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Exercises for Lesson 8

1. Which of the following statements is correct?

a. Hemostasis plays a small part in stopping the flow of blood.
b. Hemostasis plays a large part in stopping the flow of blood.
c. Hemostasis is a vascular system.
d. Hemostasis represents 15 to 20 percent of platelet protein.

2. Coagulation is one component in:

a. Fibrinolysis.
b. Hemostasis.
c. Disruption of the intrinsic system.
d. Vascular dilatation.

3. What major role do blood platelets perform?

a. In the hemostatic process, blood platelets swell, congeal, and adhere to blood vessel wall to plug the site of the injury.
b. They contract.
c. They stimulate collagen.
d. Platelets extend pseudopodia.

4. Which occurs last in the clotting process?

a. Formation of thrombin.
b. Formation of thromboplastin.
c. Aggregation of platelets.
d. Formation of fibrin network.

5. Which of the following lists coagulation factors I through IV in order?

a. Calcium, fibrinogen, prothrombin, and Christmas.
b. Fibrinogen, prothrombin, thromboplastin, and calcium.
c. Prothrombin, calcium, fibrinogen, and thromboplastin.
d. Thromboplastin, prothrombin, calcium, and fibrinogen.

6. Which is the Stuart Prower factor?

a. Factor V.
b. Factor VII.
c. Factor X.
d. Factor XIII.

7. Thromboplastin eliminates the need for what item in stage I?

a. Globulin.
b. The accelerator, proconvertin.
c. High concentration of serum and plasma.
d. Platelets.

8. What are the two systems that make up the coagulation process?

a. Vascular and hemolysis.
b. Extrinsic and intravascular.
c. Intravascular and vascular.
d. Intrinsic and extrinsic.

9. Coagulation factor XIII produces a tough gel through:

a. Increasing the serum content.
b. Stabilizing serum.
c. Converting a loosely linked fibrin clot with the help of calcium ions.
d. Decreasing the conversion of prothrombin with the help of calcium ions.

10. The synthesis of prothrombin takes place in the liver and requires the presence of:

a. Folic acid.
b. Vitamin A.
c. Vitamin B12.
d. Vitamin K.

11. Prothrombin is the precursor of:

a. Fibrin.
b. Fibrinogen.
c. Thrombin.
d. Thromboplastin.

12. A deficiency is unlikely to interfere with coagulation because clinical tetany would intervene.

a. Calcium.
b. Fibrinogen.
c. Prothrombin.
d. Factor VIII.

13. Which factor is thought to be an accelerator in the conversion of prothrombin to thrombin?

a. Factor VII.
b. Factor VIII.
c. Factor IX.
d. Factor XII.

14. Which of the following is consumed during the clotting process and is therefore not present in serum?

a. Factor V.
b. Factor VII.
c. Factor IX.
d. Factor XI.

15. Which platelet factor activates prothrombin?

a. 2.
b. 3.
c. 4.
d. 7.

16. Hemophilias A and B are hereditary deficiencies of which coagulation factors, respectively?

a. VII and IX.
b. VIII and IX.
c. XI and VIII.
d. XI and IX.

17. Platelet factor 3 is found in the platelet and is a component of platelets.

a. Membrane; extrinsic.
b. Plasma; extrinsic.
c. Membrane; intrinsic.
d. Plasma; intrinsic.

18. A fibrin clot is ultimately formed by the interaction of fibrinogen and:

a. Calcium.
b. Thrombin.
c. Thromboplastin.
d. Platelets.

19. The formation of thrombin from prothrombin occurs in what stage?

a. Stage I.
b. Stage II.
c. Stage III.
d. Stage IV.

20. During the clot lysis stage, what happens to the blood clot when plasmin interacts with it?

a. Enlarges.
c. Shrivels up like an old red blood cell.
c. Enlongates like an ameoba.
d. Dissolves into fragments.

21. One anticoagulant that inhibits the clotting activity of blood is:

a. Coumarin derivitives.
b. Fibrin.
c. Throboplastin.
d. Proconvertin.

22. In the Template method for determining the bleeding time, the blood pressure cuff is inflated to:

a. 20 mm Hg.
b. 30 mm Hg.
c. 40 mm Hg.
d. 50 mm Hg.

23. The normal bleeding time with the Template method is:

a. Up to 9 minutes.
b. 3 to 10 minutes.
c. 10 to 15 minutes.
d. 15 to 20 minutes.

24. What should be the temperature of the water bath for the whole blood clotting time?

(NOTE: The whole blood clotting time is also referred to as the coagulation time or clotting time.
a. 10oC.
b. 20oC.
c. 37oC.
d. 56oC.

25. Which of the variables listed below does NOT decrease the clotting time of whole blood?

a. Excessive agitation of the blood specimen.
b. Air bubbles in the blood.
c. Tissue fluid in the blood.
d. Performing test at room temperature.

26. Using the Lee-White method for whole blood clotting, what should be done to tube #1 after tube #2's blood has clotted for 30 seconds?

a. Place it straight up for no blood to flow.
b. Tilt it until no flow blood is observed.
c. Tilt it upside down for blood to flow.
d. Gently tilt it upward.

27. The clot retraction is normal in hemophilia because of:

a. A reduced number of platelets.
b. A normal number of platelets.
c. Increased prothrombin activity.
d. The presence of calcium.

28. To measure clot retraction, we can use tubes previously used to determine:

a. Coagulation time.
b. Prothrombin time.
c. Prothrombin consumption time.
d. Thromboplastin generation time.

29. The tourniquet test is positive in:

a. Purpuras.
b. Hemophilia.
c. Polycythemia.
d. Agranulocytosis.

30. The partial thromboplastin time cannot be used to reveal a deficiency of:

a. Factors V or X.
b. Factors XI or XII.
c. Prothrombin or fibrinogen.
d. Factor VII or platelet factor 3.

31. Which of the following values for the activated partial thromboplastin time is normal?

a. 30 seconds.
b. 50 seconds.
c. 1 minute, 10 seconds.
d. 1 minute, 30 seconds.

32. The anticoagulant used in preparing the patient's plasma for the one-stage prothrombin time is:

a. 0.2 ml of EDTA.
b. 0.5 ml of 3.2 percent sodium citrate.
c. 0.5 ml of 1.34 percent sodium citrate.
d. 0.1 ml of 5 percent potassium oxalate.

33. The prothrombin time is sensitive to a deficiency of factor:

a. VII.
b. VIII.
c. IX.
d. XI.
e. XII.

34. A prothrombin consumption time of less than 20 seconds indicates a deficiency in:

a. Fibrinogen.
b. Prothrombin.
c. Factor V, VII, or X.
d. Platelet and factors VIII, IX, XI, or XII.

35. What is the most important difference between the procedures for the one-stage prothrombin time and the prothrombin consumption time?

a. Sensitivity.
b. Sources of error.
c. Blood fraction tested.

36. Deficiencies of which two factors cannot be distinguished from each other by using the thromboplastin generation time, the prothrombin time, and the partial thromboplastin time?

a. V and VII.
b. VIII and IX.
c. X and XI.
d. XI and XII.

37. Which of the following is NOT used to determine the thrombin time?

a. Patient's plasma.
b. Thrombin solution.
c. Thromboplastin reagent.
d. A 37șC water bath.

38. The thrombin time is sensitive to a deficiency of:

a. Factor V.
b. Factor VII.
c. Fibrinogen.
d. Prothrombin.

39. Which of the following plasma concentrations of fibrinogen falls in the normal range?

a. 50 mg/dl.
b. 100 mg/dl.
c. 300 mg/dl.
d. 500 mg/dl.

40. The plasma recalcification time is used in which of the following?

a. Coagulation time.
b. Thrombin time.
c. Detection of factor XIII deficiency.
d. Detection of a circulating anticoagulant.

41. If a clot lyses within three hours after being placed in 5M urea, which factor is deficient?

a. Fibrin.
b. Platelets.
c. Factor VIII.
d. Factor XIII.

42. In the Rees-Ecker platelet count, what is the platelet count if a total of 100 platelets are counted in the two center 1-sq mm areas?

a. 50,000 per cu mm.
b. 100,000 per cu mm.
c. 150,000 per cu mm.
d. 200,000 per cu mm.

43. During the microscopy phase of the platelet count, what is the appearance of the platelets in the counting chamber after the blood has been diluted with ammonium oxalate?

a. Round or oval.
b. Pink.
c. Purple.
d. Or even black under a phase condenser.
e. All of the above.
f. None of the above.

44. Once the diluted blood has been left to stand for 15 to 20 minutes, what method is used to count the platelets and what are the results multiplied by?

a. Count the platelets in all 25 squares of the area normally used for the RBCs and then multiply those results by 1,000.
b. Count the platelets in 6 squares of the area normally used for the WBCs and then multiply those results by 1,000.
c. Count the platelets and then multiply those results by 2,000.
d. Count the platelets in all 40 squares of the area normally used for the RBCs and then multiply those results by 500.

45. What other items could be used to precipitate macroglobulins besides using distilled water?

a. Oxalated or heparinized plasma or calcium dioxide.
b. Oxalated, citrated, or heparinized plasma.
c. Cresyl blue, citrated, or heparinized plasma.
d. Oxalated, citrated, or heparinized plasma or formaldehyde.

46. When interpretating the results of the macroglobulin distilled water screening test, what do you observe?

a. The behavior of the drop of serum or plasma sinking in the water and the modifications of color of the solution.
b. The behavior of the drop of serum or plasma remaining stationary in the water and the modifications of color of the solution.
c. The behavior of the drop of serum or plasma rising in the water and the modifications of color of the solution.
d. The behavior of the drop of serum or plasma sinking in the water and the retention of the color of the solution.

47. What confirms that serum or plasma tests positive when incubated at 4șC during the cryoglobulin screening test?

a. If the serum or plasma turns a bright green color upon returning to a temperature of 37oC, then the test is confirmed.
b. The test is confirmed if the serum or plasma is brought back to a temperature of 37șC and its appearance returns to normal.
c. If the serum or plasma turns a dull yellow color upon returning to a temperature of 37oC, then the test is confirmed.
d. The test is confirmed if the serum or plasma is brought back to a temperature of 44șC and its appearance returns to normal.

48. What is a range of values for the fibrin/frininogen degredation products?

a. Normal is above 10 ug/ml.
b. DIC levels of FDP are below 8 ug/ml.
c. Severe cases exceed 40 ug/ml.
d. Normal levels are at 10ug/ml.

49. In performing a factor V assay, what percentage of dilution should the second tube be with 0.01 ml of imidazole buffered saline?

a. 100.
b. 60.
c. 50.
d. 25.

50. Which factors are analyzed using the factor VIII assay procedure?

a. Factors II and III.
b. Factors V, VI, and VII.
c. Factors I and IX.
d. Factors VIII, IX, XI, and XII.

Solutions to Exercises for Lesson 8

1. b
2. b
3. a
4. d
5. b
6. c
7. d
8. d
9. c
10. d
11. c
12. a 
13. a
14. a
15. b
16. b
17. c
18. b 
19. b
20. d
21. a
22. c
23. a
24. c
25. d
26. b
27. b
28. c
29. a
30. c
31. a
32. b
33. a
34. d
35. c
36. d
37. c
38. c
39. c
40. d
41.  
42. b
43. e
44. a
45. b
47. b
48. c
49. c
50. d

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