Question 1

The bleeding associated with renal disease is related most to defective:

Accepted Answer

A)  Blood vessels 
B)  Plasma procoagulants 
C)  Platelets 
D)  Inhibitors 
A)  Blood vessels 
B)  Plasma procoagulants 
C)  Platelets 
D)  Inhibitors C

Question 2

Which is the most common form of von Willebrand disease (VWD)?

Accepted Answer

A)  Type 1 
B)  Type 2A 
C)  Type 3 
D)  Acquired 
A)  Type 1 
B)  Type 2A 
C)  Type 3 
D)  Acquired A

Question 3

The urea solubility test is used to detect deficiencies in which factor?

Accepted Answer

A)  Fibrinogen 
B)  Factor V 
C)  Factor XII 
D)  Factor XIII 
A)  Fibrinogen 
B)  Factor V 
C)  Factor XII 
D)  Factor XIII D

Question 4

All of the following can mask a deficiency of VWF and thus of type 1 VWD except:

Accepted Answer

A)  Type A blood group 
B)  Pregnancy 
C)  Acute stress 
D)  Type AB blood group 
A)  Type A blood group 
B)  Pregnancy 
C)  Acute stress 
D)  Type AB blood group

Question 5

What is or are the possible mechanism (or mechanisms) for bleeding in patients with severe liver disease?

Accepted Answer

A)  Thrombocytopenia 
B)  Inadequate production of procoagulants 
C)  Disseminated intravascular coagulation (DI
C)  
D)  All of the above 
A)  Thrombocytopenia 
B)  Inadequate production of procoagulants 
C)  Disseminated intravascular coagulation (DI
C)  
D)  All of the above

Question 6

Which of the following would be appropriate initial testing for the siblings in Question 1?

Accepted Answer

A)  Fibrinogen, D-dimer, and platelet aggregation studies 
B)  Factor VIII assay, liver function tests, and vitamin K level 
C)  von Willebrand factor (VWF) antigen, Bethesda titer, and reptilase time 
D)  Prothrombin time (PT), partial thromboplastin time (PTT), and platelet count 
A)  Fibrinogen, D-dimer, and platelet aggregation studies 
B)  Factor VIII assay, liver function tests, and vitamin K level 
C)  von Willebrand factor (VWF) antigen, Bethesda titer, and reptilase time 
D)  Prothrombin time (PT), partial thromboplastin time (PTT), and platelet count

Question 7

Which of the following single-factor inherited deficiencies is most common as the cause for hemophilia?

Accepted Answer

A)  Factor V 
B)  Factor VIII 
C)  Factor IX 
D)  Factor XI 
A)  Factor V 
B)  Factor VIII 
C)  Factor IX 
D)  Factor XI

Question 8

What procedure is used to quantitate a factor VIII inhibitor?

Accepted Answer

A)  Bethesda assay 
B)  Reptilase time 
C)  Factor VIII concentration 
D)  VWF assay 
A)  Bethesda assay 
B)  Reptilase time 
C)  Factor VIII concentration 
D)  VWF assay

Question 9

Two children in the same family have recurrent, chronic bruising in multiple sites, repeated long-lasting epistaxis, and minor bleeding after dental work. Which type of disorder is most likely?

Accepted Answer

A)  Localized, acquired, anatomic 
B)  Localized, congenital, anatomic 
C)  Generalized, congenital, systemic 
D)  Generalized, acquired, systemic 
A)  Localized, acquired, anatomic 
B)  Localized, congenital, anatomic 
C)  Generalized, congenital, systemic 
D)  Generalized, acquired, systemic

Question 10

What is the typical clinical picture in patients with severe hemophilia A?

Accepted Answer

A)  Generalized bleeding after trauma or dental work 
B)  Generalized hemorrhage 
C)  Major bruising on extremities and chronic nosebleeds 
D)  Serious anatomic bleeds into joints 
A)  Generalized bleeding after trauma or dental work 
B)  Generalized hemorrhage 
C)  Major bruising on extremities and chronic nosebleeds 
D)  Serious anatomic bleeds into joints

Question 11

What coagulation screening test is the most sensitive for detecting mild liver disease?

Accepted Answer

A)  Fibrinogen 
B)  PTT 
C)  PT 
D)  TT 
A)  Fibrinogen 
B)  PTT 
C)  PT 
D)  TT

Question 12

Which of the following tests is increased in a patient with severe hemophilia A?

Accepted Answer

A)  PTT 
B)  Thrombin time (TT) 
C)  PT 
D)  Factor VIII assay 
A)  PTT 
B)  Thrombin time (TT) 
C)  PT 
D)  Factor VIII assay

Question 13

In what is a patient with the following coagulation test results most likely deficient?

Accepted Answer

A)  Fibrinogen 
B)  VII 
C)  VIII 
D)  X 
A)  Fibrinogen 
B)  VII 
C)  VIII 
D)  X

Question 14

Clot-based mixing studies and Bethesda titers are used to test for:

Accepted Answer

A)  Vitamin K deficiency 
B)  Inhibitors (antibodies) against coagulation factors 
C)  DIC 
D)  Hemophilia 
A)  Vitamin K deficiency 
B)  Inhibitors (antibodies) against coagulation factors 
C)  DIC 
D)  Hemophilia

Question 15

Which type of VWD gives a positive response to low-dose ristocetin-induced platelet aggregation?

Accepted Answer

A)  1 
B)  2A 
C)  2B 
D)  2N 
A)  1 
B)  2A 
C)  2B 
D)  2N

Question 16

Which of the following proteins is the best test to distinguish moderate to severe liver disease from vitamin K deficiency?

Accepted Answer

A)  Factor V concentration 
B)  Factor VII concentration 
C)  Factor VIII concentration 
D)  Factor IX concentration 
A)  Factor V concentration 
B)  Factor VII concentration 
C)  Factor VIII concentration 
D)  Factor IX concentration

Question 17

A 67-year-old woman arrives at the emergency department with acute bleeding into the back of the throat. A coagulation screen is ordered with the following results: 
 
What would be a reasonable next step to perform?

Accepted Answer

A)  Perform factor IX assay. 
B)  Perform factor VII assay. 
C)  Incubate the 1:1 mix at 37 $\degree$ C for 1 hour and then repeat the PTT. 
D)  Perform TT. 
A)  Perform factor IX assay. 
B)  Perform factor VII assay. 
C)  Incubate the 1:1 mix at 37 $\degree$ C for 1 hour and then repeat the PTT. 
D)  Perform TT.

Question 18

A 39-year-old male patient shows evidence of poor wound healing and a history of joint bleeding. What protein deficiency is most likely present?

Accepted Answer

A)  Factor VIII 
B)  Factor IX 
C)  Factor V 
D)  Factor XIII 
A)  Factor VIII 
B)  Factor IX 
C)  Factor V 
D)  Factor XIII

Question 19

What are the primary roles of VWF?

Accepted Answer

A)  Mediates platelet adhesion and carrier molecule for factor VIII 
B)  Mediates platelet aggregation and carrier molecule for factor IX 
C)  Inhibits excess coagulation and activates protein C 
D)  Activates plasmin and enhances vitamin K factors 
A)  Mediates platelet adhesion and carrier molecule for factor VIII 
B)  Mediates platelet aggregation and carrier molecule for factor IX 
C)  Inhibits excess coagulation and activates protein C 
D)  Activates plasmin and enhances vitamin K factors

Question 20

What is the purest form of factor VIII that is available for treating a bleeding patient with hemophilia A?

Accepted Answer

A)  Cryoprecipitate 
B)  Recombinant factor VIII concentrate 
C)  Fresh frozen plasma 
D)  Factor VIII concentrate prepared by chemical concentration 
A)  Cryoprecipitate 
B)  Recombinant factor VIII concentrate 
C)  Fresh frozen plasma 
D)  Factor VIII concentrate prepared by chemical concentration

Exam 41: Hemorrhagic Coagulation Disorders

The bleeding associated with renal disease is related most to defective:

Which is the most common form of von Willebrand disease (VWD)?

The urea solubility test is used to detect deficiencies in which factor?

All of the following can mask a deficiency of VWF and thus of type 1 VWD except:

What is or are the possible mechanism (or mechanisms) for bleeding in patients with severe liver disease?

Which of the following would be appropriate initial testing for the siblings in Question 1?

Which of the following single-factor inherited deficiencies is most common as the cause for hemophilia?

What procedure is used to quantitate a factor VIII inhibitor?

Two children in the same family have recurrent, chronic bruising in multiple sites, repeated long-lasting epistaxis, and minor bleeding after dental work. Which type of disorder is most likely?

What is the typical clinical picture in patients with severe hemophilia A?

What coagulation screening test is the most sensitive for detecting mild liver disease?

Which of the following tests is increased in a patient with severe hemophilia A?

In what is a patient with the following coagulation test results most likely deficient?

Clot-based mixing studies and Bethesda titers are used to test for:

Which type of VWD gives a positive response to low-dose ristocetin-induced platelet aggregation?

Which of the following proteins is the best test to distinguish moderate to severe liver disease from vitamin K deficiency?

A 67-year-old woman arrives at the emergency department with acute bleeding into the back of the throat. A coagulation screen is ordered with the following results: What would be a reasonable next step to perform?

A 39-year-old male patient shows evidence of poor wound healing and a history of joint bleeding. What protein deficiency is most likely present?

What are the primary roles of VWF?

What is the purest form of factor VIII that is available for treating a bleeding patient with hemophilia A?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Energy Metabolism and Membrane Physiology of the Erythrocyte

Hemoglobin Metabolism

Iron Metabolism

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Routine and Point-Of-Care Testing in Hematology: Manual and Semiautomated Methods

Examination of the Peripheral Blood Film and Correlation With the Complete Blood Count

Bone Marrow Examination

Body Fluids in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron and Heme Metabolism

Anemias Caused by Defects of Dna Metabolism

Bone Marrow Failure

Introduction to Increased Destruction of Erythrocytes

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocytedestructionnonimmune Causes

Extrinsic Defects Leading to Increased Erythrocytedestructionimmune Causes

Hemoglobinopathies Structural Defects in Hemoglobin

Thalassemias

Nonmalignant Leukocyte Disorders

Introduction to Leukocyte Neoplasms

Cytochemistry

Cytogenetics

Molecular Diagnostics in the Clinical Laboratory

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Pediatric and Geriatric Hematology

Automated Cell-Counting Instrumentation

Normal Hemostasis and Coagulation

Thrombosis Risk Testing

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Monitoring Antithrombotic Therapies

Coagulation Instrumentation

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