Question 1

A patient being treated with heparin therapy has a 65% decrease in platelet count from the baseline count after 6 days of being on the anticoagulant.What is the probable cause of the decrease?

Accepted Answer

A) DIC 
B) TTP 
C) HIT 
D) APLS

Question 2

Which of the following alterations would most likely be associated with a hypercoagulable state?

Accepted Answer

A) Excess plasma coagulation proteins 
B) Decreased fibrinolytic inhibitors 
C) Excess coagulation inhibitors 
D) Decreased platelets

Question 3

What are the physiological processes involved in hypercoagulability?

Accepted Answer

The answer of What are the physiological processes involved in...

Question 4

Explain why many patients with an inherited thrombophilia are misdiagnosed.

Accepted Answer

The answer of Explain why many patients with an inherited...

Question 5

A postop heart transplant patient has been given unfractionated heparin.Five days postop, he develops petechiae, and needs multiple dressing changes over his wound site.What tests should be used to assess the patient's clinical status?

Accepted Answer

A) Platelet count and HIT antibody assay 
B) APTT and PT 
C) PT and FDP 
D) D-dimer and fibrogen

Question 6

A patient is admitted to the local hospital with a pulmonary embolus.He was initially admitted to the Emergency Department unconscious.Ultrasound revealed a large clot in the patient's saphenous vein.Thrombolytic therapy is administered, and eventually the patient's condition stabilizes.Laboratory tests are performed upon hospital admission, and are seen below: PT: 15.5 sec
INR: 2.85
APTT: 76 sec
Protein C antigen: 14%
Protein C functional activity: 18%
Molecular studies: FV-R506Q present
Based on this information, what is the most probable diagnosis for this patient?

Accepted Answer

A) PC deficiency and factor V deficiency 
B) PS deficiency and factor V deficiency 
C) APCR and PC deficiency 
D) HC-II deficiency

Question 7

Which of the following is thought to be a traditional risk factor associated with the formation of arterial thrombi?

Accepted Answer

A) von Willebrand's disease 
B) Hemophilia 
C) Dysfibrinogenemia 
D) Diabetes

Question 8

Which of the following conditions is NOT associated with an increased tendency for thrombosis?

Accepted Answer

A) Antiphospholipid antibody syndrome 
B) Pregnancy 
C) Malignancy 
D) Factor VIII deficiency

Question 9

A tendency to favor thrombus formation that is produced from an imbalance in the major constituents of the hemostatic system is defined as:

Accepted Answer

A) Hypercoagulability. 
B) Thrombophilia. 
C) Thrombosis. 
D) Thromboembolism.

Question 10

Mutations in which of the following gene(s) lead to hyperhomocysteinemia?

Accepted Answer

A) HFE and MTHFR genes 
B) CBS and MTHFR genes 
C) Prothrombin gene 
D) Factor V gene

Question 11

Which of the following test results would help differentiate between type I and II protein C deficiencies?

Accepted Answer

A) PT and APTT 
B) Protein C antigen assay 
C) Protein C functional activity assay 
D) Protein S assay

Question 12

A patient has been evaluated for a coagulopathy, and has been given Coumadin as a mode of treatment.What screening test(s) should be performed to monitor this treatment, and what effect will this therapy have on the coagulation pathway?

Accepted Answer

A) APTT; initial decrease in the vitamin K-dependent factors of the intrinsic pathway 
B) PT-INR; initial decrease in the vitamin K-dependent factors of the extrinsic pathway 
C) PT-INR and APTT; initial decrease in the vitamin K-dependent factors of all pathways 
D) PT-INR; initial decrease in all Vitamin K-dependent serine proteases

Question 13

Why are thrombolytic agents not recommended for prolonged anticoagulation therapy?

Accepted Answer

A) Because thrombolytic agents are weak anticoagulants that often cause repeat thrombotic episodes 
B) Because thrombolytic agents are powerful agents that increase the risk of hemorrhage 
C) Because thrombolytic agents often need another agent for full anticoagulant effect 
D) Thrombolytic agents are used for prolonged anticoagulation therapy.

Question 14

Patients with protein C and/or S deficiencies are at risk for which type of complication?

Accepted Answer

A) Hemorrhage 
B) Delayed bleeding after injury 
C) Thrombosis 
D) Fibrinolysis

Question 15

A 30-year-old patient is diagnosed with a DVT.This is his third episode of DVTs.He is currently hospitalized and receiving heparin therapy.The physician orders a thrombotic risk battery of tests.What is the most appropriate action that the laboratory professional should take?

Accepted Answer

A) Call the physician and explain that testing will not be accurate during anticoagulant therapy and during the thrombotic episode. 
B) Perform the battery of tests in the thrombosis risk profile, but note that results are not reliable. 
C) Perform a PT and an APTT, and, if prolonged, refuse to do the testing. 
D) Call the physician and explain that this patient is not a candidate for thrombosis risk testing.

Exam 32: Thrombophilia