HEMATOLOGY/COAG DISEASES |MEDSERG EXAM 2 |
GUARANTEED SUCCESS STARTS HERE! LEARN,
PRACTICE & EXCEL!
Protime (extrinsic) Answer: -Prothrombin Time/tests extrinsic coagulation factors
Partial Prothrombin Time (intrinsic) Answer: -20-39 sec (*for Heparin; therapeutic when
1.5-2 x the normal value)
-when prolonged, deals with intrinsic pathway --> mixing study to see if factor deficiency or
factor inhibitor
Mixing studies Answer: -PT and/or PTT is prolonged
-patient sample with normal plasma to correct factor deficiencies
-correction means factor deficiency (mixing studies)
- no correction means an inhibitor is present
Factor Assay Answer: -determines which factor is deficient
-after mixing studies
bleeding time Answer: -used to assess platelet function and vasular integrity
-tests primary hemostasis
Thrombin time Answer: -measures common pathway
-hypofibringenemia, hyper fibrinogenemia
-conversion to fibrinogen to fibrin
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1
,-Most sensitive for heparin
-prolonged by the presence of significant levels of fibrinogen or fibrin degradation products
Reptilase time Answer: Test similar to thrombin time, but is not inhibited by heparin. RR 18-
22 seconds
Russel's viper venom test (drVVT) Answer: -main test for Lupus anticoagulant (inhibitor)
-PTT is prolonged
-further testing includes fibrinogen, CBC (thrombocytopenia), thrombin time
PTT-LA Answer: -secondary LUPUS anticoagulant screen using diluted phospholipids - can
be prolonged if on anticoagulant therapy
vWF testing Answer: -measure platelet aggregation (Gp IIb/IIIa)
-bleeding time, PTT, PT
Factor 13 screening test Answer: 5M Urea Test
-detects abnormal clot formation due to Factor 13 (<24 hours)
- PT and PTT are normal!
- umbilical cord bleeding (circumcision site), spontaneous intracranial hemorrhage, repeat
miscarriages
APCR Answer: -screens for Factor 5 Leiden
-cannot degrade Factor 5 Leiden
-results in prolonged coagulation and clot formation
-APC is what inactivates factor V and VIII
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2
, Heparin-induced thrombocytopenia (HIT) Answer: -Development of IgG antibodies against
heparin- bound platelet factor 4 (PF4).
-activates platelets leading to thrombosis and thrombocytopenia.
Primary Thrombocytosis Answer: -polycythemia vera or CML
-elevated platelets that can cause blood clots
-primary is due to a gene mutation while secondary (reactive) is due to another condition
-CML, polycythemia vera, refractory anemia with ringed sideroblasts
G6PD deficiency Answer: -Low NADPH leads to hemolytic anemia with bite cells, blister
cells, and heinz bodies
-hexose monophosphate shunt
-anti-malarial drugs can cause hemolytic anemia
-Dark urine and back pain
-Quantitation G6PD is the gold standard: G6P and NADPH, measures the rate of reduction
of NADP to HADPH in a spectrophotometer
Transfusion reaction Answer: -rbc agglutination
-different types (acute vs. delayed)
multiple myeloma Answer: -plasma cells and rouleaux
- increased cell (lymphocytes)
-decreased RBC, WBC, and platelets (plasma cells overcrowding bone marrow)
Myelofibrosis Answer: -teardrop
-low RBC, higher or lower WBC's and platelets
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
GUARANTEED SUCCESS STARTS HERE! LEARN,
PRACTICE & EXCEL!
Protime (extrinsic) Answer: -Prothrombin Time/tests extrinsic coagulation factors
Partial Prothrombin Time (intrinsic) Answer: -20-39 sec (*for Heparin; therapeutic when
1.5-2 x the normal value)
-when prolonged, deals with intrinsic pathway --> mixing study to see if factor deficiency or
factor inhibitor
Mixing studies Answer: -PT and/or PTT is prolonged
-patient sample with normal plasma to correct factor deficiencies
-correction means factor deficiency (mixing studies)
- no correction means an inhibitor is present
Factor Assay Answer: -determines which factor is deficient
-after mixing studies
bleeding time Answer: -used to assess platelet function and vasular integrity
-tests primary hemostasis
Thrombin time Answer: -measures common pathway
-hypofibringenemia, hyper fibrinogenemia
-conversion to fibrinogen to fibrin
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,-Most sensitive for heparin
-prolonged by the presence of significant levels of fibrinogen or fibrin degradation products
Reptilase time Answer: Test similar to thrombin time, but is not inhibited by heparin. RR 18-
22 seconds
Russel's viper venom test (drVVT) Answer: -main test for Lupus anticoagulant (inhibitor)
-PTT is prolonged
-further testing includes fibrinogen, CBC (thrombocytopenia), thrombin time
PTT-LA Answer: -secondary LUPUS anticoagulant screen using diluted phospholipids - can
be prolonged if on anticoagulant therapy
vWF testing Answer: -measure platelet aggregation (Gp IIb/IIIa)
-bleeding time, PTT, PT
Factor 13 screening test Answer: 5M Urea Test
-detects abnormal clot formation due to Factor 13 (<24 hours)
- PT and PTT are normal!
- umbilical cord bleeding (circumcision site), spontaneous intracranial hemorrhage, repeat
miscarriages
APCR Answer: -screens for Factor 5 Leiden
-cannot degrade Factor 5 Leiden
-results in prolonged coagulation and clot formation
-APC is what inactivates factor V and VIII
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Heparin-induced thrombocytopenia (HIT) Answer: -Development of IgG antibodies against
heparin- bound platelet factor 4 (PF4).
-activates platelets leading to thrombosis and thrombocytopenia.
Primary Thrombocytosis Answer: -polycythemia vera or CML
-elevated platelets that can cause blood clots
-primary is due to a gene mutation while secondary (reactive) is due to another condition
-CML, polycythemia vera, refractory anemia with ringed sideroblasts
G6PD deficiency Answer: -Low NADPH leads to hemolytic anemia with bite cells, blister
cells, and heinz bodies
-hexose monophosphate shunt
-anti-malarial drugs can cause hemolytic anemia
-Dark urine and back pain
-Quantitation G6PD is the gold standard: G6P and NADPH, measures the rate of reduction
of NADP to HADPH in a spectrophotometer
Transfusion reaction Answer: -rbc agglutination
-different types (acute vs. delayed)
multiple myeloma Answer: -plasma cells and rouleaux
- increased cell (lymphocytes)
-decreased RBC, WBC, and platelets (plasma cells overcrowding bone marrow)
Myelofibrosis Answer: -teardrop
-low RBC, higher or lower WBC's and platelets
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
