Question 1

Splenomegaly can cause thrombocytopenia by which of the following mechanisms?

Accepted Answer

A)  Impaired production 
B)  Platelet sequestration 
C)  Immune-mediated 
D)  Mechanical destruction

Question 2

Give at least five markers of differentiation between acute and chronic ITP.

Accepted Answer

The answer of Give at least five markers of differentiation...

Question 3

Which of the following contributes to the pathogenesis of Bernard-Soulier syndrome?

Accepted Answer

A)  Abnormal glycoprotein Ib/IX complex 
B)  Abnormal glycoprotein IIb/IIIa 
C)  High platelet count 
D)  Low fibrinogen level

Question 4

What is the most common cause of thrombocytopenia?

Accepted Answer

A)  Increased consumption 
B)  Increased destruction 
C)  Decreased production 
D)  Increased splenic sequestration

Question 5

Which of the following best describes the effect of aspirin on platelets, and for how long does the effect last?

Accepted Answer

A)  ADP receptor blockade; 5 days 
B)  Thrombocytosis; 7 days 
C)  Inactivation of cyclooxygenase; 7 days 
D)  Thrombocytopenia; 7 days

Question 6

Minimum screening test(s) that should be considered in the evaluation of abnormal bleeding is(are) which of the following?

Accepted Answer

A)  Thrombin time 
B)  Fibrinogen level 
C)  Factor studies 
D)  Platelet count, PT, APTT

Question 7

What is a common etiology of ITP in children?

Accepted Answer

A)  Tooth extraction 
B)  Easy bruising syndrome 
C)  Vasculitis 
D)  Chickenpox

Question 8

Which of the following is not a mechanism of inducing thrombocytopenia in a patient?

Accepted Answer

A)  Antibody-mediated platelet destruction 
B)  Inherited platelet membrane defect 
C)  Increased splenic sequestration 
D)  Inherited defect in release of ADP and ATP

Question 9

a. Is it good practice to perform a bleeding time on a thrombocytopenic patient?
b. Why is a bleeding time not indicated to follow up on an abnormal PT or PTT?

Accepted Answer

The answer of a. Is it good practice to perform...

Question 10

A patient has a severe headache shortly before getting her blood tested. She takes a couple of aspirin and is scheduled for platelet aggregation studies. What effect will this have on the platelet aggregation studies?

Accepted Answer

A)  Platelets will show diminished activity with selected agonists. 
B)  Platelets will show normal activity with all agonists. 
C)  Platelets will show increased activity with selected agonists. 
D)  Platelets will show variable activity with all agonists.

Question 11

A patient has a platelet count of 80 × 109/L and an abnormal closure time. What is the most likely disorder?

Accepted Answer

A)  A platelet function disorder 
B)  A quantitative platelet disorder 
C)  A combined platelet disorder 
D)  von Willebrand disease

Question 12

A patient has a severe headache prior to his blood draw. He takes two aspirin, and his blood is drawn. Platelet aggregation studies are performed, and one comes back abnormal. Based on this information, which agonist will show a normal aggregation pattern?

Accepted Answer

A)  Arachidonic acid 
B)  Epinephrine 
C)  Collagen 
D)  Ristocetin

Question 13

A patient is experiencing pinpoint petechial bruising on her upper torso. Her history revealed frequent nosebleeds during her childhood. Clot-based screening assays are within normal reference ranges, and platelet function assays are abnormal. Based on this information, what appears to be defective in this patient?

Accepted Answer

A)  Coagulation factors 
B)  Platelets 
C)  The vasculature 
D)  Fibrinolytic system

Question 14

A patient is known to be a chronic alcoholic. His blood is drawn, and his platelet count is 72 × 109/L. What is the most likely reason for this occurrence?

Accepted Answer

A)  Immune-mediated thrombocytopenia 
B)  Acquired hypoplasia resulting from alcohol consumption 
C)  Dilutional thrombocytopenia from liver dysfunction 
D)  Increased destruction of platelets

Question 15

Explain the pathophysiology of the following and why each typically has normal coagulation screening tests.
a. Bernard-Soulier syndrome
b. Glanzmann's thrombasthenia
c. δ-storage pool disease
d. Gray platelet syndrome

Accepted Answer

The answer of Explain the pathophysiology of the following and...

Question 16

Which hemostatic disorder usually is represented by a decreased platelet count, normal PT, normal APTT, and abnormal closure time?

Accepted Answer

A)  Thrombocytosis 
B)  Thrombocytopenia 
C)  Vascular disorder 
D)  Platelet dysfunction

Exam 33: Disorders of Primary Hemostasis