Bioscience II: Test II

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Bioscience II: Test II - Quiz


A review of the material for Bioscience test 2. Covers hemostasis and hepatic physiology.


Questions and Answers
  • 1. 

    Hemostasis is not dependent on which of the following?

    • A.

      Enzyme release from endothelium

    • B.

      Coagulation of blood

    • C.

      Vascular spasm

    • D.

      Formation of platelet plug

    Correct Answer
    A. Enzyme release from endothelium
    Explanation
    Hemostasis is the process of stopping bleeding, and it involves several mechanisms such as coagulation of blood, vascular spasm, and formation of a platelet plug. However, enzyme release from the endothelium is not a direct factor in hemostasis. While the endothelium does play a role in regulating blood flow and preventing excessive clotting, it does not release enzymes that directly contribute to the process of hemostasis.

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  • 2. 

    In hemostasis, ________ occurs several minutes after the other two processes.

    • A.

      Vascular spasm

    • B.

      Coagulation of blood

    • C.

      Formation of platelet plug

    Correct Answer
    B. Coagulation of blood
    Explanation
    Coagulation of blood occurs several minutes after the other two processes in hemostasis. Vascular spasm is the initial response to vessel injury, where the smooth muscles in the blood vessel walls contract to reduce blood flow. Formation of a platelet plug follows, where platelets adhere to the damaged vessel wall and aggregate to form a temporary seal. Finally, coagulation of blood takes place, involving a complex cascade of reactions that result in the formation of a fibrin clot to stabilize the platelet plug and prevent further bleeding.

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  • 3. 

    Primary hemostasis is also known as….

    • A.

      Enzyme release from endothelium

    • B.

      Coagulation of blood

    • C.

      Formation of platelet plug

    • D.

      Vascular spasm

    Correct Answer
    C. Formation of platelet plug
    Explanation
    Primary hemostasis refers to the initial steps in the blood clotting process that occur immediately after a blood vessel is injured. During primary hemostasis, platelets become activated and adhere to the site of injury, forming a plug that helps to stop bleeding. Therefore, the correct answer is "Formation of platelet plug."

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  • 4. 

    Secondary hemostasis is also known as…

    • A.

      Enzyme release from endothelium

    • B.

      Formation of platelet plug

    • C.

      Vascular spasm

    • D.

      Coagulation of blood

    Correct Answer
    D. Coagulation of blood
    Explanation
    Secondary hemostasis refers to the process of coagulation, which is the formation of a blood clot to stop bleeding. During this process, a series of enzymatic reactions occur, leading to the conversion of soluble fibrinogen into insoluble fibrin threads. These threads form a mesh-like structure that traps platelets and other blood cells to form a stable blood clot. Therefore, the correct answer is "Coagulation of blood."

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  • 5. 

    Which layer of blood vessel lining synthesizes prostaglandins?

    • A.

      Endothelial Lining

    • B.

      Adventitia

    • C.

      Muscular Layer

    • D.

      Subendothelial Layer

    Correct Answer
    A. Endothelial Lining
    Explanation
    The endothelial lining is responsible for synthesizing prostaglandins in the blood vessels. Prostaglandins are lipid compounds that have various physiological effects, including regulating inflammation, blood clotting, and blood pressure. The endothelial cells in the lining of blood vessels produce prostaglandins in response to various stimuli, such as injury or inflammation. These prostaglandins play a crucial role in maintaining vascular homeostasis and regulating blood flow.

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  • 6. 

    The endothelial lining of the blood vessel wall promotes anticoagulant activity.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The endothelial lining of the blood vessel wall promotes anticoagulant activity because it releases substances such as nitric oxide and prostacyclin, which inhibit platelet aggregation and prevent blood clot formation. Additionally, the endothelial cells produce antithrombotic molecules like heparin sulfate and tissue factor pathway inhibitor, which further prevent clotting. This anticoagulant activity is crucial for maintaining blood flow and preventing the formation of dangerous blood clots that can lead to conditions like deep vein thrombosis or pulmonary embolism.

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  • 7. 

    Which layer of blood vessel lining activates hemostasis?               

    • A.

      Endothelial Lining

    • B.

      Adventitia

    • C.

      Muscular Layer

    • D.

      Subendothelial Layer

    Correct Answer
    D. Subendothelial Layer
    Explanation
    The subendothelial layer of the blood vessel lining activates hemostasis. This layer is located beneath the endothelial lining and plays a crucial role in initiating the clotting process. When a blood vessel is damaged, the subendothelial layer is exposed to blood components, leading to the activation of platelets and the formation of a blood clot to prevent excessive bleeding.

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  • 8. 

    Which layer of the blood vessel lining contains fibronectin?

    • A.

      Endothelial Lining

    • B.

      Adventitia

    • C.

      Muscular Layer

    • D.

      Subendothelial Layer

    Correct Answer
    D. Subendothelial Layer
    Explanation
    The subendothelial layer is the layer of the blood vessel lining that contains fibronectin. Fibronectin is a glycoprotein that plays a role in cell adhesion and is found in the extracellular matrix. It helps to anchor cells to the underlying connective tissue and provides structural support to the blood vessel wall. The other layers mentioned in the options, such as the endothelial lining, adventitia, and muscular layer, do not typically contain fibronectin.

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  • 9. 

    Which layer of blood vessel lining is primarily responsible for blood flow though the vessel?

    • A.

      Endothelial Lining

    • B.

      Adventitia

    • C.

      Muscular Layer

    • D.

      Subendothelial Layer

    Correct Answer
    C. Muscular Layer
    Explanation
    The muscular layer of blood vessel lining is primarily responsible for blood flow through the vessel. This layer, also known as the tunica media, is composed of smooth muscle cells that can contract and relax to regulate the diameter of the blood vessel. By constricting or dilating the vessel, the muscular layer controls the amount of blood that flows through it. This layer plays a crucial role in maintaining blood pressure and directing blood flow to different parts of the body.

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  • 10. 

    The outermost layer of the blood vessel lining is known as….

    • A.

      Endothelial Lining

    • B.

      Adventitia

    • C.

      Muscular Layer

    • D.

      Subendothelial Layer

    Correct Answer
    B. Adventitia
    Explanation
    The outermost layer of the blood vessel lining is known as adventitia. This layer is composed of connective tissue and provides support and protection to the blood vessel. It helps to anchor the blood vessel to surrounding tissues and organs. The adventitia also contains blood vessels, nerves, and lymphatic vessels that supply the blood vessel itself.

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  • 11. 

    Injury to the muscular layer of the blood vessel will have what result?

    • A.

      Release of Von Willebrand Factor (Factor VII) from muscular layer

    • B.

      Acute vascular contraction of muscular layer to lessen blood flow

    • C.

      Release of Prostacyclin 2 to inihibit platelet aggregation

    • D.

      Acute vascular dilation to increase blood flow and delivery of platelets to injured site.

    Correct Answer
    B. Acute vascular contraction of muscular layer to lessen blood flow
    Explanation
    When there is an injury to the muscular layer of the blood vessel, the body's response is to initiate acute vascular contraction. This contraction helps to lessen the blood flow to the injured site, which is beneficial in reducing bleeding and preventing further damage. By constricting the blood vessels, the body is able to limit the amount of blood reaching the injured area, allowing for better clot formation and healing. This response is an important mechanism in the body's overall process of repairing damaged blood vessels.

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  • 12. 

    Which of the following is not of the functions of platelets?

    • A.

      Morphologic aggregation

    • B.

      Secretion of items such as factors V and XIII

    • C.

      Activation of vascular spasm

    • D.

      Plug Formation

    Correct Answer
    C. Activation of vascular spasm
    Explanation
    Platelets have several functions in the process of blood clotting. They play a crucial role in morphologic aggregation, which involves clumping together to form a plug at the site of injury. Platelets also secrete factors V and XIII, which are important for the clotting process. Additionally, they contribute to plug formation by releasing substances that help in the formation of a stable clot. However, platelets do not directly activate vascular spasm, which is the constriction of blood vessels to reduce blood flow. This function is primarily carried out by smooth muscle cells in the blood vessel walls.

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  • 13. 

    The intrinsic pathway is initiated with the activation of …

    • A.

      Factor III

    • B.

      Thromboplastin

    • C.

      Von Willebrand Factor

    • D.

      Factor XII

    Correct Answer
    D. Factor XII
    Explanation
    The correct answer is Factor XII. The intrinsic pathway of coagulation is initiated with the activation of Factor XII, also known as Hageman factor. Factor XII is activated by binding to negatively charged surfaces, such as collagen or platelets, and undergoes a series of enzymatic reactions leading to the formation of a blood clot. This pathway plays a crucial role in maintaining hemostasis and preventing excessive bleeding.

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  • 14. 

    The extrinsic pathway is activated with the release of….

    • A.

      Thromboplastin

    • B.

      Prothrombin

    • C.

      Factor XI

    • D.

      Factor VII

    Correct Answer
    A. Thromboplastin
    Explanation
    Thromboplastin is released to activate the extrinsic pathway. This pathway is initiated by tissue damage, which leads to the release of thromboplastin from damaged cells. Thromboplastin then combines with calcium ions and factor VII to form an enzyme complex. This enzyme complex activates factor X, which ultimately leads to the formation of a blood clot.

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  • 15. 

    Which Factors are involved in the extrinsic pathway?

    • A.

      Factors XII, XI, IX, VIII

    • B.

      Factors III, VII

    • C.

      Factors V, X, I, II, XIII

    • D.

      None of the above is correct

    Correct Answer
    B. Factors III, VII
    Explanation
    The extrinsic pathway of coagulation involves the activation of factors III (tissue factor) and VII. These factors play a crucial role in initiating the clotting process by forming a complex that activates factor X. Factors XII, XI, IX, and VIII are not involved in the extrinsic pathway. Factors V, X, I, II, and XIII are not specifically associated with the extrinsic pathway either. Therefore, the correct answer is Factors III, VII.

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  • 16. 

    Which Factors are involved in the intrinsic pathway?

    • A.

      Factors III, VII

    • B.

      Factors V, X, I, II, XIII

    • C.

      Factors XII, XI, IX, VIII

    • D.

      None of the above is correct

    Correct Answer
    C. Factors XII, XI, IX, VIII
    Explanation
    The correct answer is Factors XII, XI, IX, VIII. The intrinsic pathway is one of the two pathways involved in the process of blood clotting. It is initiated by factors XII and XI, which activate factor IX. Factor IX then combines with factor VIII, calcium ions, and phospholipids to form a complex that activates factor X. This ultimately leads to the formation of a blood clot. Factors III and VII are not involved in the intrinsic pathway, and factors V, X, I, and II are not the correct combination of factors for this pathway.

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  • 17. 

    The final phase of blood clotting is the interaction of _____ with _______.

    • A.

      VonWillebrand Factor, Factor VIII

    • B.

      Plasmin, Fibrin

    • C.

      Factor XIII, Fibrin

    • D.

      Thrombin, Fibrinogen

    Correct Answer
    D. Thrombin, Fibrinogen
    Explanation
    Thrombin is a key enzyme in the blood clotting process. It converts fibrinogen, a soluble protein, into fibrin, which forms a mesh-like structure that helps to stabilize the blood clot. This interaction between thrombin and fibrinogen is crucial for the formation of a stable blood clot.

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  • 18. 

    The fibrinolytic process is normally triggered by…

    • A.

      Fibrin

    • B.

      Plasmin

    • C.

      Endothelial cells

    • D.

      Thrombaxane

    Correct Answer
    A. Fibrin
    Explanation
    The fibrinolytic process is normally triggered by fibrin. Fibrin is a protein formed during the blood clotting process, and it is responsible for the formation of the mesh-like structure that makes up a blood clot. Once the clotting process is complete and the clot is no longer needed, the fibrinolytic process is initiated to break down the fibrin and dissolve the clot. This process involves the activation of plasmin, an enzyme that specifically targets and degrades fibrin. Therefore, fibrin plays a crucial role in triggering the fibrinolytic process.

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  • 19. 

    An excess of Plasminogen Activator Inhibitor I (PAI-1) would likely result in…

    • A.

      Excessive bleeding

    • B.

      Excessive thrombus formation

    • C.

      Excessive vasodilation

    • D.

      All the above

    Correct Answer
    B. Excessive thrombus formation
    Explanation
    An excess of Plasminogen Activator Inhibitor I (PAI-1) would likely result in excessive thrombus formation. PAI-1 is a protein that inhibits the activity of plasminogen activators, which are responsible for breaking down blood clots. When there is an excess of PAI-1, the normal balance between clot formation and clot breakdown is disrupted, leading to an increased tendency for blood to clot. This excessive thrombus formation can potentially lead to serious conditions such as deep vein thrombosis, pulmonary embolism, or stroke.

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  • 20. 

    Sepsis is likely to activate which of the coagulation pathways?

    • A.

      Extrinsic Pathway

    • B.

      Fibrinolytic pathway

    • C.

      Intrinsic pathway

    • D.

      Common Pathway

    Correct Answer
    C. Intrinsic pathway
    Explanation
    Sepsis is likely to activate the intrinsic pathway of the coagulation cascade. The intrinsic pathway is initiated by factors within the blood, such as activated platelets and damaged endothelial cells. Sepsis, which is a severe infection, can cause widespread inflammation and damage to blood vessels, leading to the activation of the intrinsic pathway. This pathway ultimately leads to the formation of a blood clot, which is an important response to prevent excessive bleeding.

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  • 21. 

    While prepping dinner last night you managed to cut your finger while chopping red onions.  As you furiously attempt to wash the burning onion juices from your cut, you are confident in the knowledge that you have just activated which clotting pathway?

    • A.

      Fibrinolytic pathway

    • B.

      Intrinsic pathway

    • C.

      Common Pathway

    • D.

      Extrinsic Pathway

    Correct Answer
    D. Extrinsic Pathway
    Explanation
    The correct answer is the Extrinsic Pathway. The Extrinsic Pathway is activated by tissue damage and the release of tissue factor (TF) from damaged cells. TF then forms a complex with Factor VII, which initiates a cascade of reactions leading to the formation of a blood clot. In this scenario, the cut on the finger caused tissue damage, leading to the activation of the Extrinsic Pathway.

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  • 22. 

    Which of the following will not result in likely thrombus formation?

    • A.

      Liver Failure

    • B.

      Protein C Deficiency

    • C.

      Atrial Fibrillation

    • D.

      Accidentally sawing off the tip of your pinky finger

    Correct Answer
    A. Liver Failure
    Explanation
    Liver failure will not result in likely thrombus formation because the liver plays a crucial role in the production of clotting factors and the breakdown of clotting proteins. In liver failure, the liver's ability to produce these factors is impaired, leading to a decreased ability to form blood clots. Therefore, thrombus formation is less likely to occur in individuals with liver failure.

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  • 23. 

    At a platelet count <50, the pt is at risk for spontaneous bleeding.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    A platelet count of less than 50 indicates a low number of platelets in the blood, which can lead to an increased risk of bleeding. Therefore, the statement that at a platelet count

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  • 24. 

    What effect would a plt. Count of 62 have on bleeding times?

    • A.

      None, platelets still above 50.

    • B.

      Shortened bleeding time.

    • C.

      Prolonged bleeding time.

    • D.

      Bleeding time is unrelated to plt. Count.

    Correct Answer
    C. Prolonged bleeding time.
    Explanation
    A plt. count of 62 refers to a platelet count of 62, which is below the normal range. Platelets play a crucial role in blood clotting, and a low platelet count can lead to prolonged bleeding time. Therefore, a plt. count of 62 would have the effect of causing a prolonged bleeding time.

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  • 25. 

    Normal bleeding time is….

    • A.

      10-14 minutes

    • B.

    • C.

      30-60 seconds

    • D.

      2-9 minutes

    Correct Answer
    D. 2-9 minutes
    Explanation
    Normal bleeding time refers to the time it takes for bleeding to stop after a small cut or injury. The correct answer, 2-9 minutes, indicates the normal range for bleeding to cease. This range is considered normal as it allows for the body's natural clotting mechanisms to take effect and stop the bleeding. Bleeding times that are significantly shorter or longer than this range may indicate underlying health conditions or disorders affecting the blood's ability to clot.

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  • 26. 

    What is the most common cause of platelet abnormalities?

    • A.

      Drug Therapy

    • B.

      Sickle Cell

    • C.

      Von Willebrand Deficiency

    • D.

      DIC

    Correct Answer
    A. Drug Therapy
    Explanation
    Drug therapy is the most common cause of platelet abnormalities because certain medications can affect the production, function, or lifespan of platelets. Drugs like aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and certain antibiotics can inhibit platelet aggregation and increase the risk of bleeding. Other medications, such as heparin and certain chemotherapy drugs, can cause a decrease in platelet count, leading to a condition called thrombocytopenia. Therefore, drug therapy is often associated with platelet abnormalities.

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  • 27. 

    Heparin affects which pathway of the clotting cascade?

    • A.

      Extrinsic

    • B.

      Intrinsic

    • C.

      Common

    • D.

      Finbrinolytic

    Correct Answer
    B. Intrinsic
    Explanation
    Heparin affects the intrinsic pathway of the clotting cascade. The intrinsic pathway is activated by contact with negatively charged surfaces, such as collagen or glass, and involves factors XII, XI, IX, and VIII. Heparin enhances the activity of antithrombin III, which inactivates factors XIIa, XIa, IXa, and Xa, thereby inhibiting the intrinsic pathway. This ultimately leads to the prevention of blood clot formation.

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  • 28. 

    APTT is generally used to assess the effectiveness of _____ and the _____ pathway.

    • A.

      Heparin, Extrinsic

    • B.

      Coumadin, Extrinsic

    • C.

      Heparin, Intrinsic

    • D.

      Coumadin, Intrinsic

    Correct Answer
    C. Heparin, Intrinsic
    Explanation
    aPTT (activated partial thromboplastin time) is a laboratory test used to evaluate the effectiveness of heparin, an anticoagulant medication, in inhibiting the intrinsic pathway of blood coagulation. The intrinsic pathway is one of the two main pathways involved in the formation of blood clots. Coumadin, another anticoagulant, primarily affects the extrinsic pathway. Therefore, the correct answer is heparin and intrinsic pathway, as aPTT is specifically used to monitor the effectiveness of heparin in inhibiting the intrinsic pathway of blood coagulation.

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  • 29. 

    A patient is at risk for spontaneous bleeding at any platelet level that is below…

    • A.

      100

    • B.

      70

    • C.

      50

    • D.

      20

    Correct Answer
    D. 20
    Explanation
    A patient is at risk for spontaneous bleeding at any platelet level that is below 20. Platelets are responsible for blood clotting, and a low platelet count can result in difficulty in clotting, leading to spontaneous bleeding. Therefore, a platelet level below 20 indicates a significant risk for bleeding.

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  • 30. 

    To examine the extrinsic pathway, which labs would be most helpful?

    • A.

      PT, INR

    • B.

      Bleeding Time

    • C.

      APTT

    • D.

      ACT

    Correct Answer
    A. PT, INR
    Explanation
    To examine the extrinsic pathway, the most helpful labs would be PT (Prothrombin Time) and INR (International Normalized Ratio). PT measures the time it takes for blood to clot, specifically evaluating the extrinsic pathway. INR is a standardized measurement used to interpret PT results, allowing for comparison across different laboratories. Bleeding Time, aPTT (Activated Partial Thromboplastin Time), and ACT (Activated Clotting Time) are not specific to the extrinsic pathway and would not provide the most relevant information in this context.

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  • 31. 

    Coumadin exerts its effects primarily on which coagulation pathway?

    • A.

      Intrinsic

    • B.

      Extrinsic

    • C.

      Common

    • D.

      Fibrinolytic

    Correct Answer
    B. Extrinsic
    Explanation
    Coumadin, also known as warfarin, primarily exerts its effects on the extrinsic coagulation pathway. The extrinsic pathway is one of the two main pathways involved in the coagulation cascade. It is initiated by tissue factor, which is released from damaged blood vessels. Coumadin works by inhibiting the production of vitamin K-dependent clotting factors, including factors II, VII, IX, and X, which are all involved in the extrinsic pathway. By inhibiting these factors, Coumadin helps to prevent the formation of blood clots.

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  • 32. 

    Which of the following labs assesses the fibrinolytic system?

    • A.

      PTT

    • B.

      TT

    • C.

      FDP

    • D.

      INR

    Correct Answer
    C. FDP
    Explanation
    FDP, or fibrin degradation products, is a lab test that assesses the fibrinolytic system. Fibrinolytic system refers to the body's ability to break down blood clots. FDP measures the levels of breakdown products of fibrin, a protein involved in clot formation. Elevated levels of FDP indicate increased fibrinolysis, which may be seen in conditions such as disseminated intravascular coagulation (DIC) or thrombolytic therapy. PTT (partial thromboplastin time), TT (thrombin time), and INR (international normalized ratio) are other lab tests that assess different aspects of the coagulation system and are not specific to the fibrinolytic system.

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  • 33. 

    To measure to conversion of fibrinogen to fibrin, what lab would you use?

    • A.

      PT

    • B.

      D-dimer

    • C.

      FDP

    • D.

      TT

    Correct Answer
    D. TT
    Explanation
    The lab test that would be used to measure the conversion of fibrinogen to fibrin is TT (Thrombin Time). Thrombin is the enzyme responsible for converting fibrinogen to fibrin, which is essential for blood clot formation. Therefore, measuring the time it takes for thrombin to convert fibrinogen to fibrin can provide information about the clotting ability of the blood. PT (Prothrombin Time) measures the extrinsic pathway of coagulation, D-dimer is a marker of fibrin degradation, and FDP (Fibrin Degradation Products) measures the breakdown products of fibrin.

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  • 34. 

    Which of the following are absolute contraindications to regional anesthesia?

    • A.

      Hemophilia

    • B.

      Pt refusal

    • C.

      Current ASA Therapy

    • D.

      Infection over injection site

    • E.

      Age >85

    Correct Answer(s)
    B. Pt refusal
    D. Infection over injection site
    Explanation
    Pt refusal and infection over the injection site are absolute contraindications to regional anesthesia. Pt refusal means that the patient is unwilling to undergo the procedure, which makes it impossible to administer regional anesthesia. Infection over the injection site poses a risk of introducing bacteria into the surrounding tissues, potentially leading to a more severe infection. Both of these contraindications should be taken seriously to ensure patient safety and prevent complications.

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  • 35. 

    You are following Mrs. Lindgren who has gone into DIC following a placental abruption.This patient  would most likely present with which of the following lab abnormalities?

    • A.

      Prolonged PTT

    • B.

      Increased FDP

    • C.

      Increased Fibrinogen

    • D.

      Decreased D-Dimer

    • E.

      Decreased Plt Count

    Correct Answer(s)
    A. Prolonged PTT
    B. Increased FDP
    E. Decreased Plt Count
    Explanation
    DIC (Disseminated Intravascular Coagulation) is a condition characterized by widespread activation of the clotting cascade, leading to both thrombosis and bleeding. Prolonged PTT (Partial Thromboplastin Time) is a common lab abnormality seen in DIC due to consumption of clotting factors. Increased FDP (Fibrin Degradation Products) is also seen as a result of fibrinolysis. Decreased Plt (Platelet) count occurs due to platelet consumption and activation. Therefore, the correct lab abnormalities in DIC are Prolonged PTT, Increased FDP, and Decreased Plt Count. Increased Fibrinogen and Decreased D-Dimer are not typically seen in DIC.

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  • 36. 

    Transfusion on multiple units of PRBC’s is associated with decreased levels of platelets, fibrinogen, and coagulation factors.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Transfusion of multiple units of PRBCs (packed red blood cells) can lead to a decrease in platelet levels, fibrinogen levels, and coagulation factors. This is because PRBC transfusions do not contain these components, and repeated transfusions can dilute the existing levels in the recipient's blood. Consequently, this can impair the blood's ability to clot properly and increase the risk of bleeding. Therefore, the statement is true.

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  • 37. 

    Following gastric bypass many patients must take vitamin supplements such as calcium, iron, and B12. A patient who is non-compliant with these vitamins may be at an increased risk for developing which of the following?

    • A.

      Thrombophilia

    • B.

      Anemia

    • C.

      Coagulopathy

    • D.

      Fluid Overload

    Correct Answer
    B. Anemia
    Explanation
    A patient who is non-compliant with vitamin supplements such as calcium, iron, and B12 after gastric bypass surgery may be at an increased risk for developing anemia. This is because these vitamins are essential for the production of healthy red blood cells, and a deficiency in any of them can lead to decreased red blood cell production and subsequently anemia. Anemia is characterized by a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood, resulting in symptoms such as fatigue, weakness, and shortness of breath.

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  • 38. 

    Mr. Quoya has just received a blood transfusion of two units of type B+ blood. Woops…. He is A-. This is most likely to result in which of the following?

    • A.

      Pernicious Anemia

    • B.

      Iron Deficient Anemia

    • C.

      Hemolytic Anemia

    • D.

      Aplastic Anemia

    Correct Answer
    C. Hemolytic Anemia
    Explanation
    Hemolytic Anemia occurs when there is an incompatibility between the blood types of the donor and the recipient. In this case, Mr. Quoya received type B+ blood, which is incompatible with his A- blood type. This leads to the destruction of the donor red blood cells by the recipient's immune system, causing hemolysis and resulting in Hemolytic Anemia.

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  • 39. 

    In sickle cell anemia, sickling will usually be noted once PO2 reaches a pressure of…

    • A.

      20-30 mm HG

    • B.

      50-60 mm HG

    • C.

      45-55 mm HG

    • D.

      30-40 mm HG

    Correct Answer
    D. 30-40 mm HG
    Explanation
    Sickle cell anemia is a genetic disorder that affects the shape of red blood cells. When the oxygen level in the blood is low, these abnormal red blood cells can become rigid and take on a sickle shape. This process is known as sickling. The question is asking at what level of oxygen pressure sickling is usually noted. The correct answer is 30-40 mm HG, indicating that sickling is more likely to occur when the oxygen pressure in the blood is at this range.

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  • 40. 

    To prepare a patient with sickle cell anemia for surgry, your HCT should ideally be at least…

    • A.

      35%

    • B.

      28%

    • C.

      30%

    • D.

      33%

    Correct Answer
    A. 35%
    Explanation
    The ideal hematocrit (HCT) level for a patient with sickle cell anemia before surgery should be at least 35%. Hematocrit is a measure of the percentage of red blood cells in the total blood volume. In sickle cell anemia, the red blood cells are abnormally shaped, leading to a decreased oxygen-carrying capacity and increased risk of complications during surgery. Maintaining a higher HCT level helps to ensure an adequate oxygen supply to the tissues and reduces the risk of complications such as tissue damage or organ failure. Therefore, a HCT level of at least 35% is recommended for surgical preparation in patients with sickle cell anemia.

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  • 41. 

    Which of the following is not a known precipitating factor of a sickle cell crisis?

    • A.

      Acidosis

    • B.

      Fluid Overload

    • C.

      Stress

    • D.

      Hypothermia

    Correct Answer
    B. Fluid Overload
    Explanation
    Fluid overload is not a known precipitating factor of a sickle cell crisis. A sickle cell crisis is typically triggered by factors that cause the red blood cells to become sickle-shaped and block blood flow, leading to pain and other complications. Acidosis, stress, and hypothermia are known precipitating factors as they can cause the red blood cells to sickle. However, fluid overload does not directly affect the shape of the red blood cells and is therefore not a known precipitating factor of a sickle cell crisis.

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  • 42. 

    Which of the following is true regarding anesthetic management of the pt with sickle cell anemia?

    • A.

      Narcotics should be avoided due to risk of respiratory suppression

    • B.

      During surgery, a slight hypothermia should be maintained

    • C.

      Pt should receive generous IV fluids to be well hydrated

    • D.

      All the above are false

    Correct Answer
    C. Pt should receive generous IV fluids to be well hydrated
    Explanation
    Anesthetic management of a patient with sickle cell anemia involves providing generous IV fluids to ensure the patient is well hydrated. This is because sickle cell anemia can cause vaso-occlusive crises, which can be triggered by dehydration. By maintaining good hydration, the risk of vaso-occlusive crises can be reduced. Narcotics should not be avoided due to the risk of respiratory suppression, and maintaining slight hypothermia during surgery is not a true statement regarding anesthetic management of these patients.

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  • 43. 

    The presence of hemoglobin S is seen in what disorder?

    • A.

      Aplastic Anemia

    • B.

      Fanconi Anemia

    • C.

      Megaloblastic anemia

    • D.

      Sickle cell anemia

    Correct Answer
    D. Sickle cell anemia
    Explanation
    Sickle cell anemia is caused by the presence of hemoglobin S, an abnormal form of hemoglobin. This disorder is characterized by the production of crescent-shaped red blood cells that can get stuck in blood vessels, leading to pain, organ damage, and other complications. The other options listed, such as aplastic anemia, Fanconi anemia, and megaloblastic anemia, are not associated with the presence of hemoglobin S.

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  • 44. 

    The liver is divided into right and left lobes by what?

    • A.

      Falciform ligament

    • B.

      Hilum

    • C.

      Left Triangular Ligament

    • D.

      Ampulla of vater

    Correct Answer
    A. Falciform ligament
    Explanation
    The liver is divided into right and left lobes by the falciform ligament. This ligament is a fold of peritoneum that attaches the liver to the anterior abdominal wall and separates the liver into two distinct lobes. It is a thin, flat structure that runs from the diaphragm to the anterior abdominal wall, and its presence helps to maintain the position and stability of the liver within the abdominal cavity.

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  • 45. 

    Sympathetic stimulation of the liver is provided by the spinal nerves of…

    • A.

      T1- T5

    • B.

      T6- T11

    • C.

      C5- T2

    • D.

      T10 – L2

    Correct Answer
    B. T6- T11
    Explanation
    The correct answer is T6-T11. The sympathetic stimulation of the liver is provided by the spinal nerves in this region. These nerves originate from the thoracic region of the spinal cord and innervate various organs including the liver. The sympathetic nervous system is responsible for regulating various physiological processes, including liver function, by increasing blood flow and promoting glucose release. Therefore, stimulation of the sympathetic nerves in the T6-T11 region would affect liver function.

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  • 46. 

    Parasympathetic stimulation of the liver comes mainly from what nerve?

    • A.

      Accessory

    • B.

      Hypoglossal

    • C.

      Vagus

    • D.

      Abducens

    Correct Answer
    C. Vagus
    Explanation
    Parasympathetic stimulation of the liver primarily occurs through the Vagus nerve. The Vagus nerve, also known as the tenth cranial nerve, innervates various organs in the body, including the liver. It plays a crucial role in regulating various bodily functions, including digestion and metabolism. Therefore, the Vagus nerve is responsible for transmitting parasympathetic signals to the liver, promoting activities such as bile production and glucose metabolism.

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  • 47. 

    Which of the following is not a function of the liver?

    • A.

      Production of coagulation Factors 1 & 2

    • B.

      Secretion of Bile

    • C.

      Fat Metabolism and cholesterol synthesis

    • D.

      Production and Release of the Hormone Calcitriol

    Correct Answer
    D. Production and Release of the Hormone Calcitriol
    Explanation
    The liver is responsible for many important functions in the body, including the production of coagulation factors 1 & 2, secretion of bile, and fat metabolism and cholesterol synthesis. However, the liver does not produce and release the hormone calcitriol. Calcitriol is actually produced in the kidneys from its precursor, vitamin D, and plays a role in regulating calcium and phosphorus levels in the body.

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  • 48. 

    Where would you find Kupfer cells?

    • A.

      Lining sinusoids between liver cells

    • B.

      Within endothelial cells of blood vessels

    • C.

      Lining portal tracts of each lobule

    • D.

      Specialized cells within bile canaliculi

    Correct Answer
    A. Lining sinusoids between liver cells
    Explanation
    Kupffer cells are a type of specialized macrophage found in the liver. They are responsible for removing foreign substances, such as bacteria and old red blood cells, from the blood. The sinusoids are blood vessels within the liver that are lined by liver cells, and it is within these sinusoids that Kupffer cells are found. Therefore, the correct answer is "Lining sinusoids between liver cells."

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  • 49. 

    The most well oxygenated cells in the hepatic lobules are those located….

    • A.

      Closest to central vein

    • B.

      Closest to Portal tract

    • C.

      Closest to Space of Disse

    • D.

      Closest to Kupfer Cells

    Correct Answer
    B. Closest to Portal tract
    Explanation
    The most well oxygenated cells in the hepatic lobules are those located closest to the Portal tract. The Portal tract contains branches of the hepatic artery, which supplies oxygenated blood to the liver. As the blood flows through the sinusoids in the lobules, the cells closest to the Portal tract receive the highest concentration of oxygen.

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  • 50. 

    Venous drainage from the liver goes into the…

    • A.

      Portal Vein

    • B.

      Superior vena Cava

    • C.

      Inferior Vena Cava

    • D.

      Biliary vein

    Correct Answer
    C. Inferior Vena Cava
    Explanation
    The correct answer is Inferior Vena Cava. The liver receives blood from two sources - the hepatic artery, which carries oxygenated blood, and the portal vein, which carries nutrient-rich blood from the digestive organs. After the blood passes through the liver, it is drained by the hepatic veins into the inferior vena cava, which then carries the deoxygenated blood back to the heart. Therefore, the inferior vena cava is responsible for the venous drainage from the liver.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Jan 03, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 31, 2009
    Quiz Created by
    Scottishduffy
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