Question 1

Obstetrical complications such as retained placenta or abruptio placenta are leading causes of:

Accepted Answer

Obstetrical complications like retained placenta or abruptio placenta can lead to Disseminated Intravascular Coagulation (DIC), a condition characterized by the widespread activation of clotting in the small blood vessels throughout the body, leading to depletion of platelets and clotting factors, which can cause bleeding.

Question 2

An excess of which of the following is indicative of the breakdown of fibrin products within the circulating blood?

Accepted Answer

D-dimers are a specific marker indicating the breakdown of fibrin, a protein involved in blood clotting. Their presence in the blood is often used to diagnose conditions related to abnormal clot formation and breakdown, such as deep vein thrombosis (DVT) and pulmonary embolism (PE).

Question 3

The key component to clot dissolution is:

Accepted Answer

Plasmin is the primary enzyme responsible for clot dissolution, also known as fibrinolysis. It breaks down fibrin, the main component of blood clots, into soluble fragments, thereby dissolving the clot.

Question 4

Which of the following hematology disorders will likely trigger an episode of DIC?

Accepted Answer

Acute promyelocytic leukemia (APL) is known to be associated with disseminated intravascular coagulation (DIC) due to the release of procoagulant substances from the leukemic cells, leading to a hypercoagulable state.

Question 5

The reference range for fibrinogen is:

Accepted Answer

The answer of The reference range for fibrinogen is:
...

Question 6

Which of these are byproducts of fibrinolysis?

Accepted Answer

Fibrinolysis leads to the breakdown of fibrin, resulting in the production of fibrin degradation products and D-dimers, which can be measured in the blood as markers of the process.

Question 7

D-dimer analysis may have what kind of result in DIC?

Accepted Answer

D-dimer levels are typically elevated in Disseminated Intravascular Coagulation (DIC) due to increased fibrin degradation products from excessive clotting and subsequent fibrinolysis.

Question 8

Normal levels of fibrin degradation products are removed by the reticuloendothelial system and usually measure:

Accepted Answer

The answer of Normal levels of fibrin degradation products are...

Question 9

A patient with DIC will have the all following coagulation test results except:

Accepted Answer

In DIC (Disseminated Intravascular Coagulation), fibrinogen levels typically decrease because it is consumed during the widespread activation of the coagulation cascade. PT/INR, aPTT, and D-dimer levels increase due to the activation of coagulation and subsequent fibrinolysis.

Question 10

The D-dimer test measures:

Accepted Answer

The answer of The D-dimer test measures:
...

Question 11

The lowest levels of fibrinogen are seen in which inherited disorder of fibrinogen?

Accepted Answer

Afibrinogenemia is the inherited disorder characterized by the complete absence of fibrinogen, leading to the lowest levels of fibrinogen among the options listed.

Question 12

The best component to use for patients with afibrinogenemia is:

Accepted Answer

Fresh frozen plasma is the best component to use for patients with afibrinogenemia because it contains all coagulation factors, including fibrinogen, which is deficient in these patients.

Question 13

A primary inhibitor of the fibrinolytic system is:

Accepted Answer

Alpha 2 antiplasmin is a primary inhibitor of the fibrinolytic system, directly inhibiting plasmin and preventing the breakdown of fibrin clots.

Question 14

A patient with DIC will have all the following coagulation test results except:

Accepted Answer

In DIC (Disseminated Intravascular Coagulation), fibrinogen levels typically decrease because it is consumed during the widespread activation of the coagulation cascade. PT/INR, aPTT, and D-dimer are usually increased due to the activation of coagulation and secondary fibrinolysis.

Question 15

All of the following are functions of thrombin except:

Accepted Answer

Thrombin does not activate thromboplastin.

Question 16

The substrate upon which the coagulation cascade is centered is:

Accepted Answer

Fibrinogen is the key substrate in the coagulation cascade, as it is converted into fibrin through the action of thrombin, leading to blood clot formation.

Question 17

Plasmin causes the inactivation of factors:

Accepted Answer

Plasmin is an important enzyme in the fibrinolytic system that breaks down fibrin clots. It also inactivates several coagulation factors, including factors V, VIII, XI, and XII, thereby playing a role in regulating blood clotting and preventing excessive clot formation.

Question 18

Patients with the heterozygous form of afibrinogenemia will have plasma levels of fibrinogen in the range of:

Accepted Answer

Heterozygous afibrinogenemia, also known as hypofibrinogenemia, typically results in reduced, but not absent, levels of fibrinogen. Plasma levels of fibrinogen in these patients usually range from 20 to 100 mg/dL, which is lower than the normal range (about 200-400 mg/dL) but higher than what is seen in individuals with complete afibrinogenemia, who have nearly undetectable levels.

Question 19

Primary fibrinolysis is a disorder closely related to DIC.All of the coagulation profile assays are the same as that for DIC with the exception of the:

Accepted Answer

Primary fibrinolysis is characterized by the systemic activation of the fibrinolytic system without prior clot formation, unlike disseminated intravascular coagulation (DIC) where clot formation leads to secondary fibrinolysis. In primary fibrinolysis, the platelet count remains normal, distinguishing it from DIC where platelet consumption typically leads to thrombocytopenia.

Question 20

The process of fibrin degradation is called __________ and is controlled by the enzyme _________.

Accepted Answer

Fibrinolysis is the process of breaking down fibrin, a key component of blood clots, and it is primarily controlled by the enzyme plasmin.

Quiz 18: Fibrinogen, Thrombin, and the Fibrinolytic System