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82問 • 1年前

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Which of the following platelet aggregating agents demonstrates a monophasic aggregation curve when used in optimal concentration? A. Thrombin B. Collagen C. Adenosine diphosphate (ADP) D. Epinephrine

B. Collagen

The APTT is sensitive to a deficiency of which clotting factor? A. Factor VII B. Factor X C. PF3 D. Calcium

B. Factor X

Which test result would be normal in a patient with dysfibrinogenemia? A. Thrombin time B. APTT C. PT D. Immunologic fibrinogen level

D. Immunologic fibrinogen level

A patient with a prolonged PT is given intravenous vitamin K. The PT corrects to normal after 24 hours. What clinical condition most likely caused these results? A. Necrotic liver disease B. Factor X deficiency C. Fibrinogen deficiency D. Obstructive jaundice

D. Obstructive jaundice

Which factor deficiency is associated with a prolonged PT and APTT? A. X B. VIII C. IX D. XI

A. X

A prolonged APTT is corrected with factor VIII– deficient plasma but not with factor IX–deficient plasma. Which factor is deficient? A. V B. VIII C. IX D. X

C. IX

6. Which of the following is a characteristic of classic hemophilia A? A. Prolonged bleeding time B. Autosomal recessive inheritance C. Mild to severe bleeding episodes D. Prolonged PT

C. Mild to severe bleeding episodes

Refer to the following results: PT = prolonged APTT = prolonged Platelet count = decreased Which disorder may be indicated? A. Factor VIII deficiency B. von Willebrand’s disease C. DIC D. Factor IX deficiency

C. DIC

Which of the following is a predisposing condition for the development of DIC? A. Adenocarcinoma B. Idiopathic thrombocytopenic purpura (ITP) C. Post-transfusion purpura (PTP) D. Heparin-induced thrombocytopenia (HIT)

A. Adenocarcinoma

Factor XII deficiency is associated with: A. Bleeding episodes B. Epistaxis C. Decreased risk of thrombosis D. Increased risk of thrombosis

D. Increased risk of thrombosis

The following results were obtained on a patient: normal platelet count and function, normal PT, and prolonged APTT. Which of the following disorders is most consistent with these results? A. Hemophilia A B. Bernard–Soulier syndrome C. von Willebrand’s disease D. Glanzmann’s thrombasthenia

A. Hemophilia A

The following laboratory results were obtained from a 40-year-old woman: PT = 20 sec; APTT = 50 sec; thrombin time = 18 sec. What is the most probable diagnosis? A. Factor VII deficiency B. Factor VIII deficiency C. Factor X deficiency D. Hypofibrinogenemia

D. Hypofibrinogenemia

When performing a factor VIII activity assay, a patient’s plasma is mixed with: A. Normal patient’s plasma B. Factor VIII deficient plasma C. Plasma with a high concentration of factor VIII D. Normal control plasma

B. Factor VIII deficient plasma

The most suitable product for treatment of factor VIII deficiency is: A. Fresh frozen plasma B. Factor VIII concentrate C. Prothrombin complex concentrate D. Factor V Leiden

C. Prothrombin complex concentrate

Which of the following is associated with an abnormal platelet aggregation test? A. Factor VIII deficiency B. Factor VIII inhibitor C. Lupus anticoagulant D. Afibrinogenemia

D. Afibrinogenemia

Refer to the following results: PT = normal APTT = prolonged Bleeding time= increased Platelet count = normal Platelet aggregation to ristocetin = abnormal Which of the following disorders may be indicated? A. Factor VIII deficiency B. DIC C. von Willebrand’s disease D. Factor IX deficiency

C. von Willebrand’s disease

Which results are associated with hemophilia A? A. Prolonged APTT, normal PT B. Prolonged PT and APTT C. Prolonged PT, normal APTT D. Normal PT and APTT

A. Prolonged APTT, normal PT

Fibrin monomers are increased in which of the following conditions? A. Primary fibrinolysis B. DIC C. Factor VIII deficiency D. Fibrinogen deficiency

B. DIC

Which of the following is associated with multiple factor deficiencies? A. An inherited disorder of coagulation B. Severe liver disease C. Dysfibrinogenemia D. Lupus anticoagulant

B. Severe liver disease

Fletcher factor (prekallikrein) deficiency may be associated with: A. Bleeding B. Thrombosis C. Thrombocytopenia D. Thrombocytosis

B. Thrombosis

One of the complications associated with a severe hemophilia A is: A. Hemarthrosis B. Mucous membrane bleeding C. Mild bleeding during surgery D. Immune-mediated thrombocytopenia

A. Hemarthrosis

The most common subtype of classic von Willebrand’s disease is: A. Type 1 B. Type 2A C. Type 2B D. Type 3

A. Type 1

A prolonged APTT and PT are corrected when mixed with normal plasma. Which factor is most likely deficient? A. VIII B. V C. XI D. IX

B. V

Which characteristic describes antithrombin (AT)? A. It is synthesized in megakaryocytes B. It is activated by protein C C. It is a cofactor of heparin D. It is a pathological inhibitor of coagulation

C. It is a cofactor of heparin

Which laboratory test is affected by heparin therapy? A. Thrombin time B. Fibrinogen assay C. Protein C assay D. Protein S assay

A. Thrombin time

An abnormal APTT caused by a pathological circulating anticoagulant is: A. Corrected with factor VIII–deficient plasma B. Corrected with factor IX–deficient plasma C. Corrected with normal plasma D. Not corrected with normal plasma

D. Not corrected with normal plasma

The lupus anticoagulant affects which of the following tests? A. Factor VIII assay B. Factor IX assay C. VWF assay D. Phospholipid-dependent assays

D. Phospholipid-dependent assays

Which statement about Coumadin (warfarin) is accurate? A. It is a vitamin B antagonist B. It is not recommended for pregnant and lactating women C. It needs antithrombin as a cofactor D. APTT test is used to monitor its dosage

B. It is not recommended for pregnant and lactating women

Which statement regarding protein C is correct? A. It is a vitamin K–independent zymogen B. It is activated by fibrinogen C. It activates cofactors V and VIII D. Its activity is enhanced by protein S

D. Its activity is enhanced by protein S

Which of the following is an appropriate screening test for the diagnosis of lupus anticoagulant? A. Thrombin time test B. Diluted Russell’s viper venom test (DRVVT) C. D-dimer test D. FDP test

B. Diluted Russell’s viper venom test (DRVVT)

Which of the following is most commonly associated with activated protein C resistance (APCR)? A. Bleeding B. Thrombosis C. Epistaxis D. Menorrhagia

B. Thrombosis

A 50-year-old man has been on heparin for the past 7 days. Which combination of the tests is expected to be abnormal? A. PT and APTT only B. APTT, TT only C. APTT, TT, fibrinogen assay D. PT, APTT, TT

D. PT, APTT, TT

Which of the following drugs inhibits ADP mediated platelet aggregation? A. Heparin B. Warfarin C. Aspirin D. Prasugrel

D. Prasugrel

Thrombin-thrombomodulin complex is necessary for activation of: A. Protein C B. Antithrombin C. Protein S D. Factors V and VIII

A. Protein C

What test is used to monitor heparin therapy? A. INR B. APTT C. TT D. PT

B. APTT

What test is commonly used to monitor warfarin therapy? A. INR B. APTT C. TT D. Ecarin time

A. INR

What clotting factors (cofactors) are inhibited by protein S? A. V and X B. Va and VIIIa C. VIII and IX D. VIII and X

B. Va and VIIIa

Which drug promotes fibrinolysis? A. Warfarin B. Heparin C. Urokinase D. Aspirin

C. Urokinase

Diagnosis of lupus anticoagulant is confirmed by which of the following criteria? A. Decreased APTT B. Correction of the APPT by mixing studies C. Neutralization of the antibody by high concentration of platelets D. Confirmation that abnormal coagulation tests are time and temperature dependent

C. Neutralization of the antibody by high concentration of platelets

Which of the following abnormalities is consistent with the presence of lupus anticoagulant? A. Decreased APTT/bleeding complications B. Prolonged APTT/thrombosis C. Prolonged APTT/thrombocytosis D. Thrombocytosis/thrombosis

B. Prolonged APTT/thrombosis

Which of the following is a characteristic of low molecular weight heparin (LMWH)? A. Generally requires monitoring B. Specifically acts on factor Va C. Has a longer half-life than unfractionated heparin D. Can be used as a fibrinolytic agent

C. Has a longer half-life than unfractionated heparin

Which of the following tests is most likely to be abnormal in patients taking aspirin? A. Platelet morphology B. Platelet count C. Bleeding time D. Prothrombin time

C. Bleeding time

Which of the following is associated with antithrombin deficiency? A. Thrombocytosis B. Thrombosis C. Thrombocytopenia D. Bleeding

B. Thrombosis

Which of the following may be associated with thrombotic events? A. Decreased protein C B. Increased fibrinolysis C. Afibrinogenemia D. ITP

A. Decreased protein C

Aspirin resistance may be associated with: A. Bleeding B. Factor VIII deficiency C. Thrombosis D. Thrombocytosis

C. Thrombosis

A prolonged thrombin time is indicative of which of the following antithrombotic therapies? A. Prasugrel B. Clopidogrel C. Aspirin D. Heparin

D. Heparin

24. Screening tests for thrombophilia should be performed on: A. All pregnant women because of the thrombotic risk B. Patients with a negative family history C. Patients with thrombotic events occurring at a young age D. Patients who are receiving anticoagulant therapy

C. Patients with thrombotic events occurring at a young age

Prothrombin G20210A is characterized by which of the following causes and conditions? A. Single mutation of prothrombin molecule/ bleeding B. Single mutation of prothrombin molecule/ thrombosis C. Decreased levels of prothrombin in plasma/ thrombosis D. Increased levels of prothrombin in plasma/ bleeding

B. Single mutation of prothrombin molecule/ thrombosis

Factor V Leiden promotes thrombosis by preventing: A. Deactivation of factor Va B. Activation of factor V C. Activation of protein C D. Activation of protein S

A. Deactivation of factor Va

What is the approximate incidence of antiphospholipid antibodies in the general population? A. <1% B. 2% C. 10% D. 20%

B. 2%

Which of the following laboratory tests is helpful in the diagnosis of aspirin resistance? A. APTT B. PT C. Platelet count and morphology D. Platelet aggregation

D. Platelet aggregation

Which of the following complications may occur as a result of decreased tissue factor pathway inhibitor (TFPI)? A. Increased hemorrhagic episodes B. Increased thrombotic risk C. Impaired platelet plug formation D. Immune thrombocytopenia

B. Increased thrombotic risk

30. Factor VIII inhibitors occur in ____________ of patients with factor VIII deficiency? A. 40%–50% B. 30%–40% C. 25%–30% D. 10%–20%

D. 10%–20%

Which therapy and resulting mode of action are appropriate for the treatment of a patient with a high titer of factor VIII inhibitors? A. Factor VIII concentrate to neutralize the antibodies B. Recombinant factor VIIa (rVIIa) to activate factor X C. Factor X concentrate to activate the common pathway D. Fresh frozen plasma to replace factor VIII

B. Recombinant factor VIIa (rVIIa) to activate factor X

The Bethesda assay is used for which determination? A. Lupus anticoagulant titer B. Factor VIII inhibitor titer C. Factor V Leiden titer D. Protein S deficiency

B. Factor VIII inhibitor titer

Hyperhomocysteinemia may be a risk factor for: A. Bleeding B. Thrombocythemia C. Thrombosis D. Thrombocytopenia

C. Thrombosis

Which drug may be associated with deep venous thrombosis (DVT)? A. Aspirin B. tPA C. Oral contraceptives D. Plavix (clopidogrel)

A. Aspirin

Argatroban may be used as an anticoagulant drug in patients with: A. DVT B. Hemorrhage C. TTP D. Thrombocytosis

A. DVT

Heparin-induced thrombocytopenia (HIT) results from: A. Antibodies to heparin B. Antibodies to platelets C. Antibodies to PF4 D. Antibodies to heparin-PF4 complex

D. Antibodies to heparin-PF4 complex

Which laboratory test is used to screen for activated protein C resistance? A. Mixing studies with normal plasma B. Mixing studies with factor-deficient plasma C. Modified APTT with and without activated protein C D. Modified PT with and without activated protein C

C. Modified APTT with and without activated protein C

Ecarin clotting time may be used to monitor: A. Heparin therapy B. Warfarin therapy C. Fibrinolytic therapy D. Hirudin therapy

D. Hirudin therapy

Which of the following may interfere with the activated protein C resistance (APCR) screening test? A. Lupus anticoagulant B. Protein C deficiency C. Antithrombin deficiency D. Protein S deficiency

A. Lupus anticoagulant

Thrombophilia may be associated with which of the following disorders? A. Afibrinogenemia B. Hypofibrinogenemia C. Factor VIII inhibitor D. Hyperfibrinogenemia

D. Hyperfibrinogenemia

Which of the following anticoagulant drugs can be used in patients with HIT? A. Warfarin B. Heparin C. Aspirin D. Lepirudin

D. Lepirudin

Which of the following is the preferred method to monitor heparin therapy at the point of care during cardiac surgery? A. APTT B. Activated clotting time test (ACT) C. PT D. TT

B. Activated clotting time test (ACT)

Mrs. Smith has the following laboratory results, and no bleeding history: APTT: prolonged APTT results on a 1:1 mixture of the patient’s plasma with normal plasma: Preincubation: prolonged APTT 2-hour incubation: prolonged APTT These results are consistent with: A. Factor VIII deficiency B. Factor VIII inhibitor C. Lupus anticoagulant D. Protein C deficiency

C. Lupus anticoagulant

Which test may be used to monitor LMWH therapy? A. APTT B. INR C. Anti-Xa heparin assay D. Activated clotting time

C. Anti-Xa heparin assay

Patient History A 3-year-old male was admitted to a hospital with scattered petechiae and epistaxis. The patient had normal growth and had no other medical problems except for chickenpox 3 weeks earlier. His family history was unremarkable. These clinical manifestations and laboratory results are consistent with which condition? A. TTP B. DIC C. ITP D. HUS

C. ITP

The following results are obtained from a patient who developed severe bleeding: Prolonged PT and APTT Platelet count = 100 × 109 /L Fibrinogen = 40 mg/dL Which of the following blood products should be recommended for transfusion? A. Factor VIII concentrate B. Platelets C. Fresh frozen plasma D. Cryoprecipitate

D. Cryoprecipitate

A 30-year-old woman develops signs and symptoms of thrombosis in her left lower leg following 5 days of heparin therapy. The patient had open-heart surgery 3 days previously and has been on heparin ever since. Which of the following would be the most helpful in making the diagnosis? A. Fibrinogen assay B. Prothrombin time C. Platelet counts D. Increased heparin dose

C. Platelet counts

The following laboratory results were obtained on a 25-year-old woman with menorrhagia after delivery of her second son. The patient has no previous bleeding history. Normal platelet count; normal bleeding time; normal PT; prolonged APTT Mixing of the patient’s plasma with normal plasma corrected the prolonged APTT on immediate testing. However, mixing followed by 2-hour incubation at 37°C caused a prolonged APTT. What is the most probable cause of these laboratory results? A. Lupus anticoagulant B. Factor VIII deficiency C. Factor IX deficiency D. Factor VIII inhibitor

D. Factor VIII inhibitor

A 62-year-old female presents with jaundice and the following laboratory data: Peripheral blood smear: macrocytosis, target cells Platelet count: 355 × 109/L PT: 25 sec (reference range =10–14) APTT: 65 sec (reference range = 28–36) Transaminases: elevated (AST:ALT>1) Total and direct bilirubin: elevated These clinical presentations and laboratory results are consistent with: A. Inherited factor VII deficiency B. DIC C. Cirrhosis of the liver D. von Willebrand’s disease

C. Cirrhosis of the liver

When performing a mixing study, the patient’s APTT is corrected to 12% of normal. What is the most appropriate interpretation of these findings? A. The APTT is considered corrected B. The APTT is considered uncorrected C. The mixing study needs to be repeated D. A circulating anticoagulant can be ruled out

C. The mixing study needs to be repeated

A standard blue-top tube filled appropriately (with 4.5 mL blood) was submitted to the laboratory for preoperative PT and APTT testing. The results of both tests were elevated. The patient’s PT and APTT from the previous day were within normal limits, and he is not on heparin therapy. Which is the most appropriate first step to investigate the abnormal results? A. Report the result as obtained B. Perform a mixing study C. Check the sample for a clot D. Report the APTT only

C. Check the sample for a clot

A plasma sample submitted to the lab for PT testing has been stored for 25 hours at 4°C. The PT result is shortened. What is the most probable cause? A. Factor VII deficiency B. Activation of factor VII due to exposure to cold temperature C. Lupus inhibitor D. Factor X inhibitor

B. Activation of factor VII due to exposure to cold temperature

The APTT results are not elevated in a patient receiving heparin. Which of the following factors may be associated with the lack of response to heparin therapy in this patient? A. Protein C deficiency B. Antithrombin deficiency C. Protein S deficiency D. Factor VIII deficiency

B. Antithrombin deficiency

A 50-year-old patient was admitted to the emergency department complaining of pain in her right leg. Her leg was red, swollen, and warm to the touch. Deep venous thrombosis was suspected, and the patient was started on heparin therapy. Which of the following is (are) the proper protocol to evaluate patients receiving heparin therapy? A. A baseline APTT and platelet count; APTT testing every 6 hours until the target is reached B. Repeat APTT after 5 days postheparin therapy to adjust the therapeutic dose C. Monitor the platelet count daily and every other day after heparin therapy is completed D. Monitor PT daily to adjust the therapeutic dose

A. A baseline APTT and platelet count; APTT testing every 6 hours until the target is reached

A 60-year-old patient was admitted to a hospital for a liver biopsy. The biopsy was scheduled for 11:00 a.m. The coagulation results performed at the time of admission revealed a prolonged PT with an INR of 4.5. What is the physician’s most appropriate course of action? A. Proceed with biopsy, because a prolonged PT is expected in liver disease B. Postpone the procedure for a couple of days C. Cancel the procedure and start the patient on vitamin K therapy D. Put patient on vitamin K and proceed with the procedure immediately

C. Cancel the procedure and start the patient on vitamin K therapy

A fresh blood sample was sent to the laboratory at 8:00 a.m. for a PT test. At 4:00 p.m., the doctor requested an APTT test to be done on the same sample. What should the technologist do? A. Rerun APTT on the 8:00 a.m. sample and report the result B. Request a new sample for APTT C. Run APTT in duplicate and report the average D. Mix the patient plasma with normal plasma and run the APTT

B. Request a new sample for APTT

An APTT test is performed on a patient and the result is 50 sec (reference range 27–37 sec). The instrument flags the result owing to failure of the delta check. The patient had an APTT of 35 sec the previous day. The technologist calls the nursing unit to check whether the patient is on heparin therapy. The patient is not receiving heparin. What is the next appropriate step? A. Check the family history for an inherited factor VIII deficiency B. Check to see if the patient has received any other anticoagulant medications C. Perform mixing studies D. Perform a factor VIII assay

B. Check to see if the patient has received any other anticoagulant medications

A patient was put on heparin therapy postoperatively for prevention of thrombosis. The patient had the following laboratory results on admission: Platelet count = 350 × 109/L; PT = 12 sec (reference: 10–13 sec); APTT = 35 sec (reference: 28–37). After 6 days of heparin therapy, the patient complained of pain and swelling in her left leg. Her platelet count dropped to 85 × 109/L and her APTT result was 36 sec. The physician suspected heparin-induced thrombocytopenia (HIT) and ordered a platelet aggregation test to be performed immediately. The heparin-induced platelet aggregation test result was negative. Heparin therapy was continued. Several days later, the patient developed a massive clot in her left leg that necessitated amputation. Which of the following should have been recognized or initiated? A. The patient should have been placed on LMWH B. The heparin dose should have been increased C. The negative platelet aggregation does not rule out HIT D. The patient should have been placed on warfarin therapy

C. The negative platelet aggregation does not rule out HIT

A 50-year-old female was admitted to a hospital for hip replacement surgery. The preoperative tests were performed and the results showed an Hgb of 13.5 g/dL; Hct = 42%; PT = 12 sec; APTT = 36 sec. The patient was bleeding during surgery and the postoperative test results revealed an Hgb = 5.0 g/dL; Hct = 16%; PT = 8 sec; and APTT = 25 sec. What steps should be taken before releasing these results? A. No follow-up steps are needed; report the results as obtained B. Report Hgb and Hct results, adjust the anticoagulant volume, and redraw a new sample for PT and APTT C. Call the nurse and ask if the patient is receiving heparin D. Because the patient is severely anemic, multiply the PT and APTT results by two and report the results

B. Report Hgb and Hct results, adjust the anticoagulant volume, and redraw a new sample for PT and APTT

other names parasitology

Yves Laure Pimentel · 70問 · 2年前

other names parasitology