 2% HbF 0% - 3.5% HbA2
Answer
  • True
  • False

Question 6

Question
Sickle Solubility screening test is a qualitative screening test that dectects the presence of sickling hemoglobins mainly HbA.
Answer
  • True
  • False

Question 7

Question
What are the components of an alkaline hemoglobin electrophoresis?
Answer
  • EDTA-borate buffer and cellulose acetate gel
  • pH 10.1
  • enzymatic reactions that move from cathode to anode
  • able to separate HbC from HbE

Question 8

Question
Alkaline electrophoresis runs SDG and CEOA2 together.
Answer
  • True
  • False

Question 9

Question
What techniques can be used to separate hemoglobin?
Answer
  • HbA2 ion exchange chromatography
  • HPLC: High Performance Liquid Chromatography
  • IEF: Isoelectric Focusing
  • Capillary Electrophoresis
  • Globin Chain Electrophoresis
  • All of the above

Question 10

Question
A positively charges cellulose attracts a negatively charged hemoglobin molecule. Which separation technique does this describe?
Answer
  • HPLC
  • Ion Exchange Chromatography
  • IEF
  • Globin Chain Electrophoresis

Question 11

Question
During HbA2 Column Chromatography, A2 is eluted as the 3mL glycine reagent and the absorbance of the A2 fraction and total hemoglobin are measured to determine the %HbA2.
Answer
  • True
  • False

Question 12

Question
Which hemoglobin fractions is HPLC able to detect and distinguish?
Answer
  • HbS
  • HbA2
  • HbF
  • HbA
  • HbC

Question 13

Question
Which hemoglobin separation technique separates fractions based on the difference in charge to size ratio through an electric field?
Answer
  • Isoelectric Focusing
  • Gas Chromatogrpahy
  • Ion Exchange Chromatography
  • Capillary Electrophoresis
  • Gel Electrophoresis

Question 14

Question
An increase in HbA2 is associated with which condition?
Answer
  • IDA
  • Beta-Thal Major
  • Alpha-Thal Minor
  • Beta-Thal Minor
  • Megaloblastic Anemia

Question 15

Question
The principle behind the Kleihauer-Betke Acid Elution test is eluting HbF out of the solution, making the cells colourless, while HbA are resistant to elution and will stain pink.
Answer
  • True
  • False

Question 16

Question
Which clinical condition is screened for using the sucrose hemolysis test?
Answer
  • Hereditary Persistence of Fetal Hemoglobin (HPFH)
  • Paroxymal Nocturnal Hemoglobinuria (PNH)
  • Autoimmune Hemolytic Anemia (AIHA)
  • Filariasis

Question 17

Question
Less than 5% hemolysis indicates that RBCs of PNH are more sensitive to complement on their cell surface.
Answer
  • True
  • False

Question 18

Question
HAM test for PNH is based on:
Answer
  • acidified serum
  • neutral serum
  • alkaline serum

Question 19

Question
Which of the following interpretations matches G6PD deficiency screening test?
Answer
  • persistant fluorescence
  • weak or no fluorescence
  • NADPH not produced
  • NAD produced

Question 20

Question
The amount of NAD produced is proportional to the amount of PK in patient cells
Answer
  • True
  • False

Question 21

Question
What stain is required to see Heinz bodies?
Answer
  • Gram stain
  • Wright stain
  • Supravital stain
  • Eosin stain

Question 22

Question
Cells that are osmotically fragile will start to lyse at:
Answer
  • 0.85
  • 0.55
  • 0.45
  • 0.95

Question 23

Question
Which of the following is not included in the major hemostatic system?
Answer
  • Vascular System
  • Platelet Activity
  • Coagulation System
  • Fibrinolytic System
  • Thrombin System
  • Regulatory System

Question 24

Question
Which of the following is an example of an anticoagulant?
Answer
  • VonWillebrande's Factor
  • Thromboplastin
  • Protein S
  • Tissue Plasmimnogen Factor Inhibitor

Question 25

Question
What is needed for platelets to adhere to the sub-endothelium?
Answer
  • Thrombin
  • vWF
  • Ca2+
  • Phospholipid
  • Negatively Charged Surface

Question 26

Question
Which of the following is true about thromboxane A2?
Answer
  • produced by platelets
  • causes vasoconstriction
  • induces aggregation
  • inhibited by aspirin
  • all of the above are true

Question 27

Question
Which platelet membrane binding site is associated with aggregation?
Answer
  • GPIb/IX
  • GPIIb/IIIa
  • vWF Ag
  • Collagen binding site
  • FVIII Ag

Question 28

Question
Which of the following is not a primary hemostasis disorder?
Answer
  • Bernard-Soulier Syndrome
  • von Willebrande Disease
  • Gray Platelet Syndrome
  • Glanzmann's Thrombasthenia
  • Hemophilia A

Question 29

Question
Reduced aggregation with Ristocetin is associated with vWD and BSS.
Answer
  • True
  • False

Question 30

Question
Which condition is present if a patient has vWF, but lacks the receptor site on the platelet for it?
Answer
  • BSS
  • Glanzmann's Thrombasthenia
  • Grey Platelet Syndrome
  • vWD
  • Storage Pool Disease

Question 31

Question
What is the condition called if the platelets lack the receptor fibrinogen?
Answer
  • BSS
  • Glanzmann's Thrombasthenia
  • Gray Platelet Syndrome
  • vWD
  • Storage Pool Disease

Question 32

Question
Which of the following does not contribute to clot formation?
Answer
  • Tissue factor
  • Calcium
  • Heparin
  • Phospholipid
  • Thrombin

Question 33

Question
Which of the following does thrombin not have an effect on?
Answer
  • FXI activation
  • FVIII activation
  • FXIII activation
  • Fibrinogen --> Fibrin
  • FVII activation

Question 34

Question
Which of the following factors is not Vitamin K dependent?
Answer
  • FII
  • FV
  • FVII
  • FIX
  • FX

Question 35

Question
Select all that are TRUE:
Answer
  • both VIII:C and VIII:Ag are deficient in hemophilia
  • FVIII is released from vWF by prothrombin
  • FVIII is labile and degrades rapidly when unbound from vWF
  • FVIII is synthesized in the liver

Question 36

Question
vWF is synthesized by:
Answer
  • the liver
  • endothelial cells
  • plasma cells
  • Vitamin K
  • bone marrow

Question 37

Question
vWD is associated with a deficiency in:
Answer
  • vWF:Rco
  • vWF:Ag
  • vWF:VIII
  • A and B
  • B and C

Question 38

Question
A decreased concentration of fibrinogen leads to bleeding disorders.
Answer
  • True
  • False

Question 39

Question
A congenital deficiency in fibrinogen will result in:
Answer
  • Prolonged PT
  • Normal aPTT
  • Normal TT
  • Prolonged aPTT
  • Prolonged TT

Question 40

Question
Which of the Hemophilia conditions is most rare?
Answer
  • Hemophilia A (FVIII Deficiency)
  • Hemophilia B (FIX Deficiency)
  • Hemophilia C (FXI Deficiency)

Question 41

Question
Which of the following is not a coagulation regulator?
Answer
  • Protein C
  • Thrombin
  • TFPI
  • Plasmin

Question 42

Question
Which of the following regarding Protein C and Protein S is incorrect?
Answer
  • activated by thrombin generation by binging to thrombomodulin on endothelial cells
  • inactivates activated V and VIII
  • main regulatory system
  • plasminogen converted Protein C to APC

Question 43

Question
Tissue factor pathway inhibitor only affects the extrinsic pathway.
Answer
  • True
  • False

Question 44

Question
What cofactor does Antithrombin III (AT) need to effectively inhibit IXa, Xa, IIa, and XIa?
Answer
  • Warfarin
  • Ca2+
  • Heparin
  • Plasmin
  • vWF

Question 45

Question
Why is fibrinogen important?
Answer
  • Prevent thrombi from getting too large
  • Aids in wound healing
  • Prevents thrombosis in undesirable places
  • All of the above
  • None of the above

Question 46

Question
Which of the following are components of the fibrinolytic system?
Answer
  • alpha-2 antiplasmin
  • Plasminogen activator inhibitor-1 (PAI-1)
  • Tissue Plasminogen Activator
  • Thrombomodulin
  • Plasmin

Question 47

Question
Thrombocytopenia can be a result of:
Answer
  • Hypersplenism
  • Post-splenectomy
  • Acute Blood Loss
  • Proliferation of stem cells

Question 48

Question
Thrombosis refers to:
Answer
  • Formation of a blood clot following an injury to a blood vessel
  • Formation of a blood clot inside an intact blood vessel, obstructing the flow of blood
  • Formation of a blood clot that is easily solubilized
  • A portion of a larger clot that breaks free

Question 49

Question
Which of the following would cause a clotting disorder?
Answer
  • Protein C deficiency
  • vWD
  • Factor Deficiency
  • Hemophilia A or B

Question 50

Question
Where do the majority of pulmonary emboli originate from?
Answer
  • thrombi in arm
  • thrombi in abdomen
  • thrombi in deep leg
  • thrombi in kidney

Question 51

Question
Strokes results from the acute blockage of arterial blood flow in which artery?
Answer
  • Pulmonary artery
  • Coronary artery
  • Corotid artery
  • Hepatic artery

Question 52

Question
Which of the following will affect platelet adhesion?
Answer
  • Gp IIb receptor on platelet
  • Thromboxane A2
  • Fibrinogen
  • Gp Ib receptor on platelet

Question 53

Question
Which of the following regarding Lupus Anticoagulant is true?
Answer
  • causes neutralization of phospholipid reagent in vitro
  • miscarriages are common in SLE
  • LA acts as an antibody to platelet
  • women are more commonly affected
  • followup tests include DRVVT

Question 54

Question
Which of the following regarding DIC is false?
Answer
  • begins with excessive clotting stimulated by a substance that enters the blood
  • results in both excessive clotting and excessive bleeding
  • fibrin degradation products are generated
  • DIC is not a systemic problem, localized to specific area
  • plasminogen is consumed as it is converted into plasmin

Question 55

Question
Identify the correct lab results for DIC:
Answer
  • increased platelets
  • schistocytes
  • PT and aPTT prolonged
  • D-dimer increased
  • Bleeding Time prolonged
  • Fibrinogen increased

Question 56

Question
D-dimer has a negative predicative value for DIC because:
Answer
  • D-dimer measures split products formed after formation of fibrin clot, but is not specific for DIC
  • Usually present in chronic conditions
  • high levels of FDPs are specific for DIC
  • none of the above

Question 57

Question
Which of the following tests is normal in a patient with vWD?
Answer
  • Bleeding Time
  • aPTT
  • Platelet count
  • PT

Question 58

Question
Congenital deficiencies of which proteins will cause thrombosis?
Answer
  • Deficiency of Thrombin
  • Deficiency of factors
  • Deficiency of Coagulation and Fibrinolytic Regulators
  • Deficiency of Vitamin K

Question 59

Question
How is antithrombin deficiency acquired?
Answer
  • Liver disease
  • Nephrotic Syndrome
  • DIC
  • Prolonged heparin therapy
  • all of the above

Question 60

Question
Protein C and Protein S are Vitamin K independent.
Answer
  • True
  • False

Question 61

Question
If APC is added, aPTT is prolonged due to inhibition of coagulation.
Answer
  • True
  • False

Question 62

Question
Which is the most common inherited cause of thrombosis?
Answer
  • Protein C or Protein S deficiency
  • Factor V Leiden
  • Plasminogen deficiency
  • Antithrombin deficiency

Question 63

Question
Prothrombin nucleotide 20210 is:
Answer
  • A deletion in the gene sequence
  • A single adenine to guanine mutation at position 20210
  • A single guanine to adenine mutation at position 20210
  • A nonsense codon in the sequence

Question 64

Question
FXII deficiency can lead to a bleeding disorder.
Answer
  • True
  • False

Question 65

Question
An increase in plasminogen activator inhibitor 1 will result in
Answer
  • a bleeding disorder
  • an increase in fibrinolysis
  • a clotting tendency
  • decrease inhibition of tPA

Question 66

Question
In a mixing study, a prolonged aPTT is corrected with FVIII deficient plasma, but not with FIX deficient plasma. What is the deficiency due to?
Answer
  • FVIII
  • FIX
  • Heparin therapy
  • Coumadin therapy

Question 67

Question
A short-filled sodium citrate tube will have what effect on coagulation results?
Answer
  • Normal
  • Prolonged for both
  • Only affects PT
  • Only affects aPTT

Question 68

Question
Platelet poor plasma is required for which studies?
Answer
  • Coagulation studies
  • Aggregation studies
  • Adhesion studies
  • Fibrinogen studies

Question 69

Question
Which factors would be used up in a clotted specimen?
Answer
  • FI
  • FII
  • FV
  • FVII
  • FVIII
  • FXI
  • FXIII

Question 70

Question
Plasma adsorbed with barium sulphate will remove which group of factors?
Answer
  • Fibrinogen group factors (I, V, VIII, XIII)
  • Vitamin K dependent factors (II, VII, IX, X)
  • Contact Group Factor (XII, Pre-K, HMWK)
  • TF complex (VII, TF)

Question 71

Question
What is needed to initiate the intrinsic pathway in vitro?
Answer
  • Kaolin
  • Tissue factor
  • Phospholipid
  • Calcium
  • Thromboplastin

Question 72

Question
INR is used to monitor heparin therapy.
Answer
  • True
  • False

Question 73

Question
Select all that are true for aPTT:
Answer
  • monitors Coumadin therapy
  • screens for defects in the intrinsic and common pathways
  • requires a source of phospholipid
  • required to calculate INR
  • Kaolin is an example of a negatively charged surface needed to activate cascade

Question 74

Question
A mixing studies was performed on a sample and was corrected. To determine if the correction was a result of a factor deficiency or factor antibody, another mixing studies was performed and incubated. The mixing studies results were corrected. This suggests the presence of a factor antibody. Is this interpretation correct?
Answer
  • True
  • False

Question 75

Question
The euglobulin lysis time tests how long it takes for the sample to clot.
Answer
  • True
  • False

Question 76

Question
Which of the following can prolong thrombin time, which looks at how long it takes a sample to clot.
Answer
  • Warfarin
  • Heparin
  • FDPs
  • Tissue factor

Question 77

Question
Clot formation time is proportional to the concentration of fibrinogen in the sample plasma.
Answer
  • True
  • False

Question 78

Question
The Clauss method of fibrinogen assay involves
Answer
  • extended incubation time
  • using an undiluted plasma sample
  • excess thrombin
  • fibrinogen neutralized by protamine sulphate

Question 79

Question
5M Urea Test involves removing a clot and placing it in 5M urea and incubating it. Which of the following result interpretations are valid?
Answer
  • If FII levels are normal, the clot will not dissolve in 24 hours
  • If FXIII is deficient, the clot will not dissolves in 24 hours.
  • If FXIII is normal, the clot will dissolve in 24 hours.
  • If FXIII is deficient, the clot will dissolve in 24 hours.

Question 80

Question
Low Molecular Weight Heparin (LMWH) monitors
Answer
  • FVa
  • FVIIa
  • FXa
  • FXIa

Question 81

Question
In a plasma sample with APCr, we expect that
Answer
  • Protein C is able to inactive FVa and FVIIIa
  • AT is able to inactivate FVa and FVIIIa
  • Protein C is unable to inactive FVa and FVIIIa
  • AT is unable to inactive FVa and FVIIIa

Question 82

Question
Reptilase time
Answer
  • tests for FXIII deficiency
  • compares fibrinogen deficiency and heparin contamination
  • tests for factor antibody (eg. LA)
  • is inhibited by antithrombin

Question 83

Question
Select all that apply to the DRVVT for LA:
Answer
  • venom is a potent activator for FX
  • LA binds to phospholipid, inhibiting RVV
  • RVV is affected by deficiency in factors XII, XI, IX, or VIII
  • LA confirmed if DRVVT is corrected in excess phospholipid

Question 84

Question
PT 20s, aPTT 50s, TT 25s What is the most probably diagnosis?
Answer
  • FVII Deficiency
  • FVIII Deficiency
  • FX Deficiency
  • Hypofibrinogenemia

Question 85

Question
Which coagulation test(s) would be abnormal in a vitamin K-dependent patient?
Answer
  • PT only
  • aPTT only
  • Both PT and aPTT
  • Fibrinogen level
  • Thrombin time

Question 86

Question
Which of the following is an anticoagulant therapy treatment options?
Answer
  • Dabigatran
  • Heparin
  • Anti-platelet (ASA)
  • Warfarin
  • All of the above

Question 87

Question
How does Warfarin (Coumadin) act as a Vitamin K antagonist?
Answer
  • Inactivates compound
  • Suppresses reductase activity
  • Competitively binds to Vitamin K
  • None of the above

Question 88

Question
Which factor monitored by Warfarin therapy has the shortest half-life?
Answer
  • II
  • VII
  • IX
  • X
  • Protein C

Question 89

Question
If INR low, patient is at risk of bleeding.
Answer
  • True
  • False

Question 90

Question
Which of the following can reduce the effect of Warfarin therapy?
Answer
  • Drugs that interfere with Warfarin
  • Increased Vitamin K in diet
  • Taking Warfarin pill at different times every day (not at the same time each day)
  • All of the above

Question 91

Question
Which of the following anti-clotting substances acts on factors V and VIII?
Answer
  • Antithrombin III
  • Protein C
  • TFPI
  • Plasmin
  • tPA

Question 92

Question
Which of the following is a cofactor?
Answer
  • XII
  • X
  • VIII
  • VII
  • II

Question 93

Question
Heparin activates antithrombin to neutralize serine proteases activated by thrombin.
Answer
  • True
  • False

Question 94

Question
How is Unfractionated Heparin administered?
Answer
  • Subcutaneously
  • Intravenously
  • Superficially
  • Orally

Question 95

Question
How is a heparin overdose treated?
Answer
  • Warfarin
  • Vitamin K
  • Dialysis
  • Protamine sulfate

Question 96

Question
What side affect may arise as a result of long-term Heparin use?
Answer
  • Dyspnea
  • Photophobia
  • Osteoporosis
  • Hypotension

Question 97

Question
Low Molecular Weight Heparin (LMWH) has minimal affect on FIIa activity because it is too short to properly bind IIa.
Answer
  • True
  • False

Question 98

Question
Fondaparinux is a
Answer
  • natural drug - pentasaccharide
  • inactivates thrombin by combining with antithrombin
  • intravenous administration
  • requires lab monitoring

Question 99

Question
Which of the following are requires for coagulation in aPTT?
Answer
  • Plasma + phospholipid + calcium
  • Plasma + thromboplastin + calcium
  • Plasma + phospholipid + thromboplastin
  • Plasma + thrombin + calcium

Question 100

Question
What is the most common inherited bleeding disorder?
Answer
  • TTP
  • Hemophilia A
  • vWD
  • Factor V Leiden

Question 101

Question
Heparin Induced Thrombocytopenia:
Answer
  • IgG binds to heparin/PF4 complex
  • leads to coagulation of platelets
  • increases platelet count
  • associated with LMWH

Question 102

Question
Which of the following should be avoided when treating HIT?
Answer
  • Streptokinase
  • Urokinase
  • LMWH
  • Hirudin

Question 103

Question
Patients with which of the following diseases may have a normal PTT?
Answer
  • vWD
  • Hemophilia A
  • HIT
  • Factor V Leiden

Question 104

Question
Which of the following does not directly inhibit FXa?
Answer
  • Apixaban
  • Dabigatran
  • Riveroxaban
  • Edoxaban

Question 105

Question
Which direct thrombin inhibitor is not primarily used to treat HIT?
Answer
  • Dabigatran
  • Argatroban
  • Bivalirudin
  • Lepirudin

Question 106

Question
Which of the following are advantages of using Dabigatran?
Answer
  • no food interactions (eg. with Vitamin K)
  • no need for routine monitoring
  • reversal of bleeding with charcoal
  • none of the above
  • all of the above

Question 107

Question
Which of the following is false regarding direct FXa inhibitors?
Answer
  • requires routine monitoring
  • does not need antithrombin
  • used for the prevention of thrombosis and venous thromboembolism
  • all of the above are true

Question 108

Question
How does Aspirin inhibit platelets from aggregating?
Answer
  • Inhibits thrombin
  • Inhibits fibrinogen
  • Inhibits alpha granules
  • Inhibits Thromboxane A2

Question 109

Question
Which condition may thrombolytic therapy be used for?
Answer
  • venous thrombosis
  • myocardial infarction
  • Hemophilia A
  • can be administered to any inpatient

Question 110

Question
Which of the following is a "clot buster drug"?
Answer
  • Streptokinase
  • tPA
  • Urokinase
  • Thrombin Inhibitors

Question 111

Question
Which of the following is not a thrombolytic therapy?
Answer
  • tPA
  • Streptokinase
  • Urokinase
  • Hirudin
  • All of the above are used for thrombolytic therapy
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