Question 1

How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?

Accepted Answer

Malignancies contribute to insufficient and/or ineffective thrombopoiesis in the bone marrow. These lead to impaired production and/or function of newly produced platelets.

Question 2

Scurvy can lead to vascular defects by which of the following mechanisms?

Accepted Answer

A)  Degeneration of ECM 
B)  Excessive breakdown of collagen 
C)  Insufficient collagen synthesis 
D)  Presence of paraproteins directed against collagen 
A)  Degeneration of ECM 
B)  Excessive breakdown of collagen 
C)  Insufficient collagen synthesis 
D)  Presence of paraproteins directed against collagen C

Question 3

A patient visits a physician because of unexplained bruising and prolonged bleeding from a recent tooth extraction. The physician orders a prothrombin time (PT) and an APTT. Results are within normal reference ranges. What other tests could the physician order to investigate the patient's symptoms?

Accepted Answer

A)  Platelet count and platelet function assays 
B)  Platelet function assays 
C)  Platelet count only 
D)  Repetition of the PT and the APTT after the beginning of treatment 
A)  Platelet count and platelet function assays 
B)  Platelet function assays 
C)  Platelet count only 
D)  Repetition of the PT and the APTT after the beginning of treatment A

Question 4

What would be the expected laboratory results in a patient with thrombocytopenia?

Accepted Answer

A)  Platelet counts 9/L 
B)  Normal bleeding time 
C)  Abnormally prolonged PT and APTT 
D)  Decreased fibrinogen 
A)  Platelet counts 9/L 
B)  Normal bleeding time 
C)  Abnormally prolonged PT and APTT 
D)  Decreased fibrinogen

Question 5

Immune complexes induce vasculitis by which of the following processes?

Accepted Answer

A)  Inducing aggregation of platelets and activation factor XII 
B)  Increasing pressure within the lumen of capillaries 
C)  Forming thrombi in the small vessels, inducing necrosis 
D)  Releasing enzymes and free oxygen radicals from neutrophils that have migrated to the area to phagocytize the immune complexes 
A)  Inducing aggregation of platelets and activation factor XII 
B)  Increasing pressure within the lumen of capillaries 
C)  Forming thrombi in the small vessels, inducing necrosis 
D)  Releasing enzymes and free oxygen radicals from neutrophils that have migrated to the area to phagocytize the immune complexes

Question 6

What is the condition when petechiae and ecchymoses are found in a higher-than-normal number with less-than-usual trauma?

Accepted Answer

A)  Hematoma 
B)  Purpura 
C)  Easy bruisability 
D)  Excess bleeding 
A)  Hematoma 
B)  Purpura 
C)  Easy bruisability 
D)  Excess bleeding

Question 7

A 35-year-old female is hospitalized for knee replacement surgery. Preoperative blood tests reveal a platelet count of 64 × 109/L. The surgery is postponed, and the platelet count is repeated two days later when it is 48 × 109/L. All other labs appear normal and the platelet estimate on the peripheral smear correlates with the decreased platelet count. Based on this information, what is the most likely diagnosis?

Accepted Answer

A)  Acute ITP 
B)  Chronic ITP 
C)  TTP 
D)  HUS 
A)  Acute ITP 
B)  Chronic ITP 
C)  TTP 
D)  HUS

Question 8

Which of the following characteristics of chronic ITP differentiates it from acute ITP?

Accepted Answer

A)  Platelet count of 9/L 
B)  Gender predilection in females of 3:1 
C)  Duration of 2-6 weeks 
D)  Lymphocytosis 
A)  Platelet count of 9/L 
B)  Gender predilection in females of 3:1 
C)  Duration of 2-6 weeks 
D)  Lymphocytosis

Question 9

A patient's peripheral blood smear reveals many giant platelets. All platelet function tests show normal aggregation with the exception of ristocetin. From what is the patient most likely suffering?

Accepted Answer

A)  Glanzmann's thrombasthenia 
B)  Bernard-Soulier syndrome 
C)  Storage pool disease 
D)  Wiskott-Aldrich syndrome 
A)  Glanzmann's thrombasthenia 
B)  Bernard-Soulier syndrome 
C)  Storage pool disease 
D)  Wiskott-Aldrich syndrome

Question 10

An instrument report has a platelet count of 850 x 109/L. This would be interpreted as:

Accepted Answer

A)  Normal platelet count 
B)  Thrombocytosis 
C)  Thrombocytopenia 
D)  Cannot be interpreted 
A)  Normal platelet count 
B)  Thrombocytosis 
C)  Thrombocytopenia 
D)  Cannot be interpreted

Question 11

All of the following are conditions associated with reactive thrombocytosis except:

Accepted Answer

A)  Acute hemorrhage 
B)  Postsplenectomy 
C)  Chronic idiopathic myelofibrosis 
D)  Iron deficiency anemia 
A)  Acute hemorrhage 
B)  Postsplenectomy 
C)  Chronic idiopathic myelofibrosis 
D)  Iron deficiency anemia

Question 12

A patient is exhibiting multiple pinpoint hemorrhages on his upper torso. This would be described as:

Accepted Answer

A)  Hematomas 
B)  Ecchymoses 
C)  Purpura 
D)  Petechiae 
A)  Hematomas 
B)  Ecchymoses 
C)  Purpura 
D)  Petechiae

Question 13

Acquired disorders of the vascular system including senile purpura, Cushing's syndrome, corticosteroid therapy, and scurvy have one condition in common. Which of the following best describes this condition?

Accepted Answer

A)  Decreased amount of supportive connective tissue in the blood vessel walls 
B)  Presence of abnormal proteins in the vascular system 
C)  Inflammation of the small blood vessels 
D)  Increased pressure within the lumen of capillaries after intense exercise 
A)  Decreased amount of supportive connective tissue in the blood vessel walls 
B)  Presence of abnormal proteins in the vascular system 
C)  Inflammation of the small blood vessels 
D)  Increased pressure within the lumen of capillaries after intense exercise

Question 14

What laboratory tests are used to assess disorders of primary hemostasis and secondary hemostasis?

Accepted Answer

• Primary hemostasis: bleeding

Question 15

Which of the following physical symptoms are associated with scurvy?

Accepted Answer

A)  Hemangiomas 
B)  Ecchymoses 
C)  Bleeding into joints and muscles 
D)  Purpura fulminans 
A)  Hemangiomas 
B)  Ecchymoses 
C)  Bleeding into joints and muscles 
D)  Purpura fulminans

Question 16

Aspirin affects platelet aggregation because it interferes with:

Accepted Answer

A)  Cyclooxygenase activity 
B)  Platelet adhesion to collagen 
C)  Development of platelets 
D)  Binding of fibrinogen to platelets 
A)  Cyclooxygenase activity 
B)  Platelet adhesion to collagen 
C)  Development of platelets 
D)  Binding of fibrinogen to platelets

Question 17

Thrombocytosis is associated with which of the following?

Accepted Answer

A)  Acute leukemia 
B)  ITP 
C)  HUS 
D)  Myeloproliferative disorder 
A)  Acute leukemia 
B)  ITP 
C)  HUS 
D)  Myeloproliferative disorder

Question 18

Describe the following and indicate whether they are typically seen in disorders of primary or secondary hemostasis.
a. Petechiae
b. Purpura
c. Ecchymoses
d. Hematomas

Accepted Answer

a. Petechiae: purple pinpoint hemorrhage

Question 19

Predict the typical expected results of clot-based PT in a patient with a platelet defect.

Accepted Answer

A)  Prolonged 
B)  Normal 
C)  Shortened 
D)  Cannot be predicted 
A)  Prolonged 
B)  Normal 
C)  Shortened 
D)  Cannot be predicted

Question 20

Increased risk of bleeding into the central nervous system occurs with a platelet count of:

Accepted Answer

A)  800 × 109/L 
B)  200 × 109/L 
C)  150 × 109/L 
D)  30 × 109/L 
A)  800 × 109/L 
B)  200 × 109/L 
C)  150 × 109/L 
D)  30 × 109/L

Exam 33: Disorders of Primary Hemostasis

How do hematologic disorders contribute to the pathogenesis of thrombocytopenia?

Scurvy can lead to vascular defects by which of the following mechanisms?

A patient visits a physician because of unexplained bruising and prolonged bleeding from a recent tooth extraction. The physician orders a prothrombin time (PT) and an APTT. Results are within normal reference ranges. What other tests could the physician order to investigate the patient's symptoms?

What would be the expected laboratory results in a patient with thrombocytopenia?

Immune complexes induce vasculitis by which of the following processes?

What is the condition when petechiae and ecchymoses are found in a higher-than-normal number with less-than-usual trauma?

Which of the following characteristics of chronic ITP differentiates it from acute ITP?

A patient's peripheral blood smear reveals many giant platelets. All platelet function tests show normal aggregation with the exception of ristocetin. From what is the patient most likely suffering?

An instrument report has a platelet count of 850 x 109/L. This would be interpreted as:

All of the following are conditions associated with reactive thrombocytosis except:

A patient is exhibiting multiple pinpoint hemorrhages on his upper torso. This would be described as:

Acquired disorders of the vascular system including senile purpura, Cushing's syndrome, corticosteroid therapy, and scurvy have one condition in common. Which of the following best describes this condition?

What laboratory tests are used to assess disorders of primary hemostasis and secondary hemostasis?

Which of the following physical symptoms are associated with scurvy?

Aspirin affects platelet aggregation because it interferes with:

Thrombocytosis is associated with which of the following?

Describe the following and indicate whether they are typically seen in disorders of primary or secondary hemostasis. a. Petechiae b. Purpura c. Ecchymoses d. Hematomas

Predict the typical expected results of clot-based PT in a patient with a platelet defect.

Increased risk of bleeding into the central nervous system occurs with a platelet count of:

Introduction

Cellular Homeostasis

Structure and Function of Hematopoietic Organs

Hematopoiesis

The Erythrocyte

Hemoglobin

Granulocytes and Monocytes

Lymphocytes

The Platelet

The Complete Blood Count and Peripheral Blood Smear Evaluation

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopathies: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Hypoproliferative Anemias

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Disorders of Leukocytes: Granulocytes and Monocytes

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Precursor Lymphoid Neoplasms

Mature Lymphoid Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Secondary Hemostasis

Thrombophilia

Hemostasis: Laboratory Testing and Instrumentation

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Quality Assessment in the Hematology Laboratory

Filters

An instrument report has a platelet count of 850 x 10⁹/L. This would be interpreted as: