Question 1

Splenomegaly can cause thrombocytopenia by which of the following mechanisms?

Accepted Answer

A)  Impaired production 
B)  Platelet sequestration 
C)  Immune-mediated 
D)  Mechanical destruction 
A)  Impaired production 
B)  Platelet sequestration 
C)  Immune-mediated 
D)  Mechanical destruction

Question 2

Give at least five markers of differentiation between acute and chronic ITP.

Accepted Answer

a. Age of the patient >>> acute: typical

Question 3

Which of the following contributes to the pathogenesis of Bernard-Soulier syndrome?

Accepted Answer

A)  Abnormal glycoprotein Ib/IX complex 
B)  Abnormal glycoprotein IIb/IIIa 
C)  High platelet count 
D)  Low fibrinogen level 
A)  Abnormal glycoprotein Ib/IX complex 
B)  Abnormal glycoprotein IIb/IIIa 
C)  High platelet count 
D)  Low fibrinogen level

Question 4

What is the most common cause of thrombocytopenia?

Accepted Answer

A)  Increased consumption 
B)  Increased destruction 
C)  Decreased production 
D)  Increased splenic sequestration 
A)  Increased consumption 
B)  Increased destruction 
C)  Decreased production 
D)  Increased splenic sequestration

Question 5

Which of the following best describes the effect of aspirin on platelets, and for how long does the effect last?

Accepted Answer

A)  ADP receptor blockade; 5 days 
B)  Thrombocytosis; 7 days 
C)  Inactivation of cyclooxygenase; 7 days 
D)  Thrombocytopenia; 7 days 
A)  ADP receptor blockade; 5 days 
B)  Thrombocytosis; 7 days 
C)  Inactivation of cyclooxygenase; 7 days 
D)  Thrombocytopenia; 7 days

Question 6

Minimum screening test(s) that should be considered in the evaluation of abnormal bleeding is(are) which of the following?

Accepted Answer

A)  Thrombin time 
B)  Fibrinogen level 
C)  Factor studies 
D)  Platelet count, PT, APTT 
A)  Thrombin time 
B)  Fibrinogen level 
C)  Factor studies 
D)  Platelet count, PT, APTT

Question 7

What is a common etiology of ITP in children?

Accepted Answer

A)  Tooth extraction 
B)  Easy bruising syndrome 
C)  Vasculitis 
D)  Chickenpox 
A)  Tooth extraction 
B)  Easy bruising syndrome 
C)  Vasculitis 
D)  Chickenpox

Question 8

Which of the following is not a mechanism of inducing thrombocytopenia in a patient?

Accepted Answer

A)  Antibody-mediated platelet destruction 
B)  Inherited platelet membrane defect 
C)  Increased splenic sequestration 
D)  Inherited defect in release of ADP and ATP 
A)  Antibody-mediated platelet destruction 
B)  Inherited platelet membrane defect 
C)  Increased splenic sequestration 
D)  Inherited defect in release of ADP and ATP

Question 9

a. Is it good practice to perform a bleeding time on a thrombocytopenic patient?
b. Why is a bleeding time not indicated to follow up on an abnormal PT or PTT?

Accepted Answer

a. No, the bleeding time measures the ab

Question 10

A patient has a severe headache shortly before getting her blood tested. She takes a couple of aspirin and is scheduled for platelet aggregation studies. What effect will this have on the platelet aggregation studies?

Accepted Answer

A)  Platelets will show diminished activity with selected agonists. 
B)  Platelets will show normal activity with all agonists. 
C)  Platelets will show increased activity with selected agonists. 
D)  Platelets will show variable activity with all agonists. 
A)  Platelets will show diminished activity with selected agonists. 
B)  Platelets will show normal activity with all agonists. 
C)  Platelets will show increased activity with selected agonists. 
D)  Platelets will show variable activity with all agonists.

Question 11

A patient has a platelet count of 80 × 109/L and an abnormal closure time. What is the most likely disorder?

Accepted Answer

A)  A platelet function disorder 
B)  A quantitative platelet disorder 
C)  A combined platelet disorder 
D)  von Willebrand disease 
A)  A platelet function disorder 
B)  A quantitative platelet disorder 
C)  A combined platelet disorder 
D)  von Willebrand disease

Question 12

A patient has a severe headache prior to his blood draw. He takes two aspirin, and his blood is drawn. Platelet aggregation studies are performed, and one comes back abnormal. Based on this information, which agonist will show a normal aggregation pattern?

Accepted Answer

A)  Arachidonic acid 
B)  Epinephrine 
C)  Collagen 
D)  Ristocetin 
A)  Arachidonic acid 
B)  Epinephrine 
C)  Collagen 
D)  Ristocetin

Question 13

A patient is experiencing pinpoint petechial bruising on her upper torso. Her history revealed frequent nosebleeds during her childhood. Clot-based screening assays are within normal reference ranges, and platelet function assays are abnormal. Based on this information, what appears to be defective in this patient?

Accepted Answer

A)  Coagulation factors 
B)  Platelets 
C)  The vasculature 
D)  Fibrinolytic system 
A)  Coagulation factors 
B)  Platelets 
C)  The vasculature 
D)  Fibrinolytic system

Question 14

A patient is known to be a chronic alcoholic. His blood is drawn, and his platelet count is 72 × 109/L. What is the most likely reason for this occurrence?

Accepted Answer

A)  Immune-mediated thrombocytopenia 
B)  Acquired hypoplasia resulting from alcohol consumption 
C)  Dilutional thrombocytopenia from liver dysfunction 
D)  Increased destruction of platelets 
A)  Immune-mediated thrombocytopenia 
B)  Acquired hypoplasia resulting from alcohol consumption 
C)  Dilutional thrombocytopenia from liver dysfunction 
D)  Increased destruction of platelets

Question 15

Explain the pathophysiology of the following and why each typically has normal coagulation screening tests.
a. Bernard-Soulier syndrome
b. Glanzmann's thrombasthenia
c. δ-storage pool disease
d. Gray platelet syndrome

Accepted Answer

a. Pathophysiology: Bernard-Soulier synd

Question 16

Which hemostatic disorder usually is represented by a decreased platelet count, normal PT, normal APTT, and abnormal closure time?

Accepted Answer

A)  Thrombocytosis 
B)  Thrombocytopenia 
C)  Vascular disorder 
D)  Platelet dysfunction 
A)  Thrombocytosis 
B)  Thrombocytopenia 
C)  Vascular disorder 
D)  Platelet dysfunction

Exam 33: Disorders of Primary Hemostasis

Splenomegaly can cause thrombocytopenia by which of the following mechanisms?

Give at least five markers of differentiation between acute and chronic ITP.

Which of the following contributes to the pathogenesis of Bernard-Soulier syndrome?

What is the most common cause of thrombocytopenia?

Which of the following best describes the effect of aspirin on platelets, and for how long does the effect last?

Minimum screening test(s) that should be considered in the evaluation of abnormal bleeding is(are) which of the following?

What is a common etiology of ITP in children?

Which of the following is not a mechanism of inducing thrombocytopenia in a patient?

a. Is it good practice to perform a bleeding time on a thrombocytopenic patient? b. Why is a bleeding time not indicated to follow up on an abnormal PT or PTT?

A patient has a severe headache shortly before getting her blood tested. She takes a couple of aspirin and is scheduled for platelet aggregation studies. What effect will this have on the platelet aggregation studies?

A patient has a platelet count of 80 × 109/L and an abnormal closure time. What is the most likely disorder?

A patient has a severe headache prior to his blood draw. He takes two aspirin, and his blood is drawn. Platelet aggregation studies are performed, and one comes back abnormal. Based on this information, which agonist will show a normal aggregation pattern?

A patient is known to be a chronic alcoholic. His blood is drawn, and his platelet count is 72 × 109/L. What is the most likely reason for this occurrence?

Explain the pathophysiology of the following and why each typically has normal coagulation screening tests. a. Bernard-Soulier syndrome b. Glanzmann's thrombasthenia c. δ-storage pool disease d. Gray platelet syndrome

Which hemostatic disorder usually is represented by a decreased platelet count, normal PT, normal APTT, and abnormal closure time?

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

A patient has a platelet count of 80 × 10⁹/L and an abnormal closure time. What is the most likely disorder?

A patient is known to be a chronic alcoholic. His blood is drawn, and his platelet count is 72 × 10⁹/L. What is the most likely reason for this occurrence?