27

Question 1

1. Fibrinogen group consists of
   A. factors II, VII, IX, and X
   B. factors I, V, VIII, and XIII
   C. factors XI, XII, prekallikrein, and high–molecular weight kininogen

Answer 1

B. factors I, V, VIII, and XIII

Question 2

2. Prothrombin group consists of
   A. factors II, VII, IX, and X
   B. factors I, V, VIII, and XIII
   C. factors XI, XII, prekallikrein, and high–molecular weight kininogen

Answer 2

A. factors II, VII, IX, and X

Question 3

3. Contact group consists of
   A. factors II, VII, IX, and X
   B. factors I, V, VIII, and XIII
   C. factors XI, XII, prekallikrein, and high–molecular weight kininogen

Answer 3

C. factors XI, XII, prekallikrein, and high–molecular weight kininogen

Question 4

4. The fibrinogen group of coagulation factors is
   A. known to increase during pregnancy
   B. known to increase in conditions of inflammation
   C. known to increase subsequent to the use of oral contraceptives
   D. all of the above

Answer 4

D. all of the above

Question 5

5. The prothrombin group of coagulation factors is
   A. dependent on vitamin K for production
   B. considered to be stable
   C. well preserved in stored plasma
   D. all of the above

Answer 5

D. all of the above

Question 6

6. Warfarin acts by

A. neutralizing the effects of thrombin
B. interfering with fibrin monomer formation
C. acting as a vitamin K antagonist
D. inducing hypercoagulation

Answer 6

C. acting as a vitamin K antagonist

Question 7

7. Warfarin drugs interfere with the normal synthesis of factor(s)
   A. II
   B. VII
   C. X
   D. all of the above

Answer 7

A. II

Question 8

8. Vitamin-K dependent coagulation factors include factor(s)
   A. II
   B. V
   C. VIII
   D. XIII

Answer 8

A. II

Question 9

9. Symbolic designation for thrombin is
   A. III
   B. XII
   C. VIII
   D. IIa

Answer 9

D. IIa

Question 10

10. Symbolic designation for tissue thromboplastin is
    A. III
    B. XII
    C. VIII
    D. IIa

Answer 10

A. III

Question 11

11. Symbolic designation for antihemophilic factor is
    A. III
    B. XII
    C. VIII
    D. IIa

Answer 11

C. VIII

Question 12

12. Symbolic designation for Hageman factor is
    A. III
    B. XII
    C. VIII
    D. IIa

Answer 12

B. XII

Question 13

13 through 16. Arrange the four stages of coagulation in their proper sequence.
A. Fibrinolysis
B. Formation of thrombin from prothrombin
C. Generation of plasma thromboplastin
D. Formation of fibrin from fibrinogen

13. _______
14. _______
15. _______
16. _______

Answer 13

13. C. Generation of plasma thromboplastin
14. B. Formation of thrombin from prothrombin
15. D. Formation of fibrin from fibrinogen
16. A. Fibrinolysis

Question 14

17. The extrinsic pathway of coagulation is triggered by the entry of _______ into the circulation.
    A. membrane lipoproteins (phospholipoproteins)
    B. tissue thromboplastin
    C. Ca2+
    D. factor VII

Answer 14

B. tissue thromboplastin

Question 15

18. The intrinsic pathway of coagulation begins with the activation of _______ in the early stage.
    A. factor II
    B. factor I
    C. factor XII
    D. factor V

Answer 15

C. factor XII

Question 16

19. The final common pathway of the intrinsic-extrinsic pathway is
    A. factor X activation
    B. factor II activation
    C. factor I activation.
    D. factor XIII activation.

Answer 16

A. factor X activation

Question 17

20. Prothrombin to thrombin conversion is accelerated by
    A. a complex of activated factors IX and VII
    B. factor V and ionized calcium
    C. a complex of phospholipids and factor VII
    D. a complex of activated factors X and V

Answer 17

B. factor V and ionized calcium

Question 18

21. Fibrinogen is converted to fibrin monomers by
    A. prothrombin
    B. thrombin
    C. calcium ions
    D. factor XIIIa

Answer 18

B. thrombin

Question 19

22. The inactive plasminogen is activated to _______ by proteolytic enzymes.

A. prothrombin
B. plasmin
C. plasma kallikrein
D. plasma thromboplastin antecedent

Answer 19

B. plasmin

Question 20

Which of the following statements are true of the fibrinolytic system?
A. Plasmin digests fibrin and fibrinogen
B. The active enzyme of the system is plasmin
C. Inactive plasminogen circulates in the plasma until an injury occurs
D. All of the above

Answer 20

D. All of the above

Question 21

If a pediatric preoperative patient has a family history of bleeding but has never had a bleeding episode herself, what test should be included in a coagulation profile in addition to the PT, APTT, and platelet count?
A. Lee-White clotting time
B. Clot retraction
C. Bleeding time
D. Fibrin split products

Answer 21

C. Bleeding time

Question 22

A patient with a severe decrease in factor X activity would demonstrate normal
A. APTT
B. PT
C. thrombin time
D. bleeding time

Answer 22

D. bleeding time

Question 23

26. Neither the APTT nor the PT detects a deficiency of
    A. platelet factor 3
    B. factor VII
    C. factor VIII
    D. factor IX

Answer 23

A. platelet factor 3

Question 24

27. The function of thromboplastin in the prothrombin test is to provide _______ to the assay.
    A. kaolin
    B. fibrinogen
    C. phospholipoprotein
    D. thrombin

Answer 24

C. phospholipoprotein

Question 25

28. An abnormally prolonged APTT may indicate A. a severe depletion of fibrinogen B. the presence of a circulating anticoagulant C. factor VIII deficiency D. all of the above

Answer 25

D. all of the above

Question 26

29. If a child ingested rat poison, which of the following tests should be performed to test the effect of the poison on the child’s coagulation mechanism? A. APTT B. PT C. Fibrinogen assay D. Thrombin time

Answer 26

B. PT

Question 27

Which of the following conditions can cause an increased thrombin time? A. Fibrin split products B. High concentrations of immunoglobulins C. Heparin therapy D. All of the above

Answer 27

D. All of the above

Question 28

Heparin inhibits the clotting of blood by neutralizing the effect of A. thrombin B. calcium ions C. platelets D. factor VIII

Answer 28

A. thrombin

Question 29

A patient has a prolonged APTT and a normal PT. The APTT is not corrected by factor VIII–deficient plasma but is corrected by factor IX–deficient plasma. In which factor does the patient appear to be deficient? A. Factor II B. Factor V C. Factor VIII D. Factor IX

Answer 29

C. Factor VIII

Question 30

33. The normal protective mechanisms against thrombosis include A. the flow of blood B. the action of antithrombin. C. protein C and protein S D. all of the above

Answer 30

D. all of the above

Question 31

34. If heparin therapy is initiated in a patient, a decreased anticoagulant response can be caused by decreased levels of A. platelet factor 3 B. platelet factor 4 C. antithrombin D. factor XIII

Answer 31

B. platelet factor 4

Question 32

35. Which of the following is (are) characteristic of protein C? A. It is not vitamin K dependent. B. It is formed in response to thrombin generation. C. It inactivates factors Va and VIIIa. D. Both B and C.

Answer 32

D. Both B and C.

Question 33

36. Which of the following characteristics is (are) true of protein S? A. It is a cofactor of protein C. B. It increases the rate of inactivation of factor Va. C. It enhances the binding of activated protein C to phospholipids. D. All of the above.

Answer 33

D. All of the above.

Question 34

37. Antithrombin is the principal physiological inhibitor of A. thrombin B. factor Xa C. factor XIa D. both A and B

Answer 34

A. thrombin

Question 35

38. Which of the following is not correct regarding cellular proteases? A. They block the activation or action of plasmin. B. They include alpha-2 inhibitor. C. They rapidly neutralize the fibrinolytic properties of plasmin. D. They participate in clot formation.

Answer 35

D. They participate in clot formation.