Question 1

A patient is screened positive for APCR.What does this mean?

Accepted Answer

A) The patient is at risk for hemorrhage. 
B) The patient has a factor VLₑᵢdₑn mutation. 
C) The patient is at risk for thrombosis. 
D) The patient is on heparin. 
A) The patient is at risk for hemorrhage. 
B) The patient has a factor VLₑᵢdₑn mutation. 
C) The patient is at risk for thrombosis. 
D) The patient is on heparin. C

Question 2

Prothrombin time measures the clotting factors in the:

Accepted Answer

A) Intrinsic pathway 
B) Formation of fibrin 
C) Extrinsic pathway 
D) Fibrinolytic pathway 
A) Intrinsic pathway 
B) Formation of fibrin 
C) Extrinsic pathway 
D) Fibrinolytic pathway C

Question 3

Calculate the INR using the following data: Patient PT = 14.8 sec;normal PT sec = 12.2 sec;ISI = 1.3.

Accepted Answer

A) 2.29 
B) 2.40 
C) 1.29 
D) 1.40 
A) 2.29 
B) 2.40 
C) 1.29 
D) 1.40 C

Question 4

Laboratory screening test results strongly suggest heparin contamination.Which of the following tests would help assess this finding?

Accepted Answer

A) DRVVT 
B) Reptilase time 
C) APTT 
D) AT III activity 
A) DRVVT 
B) Reptilase time 
C) APTT 
D) AT III activity

Question 5

A patient has severe liver disease.What test results would you expect?

Accepted Answer

A) Prolonged PT,TT,increased FDP 
B) Prolonged APTT and normal TT 
C) Decreased fibrinogen and Normal TT 
D) Prolonged bleeding time and Normal APTT 
A) Prolonged PT,TT,increased FDP 
B) Prolonged APTT and normal TT 
C) Decreased fibrinogen and Normal TT 
D) Prolonged bleeding time and Normal APTT

Question 6

A patient has a prolonged APTT with a normal PT.There were no errors in specimen collection.What does this mean for the patient?

Accepted Answer

A) There could be a defect in the intrinsic pathway. 
B) The patient is on Coumadin. 
C) The patient has developed an inhibitor to a factor in the extrinsic pathway. 
D) The patient has a vitamin K deficiency. 
A) There could be a defect in the intrinsic pathway. 
B) The patient is on Coumadin. 
C) The patient has developed an inhibitor to a factor in the extrinsic pathway. 
D) The patient has a vitamin K deficiency.

Question 7

Explain the clinical significance of a prolonged time with each of the following:
a.Bleeding time
b.Prothrombin time
c.Activated partial thromboplastin time
d.Thrombin time

Accepted Answer

Bleeding time: Indicates a potential pro

Question 8

A hemophilic A patient has a severe bleed and is being treated with Factor VIII concentrate.When testing his postinfusion,the factor VIII level does not increase.The problem could be:

Accepted Answer

A) Lupus anticoagulant 
B) Improper drawing of the specimen 
C) Factor VIII inhibitor 
D) Factor IX inhibitor 
A) Lupus anticoagulant 
B) Improper drawing of the specimen 
C) Factor VIII inhibitor 
D) Factor IX inhibitor

Question 9

An outpatient has an INR of 6.5.This patient's previous test at the same facility had results in the therapeutic range of 2-3 on long-term anticoagulant therapy.The appropriate next step for the laboratory professional would be to:

Accepted Answer

A) Retest the patient sample 
B) Recollect the specimen 
C) Report the result 
D) Notify the hematology supervisor 
A) Retest the patient sample 
B) Recollect the specimen 
C) Report the result 
D) Notify the hematology supervisor

Question 10

Which of the following tests is used to assess platelet function in vivo?

Accepted Answer

A) Prothrombin time 
B) Activated partial thromboplastin time 
C) Bleeding time 
D) Platelet aggregation studies 
A) Prothrombin time 
B) Activated partial thromboplastin time 
C) Bleeding time 
D) Platelet aggregation studies

Question 11

What preanalytical quality control procedures are necessary when performing platelet aggregation studies?

Accepted Answer

A) Assess patient medications before obtaining specimen 
B) Obtain specimen after a 12-hour fast 
C) Perform a bleeding time before testing 
D) Collect the specimen in a glass tube 
A) Assess patient medications before obtaining specimen 
B) Obtain specimen after a 12-hour fast 
C) Perform a bleeding time before testing 
D) Collect the specimen in a glass tube

Question 12

Explain the effects of the following on coagulation testing:
a.Clotted sample
b.Ratio of blood to anticoagulant 55%
d.>1-hour difference between specimen collection and analysis

Accepted Answer

Clotted sample: Because factors are cons

Question 13

Give the results (prolonged or normal)for the bleeding time,prothrombin time,activated partial thromboplastin time,and thrombin time for a patient on prolonged anticoagulant therapy.

Accepted Answer

a.BT: Bleeding time assesses primary hem

Question 14

A patient with a fibrinolytic deficiency would:

Accepted Answer

A) Be prone to increased lysis 
B) Have increased levels of plasminogen 
C) Have abnormal screening tests (PT and APTT) 
D) Be prone to increased clotting 
A) Be prone to increased lysis 
B) Have increased levels of plasminogen 
C) Have abnormal screening tests (PT and APTT) 
D) Be prone to increased clotting

Question 15

Which of the following tests can be used to monitor Coumadin therapy?

Accepted Answer

A) PT-INR 
B) Factor assays 
C) APTT 
D) Reptilase time 
A) PT-INR 
B) Factor assays 
C) APTT 
D) Reptilase time

Question 16

Which of the following is the most appropriate reflex test based on the following laboratory data?
PT: normal
APTT: prolonged
Factor VIII: C assay: <1%

Accepted Answer

A) DRVVT 
B) Bethesda titer 
C) Factor IX assay 
D) Mixing studies 
A) DRVVT 
B) Bethesda titer 
C) Factor IX assay 
D) Mixing studies

Question 17

If blood is collected through an indwelling catheter,care must be taken to:

Accepted Answer

A) Prevent the citrate contamination of the line 
B) Flush the line with saline and discard the first 5 ml of blood 
C) Draw the sample quickly to prevent clotting 
D) Flush the line with sterile water 
A) Prevent the citrate contamination of the line 
B) Flush the line with saline and discard the first 5 ml of blood 
C) Draw the sample quickly to prevent clotting 
D) Flush the line with sterile water

Question 18

The results of platelet-rich plasma (PRP)in the aggregation studies of a patient's blood were typical of ristocetin-induced platelet agglutination (RIPA)defect.The RIPA defect was corrected by adding normal plasma to the patient's PRP.In what disease is this seen?

Accepted Answer

A) Sticky platelet syndrome 
B) Bernard-Soulier syndrome 
C) Afibrinogenemia 
D) von Willebrand's disease 
A) Sticky platelet syndrome 
B) Bernard-Soulier syndrome 
C) Afibrinogenemia 
D) von Willebrand's disease

Question 19

The international normalized ratio (INR)is used to standardize the wide variations in the reagent of prothrombin testing.What is the goal of creating the ISI value?

Accepted Answer

A) Reduce the lot-to-lot variability 
B) Correlate one manufacturer with another 
C) Obtain a reagent that has an ISI of 1.0 or close to it 
D) Reduce the use of anticoagulant therapy 
A) Reduce the lot-to-lot variability 
B) Correlate one manufacturer with another 
C) Obtain a reagent that has an ISI of 1.0 or close to it 
D) Reduce the use of anticoagulant therapy

Question 20

Thrombin time is prolonged with a patient who has:

Accepted Answer

A) Increased levels of fibrin degradation products 
B) Increased levels of fibrinogen 
C) Factor deficiencies 
D) Presence of lupus anticoagulants 
A) Increased levels of fibrin degradation products 
B) Increased levels of fibrinogen 
C) Factor deficiencies 
D) Presence of lupus anticoagulants

Exam 36: Hemostasis: Laboratory Testing and Instrumentation

A patient is screened positive for APCR.What does this mean?

Prothrombin time measures the clotting factors in the:

Calculate the INR using the following data: Patient PT = 14.8 sec;normal PT sec = 12.2 sec;ISI = 1.3.

Laboratory screening test results strongly suggest heparin contamination.Which of the following tests would help assess this finding?

A patient has severe liver disease.What test results would you expect?

A patient has a prolonged APTT with a normal PT.There were no errors in specimen collection.What does this mean for the patient?

Explain the clinical significance of a prolonged time with each of the following: a.Bleeding time b.Prothrombin time c.Activated partial thromboplastin time d.Thrombin time

A hemophilic A patient has a severe bleed and is being treated with Factor VIII concentrate.When testing his postinfusion,the factor VIII level does not increase.The problem could be:

An outpatient has an INR of 6.5.This patient's previous test at the same facility had results in the therapeutic range of 2-3 on long-term anticoagulant therapy.The appropriate next step for the laboratory professional would be to:

Which of the following tests is used to assess platelet function in vivo?

What preanalytical quality control procedures are necessary when performing platelet aggregation studies?

Explain the effects of the following on coagulation testing: a.Clotted sample b.Ratio of blood to anticoagulant < 9:1 c.Patient hematocrit >55% d.>1-hour difference between specimen collection and analysis

Give the results (prolonged or normal)for the bleeding time,prothrombin time,activated partial thromboplastin time,and thrombin time for a patient on prolonged anticoagulant therapy.

A patient with a fibrinolytic deficiency would:

Which of the following tests can be used to monitor Coumadin therapy?

Which of the following is the most appropriate reflex test based on the following laboratory data? PT: normal APTT: prolonged Factor VIII: C assay: <1%

If blood is collected through an indwelling catheter,care must be taken to:

The results of platelet-rich plasma (PRP)in the aggregation studies of a patient's blood were typical of ristocetin-induced platelet agglutination (RIPA)defect.The RIPA defect was corrected by adding normal plasma to the patient's PRP.In what disease is this seen?

The international normalized ratio (INR)is used to standardize the wide variations in the reagent of prothrombin testing.What is the goal of creating the ISI value?

Thrombin time is prolonged with a patient who has:

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 Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hematology Procedures

Bone Marrow Examination

Automation in Hematology

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

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