Question 1

Which of the following conditions is associated with an elevated fibrinogen?

Accepted Answer

A) acute DIC 
B) chronic inflammation 
C) severe liver disease 
D) increased plasmin levels 
A) acute DIC 
B) chronic inflammation 
C) severe liver disease 
D) increased plasmin levels

Question 2

Which of the following will cause spuriously prolonged clot-based coagulation tests?

Accepted Answer

A) an evacuated 3.2% sodium citrate tube filled to 50% capacity 
B) an evacuated 3.2% sodium citrate tube filled to 90% capacity 
C) prolonged tourniquet application 
D) plasma collected from a traumatic tap 
A) an evacuated 3.2% sodium citrate tube filled to 50% capacity 
B) an evacuated 3.2% sodium citrate tube filled to 90% capacity 
C) prolonged tourniquet application 
D) plasma collected from a traumatic tap

Question 3

Which of the following deficiencies prolongs the PTT but does not lead to abnormal bleeding?

Accepted Answer

A) factor V 
B) factor VIII 
C) factor XI 
D) factor XII 
A) factor V 
B) factor VIII 
C) factor XI 
D) factor XII

Question 4

Standard curves are necessary for which coagulation procedures?

Accepted Answer

A) thrombin time 
B) specific factor assays 
C) fibrinogen assay 
D) both specific factor assays and fibrinogen assay 
A) thrombin time 
B) specific factor assays 
C) fibrinogen assay 
D) both specific factor assays and fibrinogen assay

Question 5

Which of the following specimens would be acceptable for platelet aggregation studies?

Accepted Answer

A) blood drawn in ethylenediaminetetraacetic acid (EDT
A)  and kept at room temperature for 6 hours 
B) blood drawn in 3.2% sodium citrate and transported to the laboratory on ice (2° to 4° 
C)  
C) blood drawn in a serum separator tube 
D) blood drawn in 3.2% sodium citrate and kept at room temperature for 2 hours after drawing 
A) blood drawn in ethylenediaminetetraacetic acid (EDT
A)  and kept at room temperature for 6 hours 
B) blood drawn in 3.2% sodium citrate and transported to the laboratory on ice (2° to 4° 
C)  
C) blood drawn in a serum separator tube 
D) blood drawn in 3.2% sodium citrate and kept at room temperature for 2 hours after drawing

Question 6

How often must the partial thromboplastin time (PTT)reference interval be determined?

Accepted Answer

A) only when both the normal and abnormal controls are outside their acceptable limits 
B) at least every 6 months 
C) with each new lot of reagent 
D) only when the normal control is outside its acceptable limits 
A) only when both the normal and abnormal controls are outside their acceptable limits 
B) at least every 6 months 
C) with each new lot of reagent 
D) only when the normal control is outside its acceptable limits

Question 7

A 53-year-old woman arrives at the hospital with bleeding into the back of the throat and has a coagulation screen performed.She has no history of abnormal bleeding before this despite major stress to hemostasis in the past: she was in a major automobile accident at age 37 and has had impacted wisdom teeth extracted.Her coagulation results follow:
$\begin{array}{|l|l|l|l|}
\hline& \begin{array}{l}
\text { Patient's } \
\text { Results }\
\
\end{array} & \begin{array}{l}
\text { Reference } \
\text { Range}\
\
\end{array} & \begin{array}{l}
\text { 1:1 Mix with } \
\text { Normal Plasma }\
\
\end{array} 
\

\hline \text { Prothrombin time (PT) } & \begin{array}{l}
13.1 \
\text { seconds }
\end{array} & \begin{array}{l}
11-15 \
\text { seconds }
\end{array} \
\hline \begin{array}{l}
\text { Partial thromboplastin } \
\text { time (PTT) }
\end{array} & \begin{array}{l}
87 \
\text { seconds }
\end{array} & \begin{array}{l}
25-37 \
\text { seconds }
\end{array} & \begin{array}{l}
35
\end{array}\
\hline \text { Fibrinogen } & 380 & 200-400 \
& \mathrm{mg} / \mathrm{dL} & \mathrm{mg} / \mathrm{dL} \
\hline
\end{array}$
Which of the following is the most likely cause for her bleeding?

Accepted Answer

A) factor XII deficiency 
B) factor IX deficiency 
C) factor VIII deficiency 
D) factor VIII inhibitor 
A) factor XII deficiency 
B) factor IX deficiency 
C) factor VIII deficiency 
D) factor VIII inhibitor

Question 8

A patient has a hematocrit of 65%.Which of the following is true related to coagulation testing?

Accepted Answer

A) Hematocrit does not affect coagulation testing. 
B) Tube must be recollected with heparin as the anticoagulant. 
C) Tube must be recollected using 0.34 mL of sodium citrate to 4.5 mL of blood. 
D) Tube must be recollected using 0.62 mL of sodium citrate to 4.5 mL of blood. 
A) Hematocrit does not affect coagulation testing. 
B) Tube must be recollected with heparin as the anticoagulant. 
C) Tube must be recollected using 0.34 mL of sodium citrate to 4.5 mL of blood. 
D) Tube must be recollected using 0.62 mL of sodium citrate to 4.5 mL of blood.

Question 9

An elevated tissue plasminogen activator (TPA)is associated with

Accepted Answer

A) abnormal bleeding 
B) aspirin use 
C) DIC 
D) decreased fibrinolysis 
A) abnormal bleeding 
B) aspirin use 
C) DIC 
D) decreased fibrinolysis

Question 10

Which of the following would likely have a normal PT?

Accepted Answer

A) patient with a factor VII deficiency 
B) patient with a factor VIII deficiency 
C) patient on warfarin 
D) clotted blood 
A) patient with a factor VII deficiency 
B) patient with a factor VIII deficiency 
C) patient on warfarin 
D) clotted blood

Exam 42: Laboratory Evaluation of Hemostasis

Which of the following conditions is associated with an elevated fibrinogen?

Which of the following will cause spuriously prolonged clot-based coagulation tests?

Which of the following deficiencies prolongs the PTT but does not lead to abnormal bleeding?

Standard curves are necessary for which coagulation procedures?

Which of the following specimens would be acceptable for platelet aggregation studies?

How often must the partial thromboplastin time (PTT)reference interval be determined?

A patient has a hematocrit of 65%.Which of the following is true related to coagulation testing?

An elevated tissue plasminogen activator (TPA)is associated with

Which of the following would likely have a normal PT?

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Blood Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Erythrocyte Metabolism and Membrane Structure and Function

Hemoglobin Metabolism

Iron Kinetics and Laboratory Assessment

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Manual, Semiautomated and Point-of-Care Testing in Hematology

Automated Blood Cell Analysis

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

Bone Marrow Examination

Body Fluid Analysis in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron Kinetics 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 Erythrocyte Destruction Nonimmune Causes

Extrinsic Defects Leading to Increased Erythrocyte Destruction Immune Causes

Hemoglobinopathies (Structural Defects in Hemoglobin)

Thalassemias

Nonmalignant Leukocyte Disorders

Cytogenetics

Molecular Diagnostics in Hematopathology

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Normal Hemostasis and Coagulation

Hemorrhagic Disorders and Laboratory Assessment

Thrombotic Disorders and Laboratory Assessment

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Antithrombotic Therapies and their Laboratory Assessment

Hemostasis and Coagulation Instrumentation

Pediatric and Geriatric Hematology and Hemostasis

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