Hematology

Hematology

The etiology of chronic lymphocytic leukemia (CLL) is

a. Due to radiationb. Due to a retrovirusc. A familial diseased. Unknown

answer is d

A 22-year-old man comes to the emergency room of your hospital because he has a diffuse, erythematous rash involving nearly all of his body. His total WBC count is greater than 100,000 cells/mm3. He also complains of bone pain, severe irritability, weakness, fatigue, nausea and vomiting, constipation, photophobia, and polyuria. His electrocardiogram (ECG) shows shortening of the QT interval, prolongation of the PR interval, and nonspecific T wave changes. The most likely cause of his symptoms

a. Hypercalcemiab. Hypocalcemiac. Hypophosphatemiad. Hyperkalemia

answer is a

Which of the following factors complexes with factor VIII, which is activated to factor VIIIa when released from the complex

a. Factor XIIIb. High molecular weight kininogenc. Von Willebrand factor (vWF)d. Thromboplastine. Plasminogen

answer is c

Which of the following factors depends on platelets for synthesis

a. Factor II (prothrombin b. Factor VII (proconvertin c. Protein Sd. Factor XIII (fibrin-stabilizing factor e. Factor X (Stuart-Prower factor

answer is d

Which of the following causes of anemia is associated with microcytosis

a. Folic acid deficiencyb. Therapy with zidovudine (AZT c. Hypothyroidismd. Alcohole. Thalassemia

answer is e

Which of the following causes of an elevated hemoglobin concentration in the blood is characterized by a LOW level of erythropoietin in the blood

a. Chronic tobacco smokingb. Dwelling at high altitudes, such as in the Andesc. Erythrocytosis associated with renal tumorsd. Primary polycythemia (polycythemia vera e. Erythrocytosis secondary to chronic pulmonary insufficiency

answer is d

Which of the following causes a leukocytosis without an increase in the number of circulating polymorphonuclear neutrophil leukocytes

a. Acute infectionb. Release of epinephrinec. Tissue necrosisd. Myelocytic leukemiae. Collagen vascular disease

answer is b

In a typical case of iron deficiency, which of the following molecular forms that contains or can bind to iron increases in the patient’ s serum

a. Hemoglobinb. Ferritinc. Hemosiderind. Myoglobine. Transferrin

answer is e

Which of the following disorders is associated with thrombocytosis

a. Disseminated intravascular coagulationb. A plastic anemiac. Postsplenectomyd. Hypersplenisme. Prosthetic valves

answer is c

A 47-year-old man walks into the emergency room because of feeling very weak, tired, short of breath, and dizzy. He has numbness and tingling of his fingers. He appears pale and sallow. On examination, his heart rate is 132. His sclerae and nailbeds are pale. His heart is enlarged and he has dependent edema of his ankles. Laboratory findings include a negative Coombs’ test and a hemoglobin of 4 g/dL. The likely diagnosis is

a. Traumatic hemolytic anemiab. Autoimmune anemiac. Blood lossd. Pernicious anemiae. Iron-deficiency anemia

answer is d

Most drugs induce thrombocytopenia by which mechanism

a. Marrow-depressing effectb. Directly cytotoxic of plateletsc. Depress megakaryoctye productiond. Immune response in which the platelet is damaged

by complement activatione. Impair megakaryoctye production

answer is d

Which of the following statements related to circulating erythrocytes (red cells) is untrue

a. The nuclei of the precursor cells to erythrocytes are extruded from their cells shortly before the red cells leave the bone marrow. Consequently, the presence of nucleated red cells in the peripheral blood should be regarded as abnormal and may indicate an underlying disease state.b. In a thin blood smear stained with Romanowsky’ s stain (such as Wright’ s stain), the youngest cells (reticulocytes) can be recognized by a blue coloration (basophilia) as different from most of the red cells present.c. The average diameter of erythrocytes is about 8 µm; consequently, they cannotflow through the smaller capillaries that have a diameter of 2 to 4 µm.d. The protein of hemoglobin, which is the principal constituent of the red cellcontents, is in tetrameric form, with two α and two β subunits.e. The iron atom of the hemoglobin molecule, which is essential to its function of carrying oxygen, is an intrinsic part of the heme complex attached to each sub-unit of protein

answer is

c

Which of the following statements concerning the relationship of the neutrophil polymorphonuclear leukocyte (PMN) to infection with bacterial pathogens is incorrect

a. The principal functions of the PMN are expressed in the tissues and not usually in the bloodstream, which is simply the transport path of the cells to their required site of action.b. The cytoplasmic granules of PMN are essentially inert, but metabolically have only vegetative role in maintaining cell viability.c. When the cell numbers of PMN are reduced significantly , the probability of severe bacterial infection can be greatly increased.d. The average duration of the period of circulation of PMN after entering the bloodstream is about 6 to 8 h.e. An increasing need for PMN produced by infection is met in part by large numbers of immature cells (especially band cells) being released from the marrow pool into the bloodstream

answer is b

Which pathologic cells in a stained blood film have appearances very similar to those of normal mature white cells or their precursors

a. Chronic lymphocytic leukemia (B cell type b. Chronic myelocytic leukemiac. Lymphoblastic leukemiad. Hodgkin’ s diseasee. Non-Hodgkin’ s disease

answer is b

On karyotyping, a well-defined chromosomal abnormality is pathognomonic of which condition


answer is b

Which condition customarily terminates by transition to a blast cell phase with similarities to acute leukemia

a. Chronic lymphocytic leukemia (B cell type b. Chronic myelocytic leukemiac. Lymphoblastic leukemiad. Hodgkin’ s disease

e. Non-Hodgkin’ s disease

answer is b

The principal complication of which condition is susceptibility to infection


answer is a

Which disorder presents mainly as a localized new mass or group of superficial lymph nodes


answer is d

Which mechanism is responsible for thrombocytopenia in vitamin B12 deficiency

a. Decreased productionb. Maldistributionc. Accelerated destructiond. Decreased survivale. Inherited

answer is a

Another:

MCQs

………………………………………

1. Major hematopeotic embryo:

A. lymph nodes

B. Bone marrow

C. liver

D. spleen

E. Yolk sac

2. All can cause Iron deficiency anemia EXCEPT:

A. Menorrhagia

B. bleeding from GIT

C. Pregnancy.

D. Transcoblamin 1 deficiency

3. 1ry site of folate absorption is:

A. both

B. neither

C. Duodenum

D. Proximal jejunum.

4. Which of the following test is most helpful in diagnosis of thalassemia :

A. serum iron and iron binding capacity

B. bone marrow iron stain

C. hemoglobin electrophoresis

5. all can be associated with Sickle Cell Anemia EXCEPT:

A. vasoocclusive cresis

B. infection

C. Aplastic cresis

D. organ damage

E. chest Syndrome

F. bleeding disease

6. Anemia characterized by increase RBCs production is:

A. chronic renal failure

B. Anemia of chronic disease

C. Fanconi's Anemia

D. Hereditary Spherocytosis

7. All of the following common finding in Acute Lymphocytic leukemia EXCEPT:

A. epistaxis

B. fever

C. marked elevation in WBCs

D. Gum hypertrophy

8. In Acute myelocytic leukemia all of the following correct EXCEPT :

A. Bone marrow examination is essential diagnosis

B. it is worse prognosis than chronic myeloid leukemia

C. more common in adult

D. Philadelphia +ve chromosome

9. the Philadelphia chromosome observed in which one of the following leukemia:

A. chronic myeloid leukemia

B. Acute Lymphocytic Leukemia

C. Neither

D. Both

10. Diagnostic criteria of 2ry polycythemia all of the following EXCEPT:

A. smoking

B. renal cyst

C. a high altitude

D. D.M

11. Haemophilia A ( factor IIIV deficiency) EXCEPT:

A. All males with defective gene have hemophilia

B. 50% of daughter's of hemophilic man are diseased

C. 50% of daughter's of hemophilic man are carrier

D. It is Autosomal dominant inheritance

12. Thrombocytopenia can be all of the following EXCEPT:

A. ITP

B. ALL

C. AML

D. Essential thrombocytopenia

13. R factor for venous thrombosis include all EXCEPT:

A. immobilization

B. Estrogen therapy

C. Anti thrombin III deficiency

D. Exercise

14. which can cause thrombosis:

A. liver disease

B. thrombocytopenia

C. Anti phospholipid Syndrome

15. Blood Transfusion for all EXCEPT:

A. Hepatitis B & C virus

B. HIV

C. Syphilis

D. Hepatitis A virus

16. The packed RBCs are stored at :

A. 20 degree Centigrade

B. 30 degree Centigrade

C. 37 degree Centigrade

D. 4 degree Centigrade

(note: platelets at room temperature=25)

17. Vitamin K dependent coagulation Factors may include all EXCEPT:

A. Factor 2

B. Factor 7

C. Factor 9

D. Factor 11

18. All of the following features of Multiple Myeloma EXCEPT:

A. Pathological fracture

B. Increase plasma abnormal cells in bone marrow

C. Increase peak serum of monoclonal protein in electrophoresis

D. Increase Hemoglobin level

19. Hodgkin's Disease the most common histological subtype is:

A. Lymphocytic predominant

B. Mixed Cellularity

C. Lymphocyte depleted

D. Nodular sclerosing

20. In which of the following Hematological disorders the polymerase chain

reaction is helpful:

A. Megaloblastic anemia

B. Hemolytic anemia

C. Iron deficiency anemia

D. Hemolytic malignancy

All the last answers are correct

Non Specific Esterase(NSE) is seen in which type of leukaemia:

a.) AML 3

b.) AML 0

c.) ALL

d.) All of the above

Highest peroxidase activity is seen in

A- Myeloblast

B- Promyelocyte

C- Lymphoblast

D- Monocyte

E- Reed Sternberg cell

120- Glycophorein positive cells are seen especially in

A- AML-M1

B- AML-M2

C- AML-M3

D- AML-6

E- Non of the above

Fibrin/Fibrinogen split products may cause prolongation of the aPTT due to:

A. Inhibition of platelet aggregation

B. Inhibition of fibrin crosslinking by factors XIIIa

C. Inhibition of thrombin mediated conversion of fibrinogen to fibrin

D. Conversion of plasminogen to plasmin

2. Both the aPTT and PT would be expected to be prolonged with:

A. Deficiency of factors X, V, II or I

B. Deficiency of factors X, V, II or XIII

C. Deficiency of factors XII, XI, IX, VIII, or IV

D. Deficiency of factors III or VII

E. Deficiency of HWMK (High molecular weight kininogen) or Prekallikrein

3. Which of the following would be increased with deficiency(ies) of factors XI, IX,

or VIII:

A. aPTT (activated partial thromboplastin time)

B. PT (prothrombin time)

C. Ivey bleeding time

D. Platelet count

ATYPICAL CELLS OF INFECTIOS MONONUCLEIOSISIS IS

A. KILLER CELL

B. NK CELL

C. CD 8

D. MONOCYTE

Which of the following cells share a common progenotor cells with macrophages?

A-astrocytes.

B-epedendymal cells.

C-microglia

Dmullers fibers

E- oligodendrocytes.

poor prognosis for AML is..?

a. t(8;25)

b. t(15,17)

c. inv(16)

d. inv(3)

sezary syndrome in included under

a. B cell leukemia

b. T cell leukemia

c. lymphoma

d. genodermatosis

in mycosis fungoides proliferation of which cells is seen..?

a. T helper cells

b. T suppressor cells

c. plasma cells

d. B-cells

highest LAP score is seen in ?

a. CML

b. polycythemia vera

c. PNH

d. MDS

osmotic fragility increased in..?

a. thalassemia

b. SCD

c. chronic lead poisoning

d. hereditary spherocytosis

ESR raised in ?

a. SCD

b. multiple myeloma

c. angina petoris

d. thalassemia

ALP is raised in.......?

a. multiple myeloma

b. osteoporosis

c. hypoparathyroidism

d. hodgkin's disease.

true abt metastatic calcification is

a. serum ca normal

b. occurs in dead tissue

c. occurs in damaged heart valves

d. calcification starts in mitochondria.

multiple myeloma shows which calcification?

Dystrophic

Metastatic

which vitamin protects cells from free radical injury

a. vit A

b. vit C

c. vit E

d. vit K

iron is present as cofactor in all of these except

a. peroxidase

b. catalase

c. carbonic anhydrase

d. cytochrome C

ladder pattern of DNA electrophoresis in apoptosis is due to enzyme ?

a. DNAse

b. caspase

c. endonuclease

d. exonuclease.

)NON SPECIFIC ESTERASE POSITIVE IS SEEN IN WHICH OF FOLLOWING

SUBCLASSES OF AML?

A)M0

B)M3

C)M6

D)M2

type 4 or delayed HS reaction occurs in which disease

a. GBS

b. graves disease

c. acute glomerulonephritis --------ans

d. pemphigus vulgaris

primary granules of neutrophil includes A/E

a. alkaline phosphatase

b. myeloperoxidase

c. acid hydrolyses

d. elastases.

cytokines that affect leukocyte movement are called

a. interleukins

b. chemokines

c. lymphokines

d. monokines

thromboxaneA2 produced by

a. neutrophils

b. macrophage

c. endothelium

d. platelets

mediators involved in vasodilation are A/E

a. PGE1

b. IL-1

c. anaphylatoxin

d. TXA2

exudation of plasma and leukocytes in acute inlammation is from the

a. venules

b. capillaries

c. arterioles

d. arterioles and capillaries

pernicious anemia is associated with A/E

a. increased serum gastrin

b. increased serum autoantibodies

c. increased serum vit B12

d. decreased gastric acid secretion

L.E. cell is a

a. lymphocyte

b. neutrophil

c. basophil

d. eosinophil

if both parents are sickle cell anaemia patients then the likelyhood of offsprings

having the disease is

a. 25%

b. 50%

c. 75%

d. 100%

ANNGIOTENSINOGEN SECRETED BY

KIDNEY

LIVER

LUNGS

SPLEEN

Basophilic leucocytosis occurs in?

Aml

All

Cml

Cll

Factor V is required for growth of :

1. Haemophillus

2. Staphylococci

3. Neisseria

4. All of above

The globin structure of the major hemoglobin found in human adults is:

A- α2 β2

B- α2 γ2

C- α2 δ2

D- α2 ε2

E- ζ2 ε2

2- Tear drop cells are found at increasing number in all of the following cases,

EXCEPT:

A- Thalassemias.

B- Myelofibrosis.

C- BM tumors.

D- Extramedullary hemopoiesis.

E- None of the above

3- Spherocytes can be seen in cases with:

A- Thalassemias

B- Sickle cell anemia

C- Severe burns.

D- Abetalipoproteinemia.

E- PNH

4- In Hb electrophoresis at alkaline pH, all of the following statements are true,

EXCEPT:

A- HbA is faster than HbF and HbA2.

B- HbC have the same mobility as HbA2.

C- HbH is a fast moving Hb, while Hb Bart's is a slow moving Hb.

D- Hb S and Hb D, and Hb G have the same electrophoretic mobility.

E- Hb Lepore is slower than HbA

--The hematologic disease which is expected to be highly seen in spring season is:

A- Glucose 6 phosphate dehydrogenase deficiency.

B- Hereditary pyropoikilocytosis.

C- Hereditary stomatocytosis.

D- Spur cell anemia.

E- All of the above diseases can be seen in spring at the same rate.

6- In G6PD deficiency, all of the following is true, EXCEPT:

A- The gene is carried on the X chromosome.

B- Is the commonest RBC enzyme deficiency.

C- Retics contain normal amounts of G6PD in G6PD deficient patients.

D- Should be diagnosed during acute hemolysis phase.

E- Bitten RBCs may be seen in blood films.

Kleihauer-Betke test detects:

A- Red cells containing HbF.

B- Red cells containing HbA.

C- Red cells containing HbA2.

D- Red cells containing HbH.

E- Red cells containing Hb constant spring

In Hereditary Spherocytosis all of the following are FALSE statements, EXCEPT:

A- The genetic defect can be seen by a G banded karyotype.

B- Spherocytes are larger than normal RBCs.

C- Decreased osmotic fragility

D- Has a X-linked mode of inheritance.

E- Spherocytes are red cells with absent central pallor.

Hemoglobin can be increased erroneously when there is:

A] Leukopenia.

B] Increased plasma hemoglobin

C] Paraproteinemias

D] Low triglycerides levels.

E] High RDW

10- When precursor cells are present in a blood film, they tend to accumulate in

the:

A] Tail.

B] Edges.

C] Multilayer zone.

D] Monolayer zone.

E] Thick area\

A patient with a platelet count of 43x109/L, you noted the presence of platelet

aggregates in his blood film, the most probable cause of his thrombocytopenia is:

A- Idiopathic thrombocytopenia purpura (ITP).

B- This is most probably a manual count but in automated count PLT will be

normal.

C- Disseminated intravascular coagulation (DIC).

D- EDTA induced platelet aggregation.

E- Thrombotic thrombocytopenic purpura (TTP).

12- Left shift in a blood film means:

A- Presence of all blood cell types.

B- Presence of immature granulocytes.

C- Presence of NRBCs.

D- Presence of immature platelet forms.

E- None of the above.

58-year-old female has a decreased serum iron and TIBC in association with an

increased serum ferritin. These findings are most indicative of:

A- Anemia of chronic disease.

B- Iron deficiency anemia.

C- Sickle cell anemia.

D- Sideroblastic anemia, Hereditary type.

E- Low hepcidin levels.

15- Select the Hb that is the major hemoglobin found in infants with hydrops

fetalis:

A- Hb A

B- Hb Lepore

C- Hb H

D- Hb Bart's

E- Hb F

16- NRBC in the peripheral blood could normally be seen in:

A- Newborns.

B- Infants.

C- Children.

D- Female adults.

E- Male adults

A patient with anemia has an RDW-CV% of 14.0 and an MCV of 120 fL. However,

examination of the blood smear reveals significant anisocytosis. How do you

explain these results?

A- The instrument needs calibration.

B- MCV looks like to be falsely elevated.

C- The RDW is only elevated if there is anisocytosis and a normal MCV.

D- High MCV may causes a falsely normal RDW-CV%.

E- High MCV will not affect RDW-SD.

18- Regarding to sideroblastic anemia, which is a false statement among the

following:

A- Ringed sideroblasts are found in the BM.

B- May end as acute leukemia

C- Dimorphic blood film picture is characteristic within the inherited types..

D- Mode of inheritance within the inherited types is X-linked and autosomal

recessive

E- Serum iron will be low.

The direct precursor of the pronormoblast is:

A- CFU-E

B- BFU-E

C- CFU-GEMM

D- Pluripotential Stem Cell

E- CFU-EK

20-

What is the RPI given the following: Hct 16%, retic count 12%?

A- 4.27

B- 1.7

C- 2.9

D- 12.0

E- Non of the above

Another :

المشاركة MCQ بسؤالين الجميع من -:واتمنى1- The globin structure of the major hemoglobin found in human adults is:

A- α2 β2B- α2 γ2C- α2 δ2D- α2 ε2E- ζ2 ε2

2- Tear drop cells are found at increasing number in all of the following cases, EXCEPT:A- Thalassemias.B- Myelofibrosis.C- BM tumors.D- Extramedullary hemopoiesis.E- None of the above

لليوم الجديدين :السؤالين3- Spherocytes can be seen in cases with:A- ThalassemiasB- Sickle cell anemiaC- Severe burns.D- Abetalipoproteinemia.E- PNH

4- In Hb electrophoresis at alkaline pH, all of the following statements are true, EXCEPT:A- HbA is faster than HbF and HbA2.B- HbC have the same mobility as HbA2.C- HbH is a fast moving Hb, while Hb Bart's is a slow moving Hb.D- Hb S and Hb D, and Hb G have the same electrophoretic mobility.E- Hb Lepore is slower than HbA

Because :1- S and G and D all have the same electrophoretic mobility at alkalaine electrophoresis. ( سجد: احفظها كالتالي ( لـ ) ( S س لـ ) و ( G ج لـ دD ).2- Hb-H and Hb Bart's both are very fast moving.Hb-H is composed of 4 beta globin chains, while Hb Bart's is composed of 4 gamma globin chains, usually we see both of them in alpha thalassemia

(Hb-Barts is incompatible with life).

5--The hematologic disease which is expected to be highly seen in spring season is:A- Glucose 6 phosphate dehydrogenase deficiency.B- Hereditary pyropoikilocytosis.C- Hereditary stomatocytosis.D- Spur cell anemia.E- All of the above diseases can be seen in spring at the same rate.

6- In G6PD deficiency, all of the following is true, EXCEPT:A- The gene is carried on the X chromosome.B- Is the commonest RBC enzyme deficiency.C- Retics contain normal amounts of G6PD in G6PD deficient patients.D- Should be diagnosed during acute hemolysis phase.E- Bitten RBCs may be seen in blood films

G6PD enzyme is carried on the X chromosome, this is why is seen in males more more tham females. In acute hemolysis there will be reticulocytosis, and reticulocytes are characterized by increasing amounts of G6PD enzyme, so G6PD enzyme in deficient patients will be normal during hemolytic episodes

الجديدين :السؤالين7- Kleihauer-Betke test detects:A- Red cells containing HbF.B- Red cells containing HbA.C- Red cells containing HbA2.D- Red cells containing HbH.E- Red cells containing Hb constant spring

8- In Hereditary Spherocytosis all of the following are FALSE statements, EXCEPT:A- The genetic defect can be seen by a G banded karyotype.B- Spherocytes are larger than normal RBCs.

C- Decreased osmotic fragilityD- Has a X-linked mode of inheritance.E- Spherocytes are red cells with absent central pallor

9] Hemoglobin can be increased erroneously when there is:A] Leukopenia.B] Increased plasma hemoglobinC] ParaproteinemiasD] Low triglycerides levels.E] High RDW

Hemoglobin is increased errornously when there is leukocytosis (high WBC count), Lipidemia (high lipids), and high protein. With paraproteinemia there is high protein!!!!

10- When precursor cells are present in a blood film, they tend to accumulate in the:A] Tail.B] Edges.C] Multilayer zone.D] Monolayer zone.E] Thick area

Immature precursor cells tend to accumulate at the edges of the blood film because of there big size. This is why in blood film preparation it is recommended that the film shouldnot touch the edges of the slide.!!!

11- A patient with a platelet count of 43x109/L, you noted the

presence of platelet aggregates in his blood film, the most probable cause of his thrombocytopenia is:A- Idiopathic thrombocytopenia purpura (ITP).B- This is most probably a manual count but in automated count PLT will be normal.C- Disseminated intravascular coagulation (DIC).D- EDTA induced platelet aggregation.E- Thrombotic thrombocytopenic purpura (TTP).

12- Left shift in a blood film means:A- Presence of all blood cell types.B- Presence of immature granulocytes.C- Presence of NRBCs.D- Presence of immature platelet forms.E- None of the above.

Another :

What is the most important side effect of heparin? Heparin can cause thrombocytopenia that in some unlucky patients is associated with arterial thrombosis.

Measure complete blood counts to monitor for this side effect, which usually occurs on day 3-7 of heparin administration. Discontinue heparin immediately if platelet counts begin to fall.

How is the effect of heparin monitored? Heparin is monitored with PTT (partial thromboplastin time), a measure of the internal coagulation pathway

How is the effect of warfarin monitored?

Warfarin is monitored with the PT (prothrombin time), a measure of the external coagulation pathway

How do you keep PTT and PT straight? PTT has a "T" inside, intrinsic, internal coagulation pathway.

PT is the other Memorize: Measure heparin with ______Measure warfarin with ______

Measure heparin with PTT(Hep to the PTT!)

Measure warfarin with PT(War with the PT)

How is the effect of aspirin monitored? Aspirin prolongs bleeding time, a measure of platelet function. Clinically, the effect of aspirin is not monitored with lab testing, but be aware that it prolongs bleeding time test.

How are the effects of low-molecular-weight heparin monitored? LMW Heparin does not affect any of the coagulation parameters (PT or PTT or bleeding time), and its effect is not clinically monitored. Rarely, a special type of factor X assay (anti-Xa) is used to measure the effect.

In an emergency, how can you reverse the effects of heparin? Heparin and LMW heparin can be reversed with protamine.

In an emergency, how can you reverse the effects of warfarin? Warfarin with fresh frozen plasma (contains clotting factors; immediate effect) and or vitamin K (takes a few days to work).

In an emergency, how can you reverse the effects of aspirin? Platelet transfusions

Condition: Hemophilia A

PTPTTBleeding timeInheritance

Condition: Hemophilia A

PT: normalPTT: prolonged (low levels of factor 8)Bleeding time: normalInheritance: X-linked

Condition: Hemophilia B


Condition: Hemophilia B

PT: normalPTT: prolonged (low levels of factor 9)Bleeding time: normalInheritance: X-linked

How do you keep Hemophilia A and B straight? Hemophilia A is 8A (eight = ate = A) missing factor 8), the more common form.

Hemophilia B is 9B Condition: vWF deficiency


Condition: vWF deficiency

PT: normalPTT: prolongedBleeding time: prolonged

Inheritance: autosomal dominant

***Normal levels of factor 8 and factor 9 Condition: Disseminated intravascular coagulation

PTPTTBleeding timeInheritanceWhat else is elevated in terms of labs?When do you encounter DIC?What do you see on the blood smear?

Condition: DIC

PT: prolongedPTT: prolongedBleeding time: prolongedInheritance: N/A

Positive D-dimer or FDPs (fibrin degradation products); postpartum, infection, malignancy; schistocytes and fragmented cells on peripheral smear.

Condition: Liver Disease


Condition: Liver Disease

PT: ProlongedPTT: normal or prolongedBleeding time: normalInheritance: N/A

All factors but 8 are low, you see stigmata of liver disease; no correction with vitamin K Condition: vitamin K deficiency


Condition: vitamin K deficiency

PT: prolongedPTT: slightly prolongedBleeding time: normalInheritance: N/A** low levels of factors 2,7,9,10, proteins C and S; look for neonate who did not receive prophylactic vitamin K; malabsorption, alcoholism, or prolonged antibiotic use (which kills vitamin K-producing bowel flora)

MEMORIZE:

PT (extrinsic): 2,5,7,10: increased with warfarin use, vit K deficiency, liver disease

PTT (intrinsic): 8,9,11,12: increased with heparin use, hemophilia A, B, vWF deficiency PT (extrinsic): 2,5,7,10: increased with warfarin use, vit K deficiency, liver disease

PTT (intrinsic): 8,9,11,12: increased with heparin use, hemophilia A, B, vWF deficiency Remember that uremia causes a qualitative platelet defect and that vitamin C deficiency and chronic steroid therapy can cause bleeding tendency with normal coagulation tests.

Remember that uremia causes a qualitative platelet defect and that vitamin C deficiency and chronic steroid therapy can cause bleeding tendency with normal coagulation tests.

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Hematology