Master Hemostasis for your laboratory certification exam with our comprehensive collection of 160 multiple-choice questions (MCQs). Focused exclusively on Laboratory Determinations, these practice questions align with the latest syllabi of ASCP MLS, AMT MLT/MT, AIMS, CSMLS, IBMS, HAAD/DOH, DHA, and MOH exams. Each MCQ includes detailed explanations and references to reinforce key concepts. Sharpen your critical thinking, identify knowledge gaps, and build speed with exam-style questions—all for free. Ideal for targeted revision!
160 MCQs (573-732):
- Which test evaluates the extrinsic coagulation pathway?
A) aPTT
B) PT
C) TT
D) Fibrinogen assay - What reagent is essential in the PT test?
A) Platelet factor 3
B) Thromboplastin with calcium
C) Kaolin
D) Thrombin - A prolonged aPTT with a normal PT suggests a defect in:
A) Factor VII
B) Factor VIII
C) Factor X
D) Factor V - A normal PT and aPTT with clinical bleeding may be due to:
A) Vitamin K deficiency
B) Platelet function defect
C) Factor IX deficiency
D) DIC - Which factor is exclusive to the extrinsic pathway?
A) Factor IX
B) Factor VIII
C) Factor VII
D) Factor X - A thrombin time is used to evaluate:
A) Fibrinogen to fibrin conversion
B) Intrinsic factor activity
C) Platelet aggregation
D) D-dimer - The primary cause of prolonged thrombin time:
A) Factor V deficiency
B) Low fibrinogen
C) Heparin contamination
D) Protein C defect - What test differentiates a factor deficiency from an inhibitor?
A) Bleeding time
B) Mixing study (50:50 correction)
C) Fibrinogen assay
D) Thrombin time - A 50:50 mix that corrects the prolonged aPTT suggests:
A) Presence of lupus anticoagulant
B) Presence of heparin
C) Factor deficiency
D) Factor inhibitor - Which test is most useful to monitor heparin therapy?
A) PT
B) aPTT
C) Fibrinogen
D) Thrombin time - In DIC, which lab result is most commonly elevated?
A) Platelet count
B) Fibrinogen
C) D-dimer
D) Factor VIII - The best screening test for von Willebrand disease is:
A) aPTT
B) PT
C) Bleeding time
D) Ristocetin cofactor activity - Platelet aggregation tests help diagnose:
A) Thalassemia
B) Hemophilia
C) Bernard-Soulier syndrome
D) DIC - What is evaluated by the platelet function analyzer (PFA-100)?
A) Factor X activity
B) Platelet adhesion and aggregation
C) aPTT
D) D-dimer - What is the reference range for bleeding time (template method)?
A) 1–2 min
B) 2–4 min
C) 2–9 min
D) 6–12 min - Which test is prolonged in aspirin therapy?
A) PT
B) Platelet count
C) Bleeding time
D) D-dimer - In platelet aggregation studies, a lack of response to ristocetin indicates:
A) Glanzmann thrombasthenia
B) von Willebrand disease
C) Bernard-Soulier syndrome
D) Storage pool disease - A prolonged aPTT and normal PT may be due to deficiency in:
A) Factor VII
B) Factor X
C) Factor VIII
D) Factor V - Which factor is vitamin K dependent?
A) Factor V
B) Factor VIII
C) Factor X
D) Factor I - A normal PT and prolonged aPTT that doesn’t correct with mixing suggests:
A) Heparin contamination
B) Factor deficiency
C) Lupus anticoagulant
D) DIC - The screening test most affected by factor VII deficiency is:
A) aPTT
B) PT
C) Thrombin time
D) Platelet aggregation - Which test is prolonged in both hemophilia A and B?
A) PT
B) aPTT
C) Platelet count
D) Thrombin time - Lupus anticoagulant typically causes:
A) Bleeding
B) Prolonged PT
C) Thrombosis
D) Increased fibrinogen - Which factor is most labile in stored plasma?
A) Factor II
B) Factor V
C) Factor IX
D) Factor XIII - The fibrin degradation product (FDP) test detects:
A) Platelet fragments
B) Cross-linked fibrin
C) Thrombin inhibitors
D) Uncross-linked fibrin monomers - What does D-dimer specifically indicate?
A) Fibrinogen degradation
B) Platelet lysis
C) Cross-linked fibrin breakdown
D) Von Willebrand factor activity - An increased D-dimer with thrombocytopenia suggests:
A) Hemophilia A
B) Vitamin K deficiency
C) DIC
D) Platelet function defect - Ristocetin-induced platelet aggregation evaluates the function of:
A) Fibrinogen
B) Factor VIII
C) von Willebrand factor
D) Platelet glycoprotein IIb/IIIa - Thrombin time is prolonged in the presence of:
A) Vitamin K
B) Platelet clumping
C) Heparin
D) Factor VII deficiency - A shortened aPTT may be seen in:
A) Factor deficiency
B) Anticoagulant therapy
C) Acute phase reaction
D) Platelet disorders - The PT is used to monitor therapy with:
A) Heparin
B) Warfarin
C) Aspirin
D) Streptokinase - The International Normalized Ratio (INR) is based on which test?
A) aPTT
B) PT
C) Bleeding time
D) Fibrinogen assay - Which condition is most associated with low fibrinogen and elevated FDPs?
A) von Willebrand disease
B) DIC
C) Hemophilia B
D) Thrombocytosis - The aPTT test requires addition of:
A) Tissue factor
B) Calcium and phospholipid
C) Thrombin
D) EDTA - Platelet aggregation with ADP is absent in:
A) von Willebrand disease
B) Glanzmann thrombasthenia
C) Bernard-Soulier syndrome
D) Factor VIII deficiency - Which condition shows normal aggregation with ristocetin but abnormal response to other agonists?
A) Glanzmann thrombasthenia
B) von Willebrand disease
C) Bernard-Soulier syndrome
D) Storage pool deficiency - Factor assays are performed when:
A) Both PT and aPTT are prolonged
B) PT is prolonged but aPTT is normal
C) Bleeding time is prolonged
D) Fibrinogen is low - Platelet adhesion is defective in:
A) Glanzmann thrombasthenia
B) Bernard-Soulier syndrome
C) Storage pool disease
D) Factor IX deficiency - A 5M urea clot solubility test screens for:
A) Factor V
B) Factor VIII
C) Factor XIII
D) Factor VII - Which condition may result in prolonged PT and aPTT?
A) Hemophilia A
B) von Willebrand disease
C) Liver disease
D) Glanzmann thrombasthenia - The lupus anticoagulant interferes with:
A) PT only
B) TT only
C) aPTT primarily
D) Bleeding time - Which of the following is used to assess platelet secretion defects?
A) Bleeding time
B) Platelet aggregation with thrombin
C) ATP release assay
D) aPTT - The most useful screening test for detecting aspirin effect is:
A) PT
B) aPTT
C) Platelet function analyzer (PFA-100)
D) Platelet count - A patient has abnormal bleeding, normal platelet count, prolonged bleeding time, and reduced ristocetin cofactor. The most likely cause is:
A) Bernard-Soulier syndrome
B) von Willebrand disease
C) Glanzmann thrombasthenia
D) Factor VII deficiency - Factor VIII levels are increased in:
A) von Willebrand disease
B) DIC
C) Inflammation
D) Hemophilia A - The clot retraction test evaluates:
A) Platelet count
B) Platelet contractile proteins
C) Fibrinogen levels
D) Coagulation factors - The urea solubility test helps detect deficiency of:
A) Factor XIII
B) Factor X
C) Fibrinogen
D) Platelets - Ristocetin-induced aggregation is absent in:
A) Glanzmann thrombasthenia
B) Bernard-Soulier syndrome
C) von Willebrand disease
D) Storage pool disease - An aPTT that remains prolonged after a mixing study suggests:
A) Factor VIII deficiency
B) Lupus anticoagulant
C) Factor IX deficiency
D) Normal variant - A patient has prolonged PT and aPTT. Fibrinogen is low. Platelets are decreased. D-dimer is high. Diagnosis?
A) Liver disease
B) Hemophilia
C) von Willebrand disease
D) DIC - Which test is best for monitoring low molecular weight heparin (LMWH)?
A) PT
B) aPTT
C) Anti-Xa assay
D) Bleeding time - The coagulation factor most likely deficient if PT is prolonged and aPTT is normal:
A) Factor VIII
B) Factor IX
C) Factor VII
D) Factor XI - Which factor is involved in cross-linking fibrin?
A) Factor VIII
B) Factor XIII
C) Factor V
D) Factor X
- What is measured by a D-dimer test?
A) Fibrin monomers
B) FDPs from fibrinogen
C) Degradation of cross-linked fibrin
D) Plasmin activity - The effect of heparin on coagulation is best monitored using:
A) PT
B) aPTT
C) INR
D) Bleeding time - INR standardizes results for which test?
A) aPTT
B) Thrombin time
C) PT
D) Bleeding time - A reduced platelet aggregation with ADP and collagen but normal with ristocetin suggests:
A) von Willebrand disease
B) Bernard-Soulier syndrome
C) Glanzmann thrombasthenia
D) Aspirin effect - Which test detects factor XIII deficiency?
A) PT
B) aPTT
C) Thrombin time
D) 5M urea solubility test - Which coagulation protein is not synthesized by the liver?
A) Factor VIII
B) Factor IX
C) Fibrinogen
D) Factor II - PT and aPTT are both prolonged in:
A) Hemophilia A
B) von Willebrand disease
C) Liver disease
D) Glanzmann thrombasthenia - The presence of which antibody leads to a prolonged aPTT without bleeding symptoms?
A) Anti-factor IX
B) Anti-thrombin
C) Lupus anticoagulant
D) Anti-platelet antibody - A patient with prolonged bleeding time, normal platelet count, and defective aggregation with ristocetin likely has:
A) Glanzmann thrombasthenia
B) von Willebrand disease
C) Bernard-Soulier syndrome
D) Storage pool disease - What test best assesses the effectiveness of warfarin therapy?
A) aPTT
B) PT/INR
C) Thrombin time
D) Platelet aggregation - What is the purpose of the mixing study in coagulation testing?
A) Measure fibrinolysis
B) Distinguish between inhibitor vs deficiency
C) Determine platelet count
D) Detect von Willebrand disease - Which of the following will not correct in a mixing study?
A) Factor VIII deficiency
B) Lupus anticoagulant
C) Factor IX deficiency
D) Factor XI deficiency - Platelet aggregation studies show no response to ADP, collagen, and epinephrine but normal with ristocetin. Diagnosis?
A) Bernard-Soulier syndrome
B) Glanzmann thrombasthenia
C) von Willebrand disease
D) Factor VII deficiency - What result would you expect in aspirin ingestion?
A) Normal bleeding time
B) Increased ristocetin aggregation
C) Decreased aggregation with arachidonic acid
D) Decreased D-dimer - Which test differentiates DIC from primary fibrinolysis?
A) Fibrinogen
B) Platelet count
C) D-dimer
D) aPTT - A prolonged PT and aPTT that corrects with vitamin K suggests:
A) Liver failure
B) Vitamin K deficiency
C) DIC
D) Hemophilia A - The role of calcium in coagulation testing is to:
A) Initiate fibrinolysis
B) Prevent clotting
C) Reverse anticoagulant
D) Recalcify plasma - Which test directly assesses fibrinogen function?
A) PT
B) Thrombin time
C) aPTT
D) Platelet function - Which factor remains stable in stored plasma?
A) Factor V
B) Factor VIII
C) Factor II
D) Factor VII - The screening test for platelet adhesion is:
A) PT
B) Platelet count
C) Bleeding time
D) Thrombin time - What is typically prolonged in patients with liver disease?
A) aPTT only
B) PT only
C) PT and aPTT
D) Bleeding time - Which coagulation test is most affected by factor VII?
A) aPTT
B) PT
C) Thrombin time
D) Clot solubility - Platelet aggregation with normal response to ristocetin but poor response to ADP and collagen suggests:
A) Glanzmann thrombasthenia
B) von Willebrand disease
C) Bernard-Soulier syndrome
D) Storage pool disease - What condition may present with low platelets, high PT, high aPTT, and elevated D-dimer?
A) Hemophilia A
B) DIC
C) von Willebrand disease
D) Bernard-Soulier syndrome - Which test is not used to evaluate primary hemostasis?
A) Bleeding time
B) Platelet count
C) Platelet aggregation
D) PT - The presence of FDPs indicates:
A) Fibrinolysis
B) Coagulation defect
C) Platelet function defect
D) Vitamin K deficiency - An isolated prolonged thrombin time suggests:
A) Factor VIII deficiency
B) Heparin presence
C) Factor VII deficiency
D) Lupus anticoagulant - A patient receiving clopidogrel undergoes platelet aggregation testing. Which agonist would show a reduced aggregation response?
A) Collagen
B) Epinephrine
C) Ristocetin
D) ADP - In Glanzmann thrombasthenia, what would a light transmission aggregation curve demonstrate?
A) Reduced response to ristocetin
B) Normal aggregation to all agonists
C) Increased response to ristocetin
D) Minimal aggregation to ADP, epinephrine, and collagen - Which of the following tests is most likely to be abnormal in a patient regularly taking aspirin for arthritis?
A) Platelet count
B) PFA-100
C) PT
D) aPTT - What is the characteristic platelet response seen in Type 2B von Willebrand disease?
A) Decreased aggregation with low-dose ristocetin
B) Normal aggregation with low-dose ristocetin
C) Enhanced aggregation with low-dose ristocetin
D) Decreased aggregation with high-dose ristocetin - What is the final product responsible for amplifying platelet aggregation?
A) Cyclooxygenase
B) Arachidonic acid
C) Prostacyclin
D) Thromboxane A₂ - A patient’s aggregation test shows no response to ADP or collagen but a normal response to ristocetin. What is the likely diagnosis?
A) von Willebrand disease
B) Storage pool disorder
C) Glanzmann thrombasthenia
D) Aspirin effect - Which of the following does not affect closure time in the PFA-100 assay?
A) Aspirin
B) Thrombocytopenia
C) Anemia
D) Leukopenia - Which is considered the gold standard for diagnosing heparin-induced thrombocytopenia (HIT)?
A) PF4 ELISA
B) Ristocetin cofactor assay
C) Reptilase time
D) Serotonin release assay - What does the secondary wave in ADP or epinephrine-induced platelet aggregation indicate?
A) Fibrin formation
B) Platelet shape change
C) Granule secretion
D) Clot retraction - What is observed during platelet aggregation as platelets clump?
A) Light absorbance increases
B) Light transmission increases
C) Light absorbance decreases
D) Light transmission decreases - Thromboelastography (TEG) provides a global assessment of what processes?
A) Platelet count and fibrinogen level
B) Clot initiation, clot strength, and fibrinolysis
C) Coagulation factor deficiencies
D) Platelet adhesion only - An aggregation study reveals enhanced platelet response to low-dose ristocetin but normal response to high-dose ristocetin. What is the likely diagnosis?
A) Type 1 von Willebrand disease
B) Type 2 von Willebrand disease
C) Type 3 von Willebrand disease
D) Normal platelet function - A thromboelastography (TEG) tracing from a post-cardiac surgery patient reveals rapid clot development. What does this indicate?
A) Over-anticoagulation
B) Adequate anticoagulation
C) Inadequate anticoagulation
D) Platelet disorder - Which coagulation factor is most unstable in stored plasma samples?
A) Factor II
B) Factor VII
C) Factor VIII
D) Factor X - A person with prolonged aPTT and no clinical bleeding is likely deficient in which factor?
A) Factor VIII
B) Factor XI
C) Factor XII
D) Factor IX - A patient presents with PT = 18.5 sec (↑), aPTT = 47.5 sec (↑), thrombin time normal, antithrombin = 82%, protein C = 54%, and protein S = 48%. What is the most likely explanation?
A) Thrombophilia
B) Hemophilia
C) Heparin use
D) Warfarin therapy - Which condition is associated with a higher risk of thrombosis due to lack of natural anticoagulants?
A) Fibrinogen deficiency
B) Platelet dysfunction
C) Protein C deficiency
D) Factor VIII deficiency - Biological assays for antithrombin measure its ability to inhibit which target?
A) Factor VIII
B) Protein C
C) Serine proteases
D) Heparin - A patient with low protein S activity and antigen levels but normal C4b-binding protein has which type of protein S deficiency?
A) No deficiency
B) Type I
C) Type II
D) Type III - Which molecular test is used to confirm activated protein C resistance?
A) MTHFR mutation
B) PAI-1 polymorphism
C) Factor V Leiden
D) Prothrombin G20210A mutation - Which lab test is most appropriate for monitoring unfractionated heparin therapy?
A) PT
B) INR
C) aPTT
D) Platelet count - A mixing study shows aPTT correction immediately after mixing, but prolongation after incubation. What does this suggest?
A) Factor deficiency
B) Circulating time-dependent inhibitor
C) Low fibrinogen
D) Antithrombin deficiency - Warfarin treatment has the most impact on which naturally occurring anticoagulant?
A) Antithrombin
B) Protein S
C) Factor V Leiden
D) Protein C - Which test is most sensitive to the presence of heparin in a blood sample?
A) PT
B) Fibrinogen
C) Thrombin time (TT)
D) D-dimer - In the Clauss method for fibrinogen measurement, what reagent is added to patient plasma?
A) Calcium
B) Kaolin
C) Thrombin
D) Tissue thromboplastin - Which test is most appropriate for monitoring low molecular weight heparin (LMWH) therapy?
A) aPTT
B) PT
C) Anti-Xa assay
D) Thrombin time - High levels of factor VIII in the blood will have what effect on aPTT?
A) Prolong aPTT
B) No change
C) Shorten aPTT
D) Cause invalid result - Activated protein C resistance is due to a mutation in which factor?
A) Factor V
B) Factor VIII
C) Protein S
D) Antithrombin - What is the most common inherited thrombophilia in the general population?
A) Protein S deficiency
B) Antithrombin deficiency
C) Factor V Leiden
D) Prothrombin mutation - Which condition is associated with purpura fulminans in neonates?
A) Protein S deficiency
B) Antithrombin deficiency
C) Severe protein C deficiency
D) Platelet transfusion reactions - Heparin resistance is most commonly associated with a deficiency in which protein?
A) Protein C
B) Protein S
C) Antithrombin
D) Factor VII - Which protein does heparin bind to in order to exert its anticoagulant effect?
A) Protein C
B) Protein S
C) Factor Xa
D) Antithrombin - The dilute Russell viper venom test (dRVVT) screen reagent contains:
A) High levels of phospholipids
B) No phospholipid
C) Low phospholipid content
D) Hexagonal phospholipid - What does a chromogenic anti-Xa assay measure?
A) Platelet aggregation
B) Factor Xa enzymatic activity using a colored substrate
C) Clot formation rate
D) Plasma fibrinogen level - Which test is the standard method for measuring factor VIII inhibitors?
A) ELISA
B) Clauss assay
C) Bethesda assay
D) Mixing study - An elevated D-dimer result reflects:
A) Increased thrombin formation
B) Platelet activation
C) Breakdown of crosslinked fibrin
D) Increased fibrinogen production - In the Clauss method, which reagent is used to initiate clot formation?
A) Tissue factor
B) Kaolin
C) Thrombin
D) Calcium - The source of D-dimer fragments in the blood is:
A) Fibrinogen degradation
B) Non-crosslinked fibrin
C) Crosslinked fibrin
D) Platelet granule release - A shortened aPTT result may be caused by:
A) Factor XII deficiency
B) Anticoagulant therapy
C) Acute phase reaction
D) Vitamin K deficiency - A sample drawn from a heparinized line shows a prolonged aPTT and thrombin time. What should be done first?
A) Repeat sample
B) Mixing study
C) Neutralize heparin in the sample
D) Perform factor assays - A patient with a mechanical heart valve has an INR of 3.1. What is the appropriate action?
A) Stop warfarin
B) Reduce warfarin dose
C) Increase warfarin dose
D) Continue current dose - A new PT reagent has an ISI (International Sensitivity Index) of 1.0, while the old reagent had an ISI of 2.1. The new reagent is:
A) Less sensitive
B) More sensitive
C) Unusable
D) Equivalent in sensitivity - A patient with a hematocrit of 76% has a prolonged PT and aPTT, but no bleeding. What is the likely explanation?
A) Liver disease
B) Polycythemia vera
C) Factor X deficiency
D) DIC - A patient receiving LMWH has an anti-Xa level of 0.9 U/mL. This indicates:
A) Subtherapeutic dosing
B) Therapeutic range
C) Supratherapeutic level
D) Risk of bleeding - A stored frozen plasma sample shows a shortened aPTT compared to the original result. What could explain this change?
A) Wrong reagent
B) Platelet contamination
C) Temperature fluctuation
D) Sample hemolysis - After cardiac surgery, a patient shows prolonged PT and aPTT that do not correct with mixing. What is the likely cause?
A) Lupus anticoagulant
B) Acquired factor inhibitor
C) Heparin contamination
D) Low fibrinogen - A prolonged PT with a normal aPTT, corrected by mixing, is most consistent with deficiency of:
A) Factor V
B) Factor VII
C) Factor IX
D) Factor X - A multiple myeloma patient shows prolonged aPTT and thrombin time, both uncorrected by mixing, but normal fibrinogen and reptilase time. This may be due to:
A) Vitamin K deficiency
B) Heparin-like anticoagulant
C) Factor XII deficiency
D) Low platelets
- A patient with prolonged PT and aPTT that corrects with mixing likely has deficiency of which factor?
A) Factor V
B) Factor X
C) Factor VIII
D) Factor XII - A patient on long-term antibiotics has low levels of factors II, VII, IX, and X, with normal factor V and VIII. What is the most likely cause?
A) Liver disease
B) Platelet dysfunction
C) Vitamin K deficiency
D) Hemophilia A - A persistently prolonged aPTT that corrects with mixing but no bleeding history is most likely due to deficiency in:
A) Factor VIII
B) Factor IX
C) Factor XI
D) Factor XII - A patient receiving low molecular weight heparin (LMWH) has an aPTT of 30 seconds. What does this indicate?
A) Subtherapeutic response
B) Therapeutic aPTT
C) Supratherapeutic heparin effect
D) Irrelevant result - A thrombophilia panel (protein C, protein S, antithrombin, lupus anticoagulant) is negative. What test should be ordered next?
A) MTHFR mutation
B) PAI-1 genotype
C) Factor V Leiden mutation
D) Factor XIII assay - How can hemophilia B be differentiated from hemophilia A?
A) Hemophilia B has normal factor VIII activity
B) Both have low factor VIII levels
C) Both show prolonged PT
D) Hemophilia B has low ristocetin cofactor - A septic patient presents with elevated PT/aPTT, low fibrinogen, and increased D-dimer. What is the most likely diagnosis?
A) DVT
B) TTP
C) DIC
D) APS - During pregnancy, which coagulation factor typically increases alongside fibrinogen?
A) Factor VII
B) Factor XI
C) Factor VIII
D) Factor XIII - What is the factor VIII activity level in severe hemophilia A?
A) <1%
B) 1–5%
C) 6–30%
D) >30% - A patient has factor VIII = 2%, vWF antigen = 3%, and ristocetin cofactor <1%. What type of von Willebrand disease is this?
A) Type 1
B) Type 2
C) Type 2B
D) Type 3 - In the dRVVT, screen = 62 seconds, confirm = 49 seconds. What is the ratio?
A) 1.18
B) 1.26
C) 1.35
D) 1.47 - Given:
- 1. dRVVT screen = 75 sec, PNP = 35 sec
- 2. Confirm = 38 sec, PNP = 36 sec
What is the normalized ratio?
A) 1.89
B) 2.03
C) 2.25
D) 2.48
- Which condition causes an uncorrected prolonged aPTT after a mixing study?
A) Hemophilia A
B) Hemophilia B
C) Heparin therapy
D) Factor VIII deficiency - In which von Willebrand subtype is platelet aggregation enhanced with low-dose ristocetin?
A) Type 1
B) Type 2A
C) Type 2B
D) Type 2N - Rare congenital bleeding disorders are most commonly seen in which context?
A) Autosomal dominant inheritance
B) Consanguineous families
C) Male-only pedigrees
D) Vitamin K–deficient states - Which of the following lab findings is most consistent with acute DIC?
A) Increased platelet count
B) Shortened PT
C) Decreased D-dimer
D) Decreased platelet count - Prolonged PT and bleeding following antibiotic therapy is most likely due to:
A) Liver failure
B) Aspirin overdose
C) Vitamin K deficiency
D) Factor VIII inhibitor - What is a common cause of inhibitor development in hemophilia A patients?
A) Viral infection
B) Vaccination
C) Factor VIII replacement therapy
D) Iron deficiency - What distinguishes acquired hemophilia A from congenital hemophilia A?
A) Found primarily in young men
B) Caused by genetic mutation
C) Caused by autoimmune antibodies
D) Associated with platelet deficiency - An uncorrected aPTT mixing study in a bleeding child is indicative of:
A) von Willebrand disease
B) Hemophilia B
C) Hemophilia A with inhibitor
D) Vitamin K deficiency - Which of the following is the fastest way to reverse warfarin-induced bleeding?
A) Vitamin K injection
B) Protamine sulfate
C) Fresh frozen plasma
D) Desmopressin (DDAVP) - To detect lupus anticoagulant, the aPTT reagent should contain:
A) No phospholipid
B) High phospholipid
C) Low phospholipid
D) Heparin neutralizer - Which best describes factor XII deficiency?
A) Normal clotting tests
B) Severe clinical bleeding
C) Prolonged aPTT without bleeding
D) Decreased platelet count - A factor XI assay shows the following results:
> 1:10 dilution = 23%
> 1:20 dilution = 42%
> 1:40 dilution = 80%
What do these findings suggest?
A) Factor XI deficiency
B) Poor specimen quality
C) Inhibitor presence
D) Normal result - A patient has normal PT, aPTT, platelet count, and fibrinogen but experiences delayed bleeding after suture removal. What condition should be suspected?
A) von Willebrand disease
B) Factor XIII deficiency
C) DIC
D) Hemophilia A - In lupus anticoagulant-positive patients, bleeding may occur due to:
A) Factor VIII inhibition
B) Low fibrinogen
C) Antibodies against prothrombin
D) Platelet dysfunction - Which lab finding is consistent with Type I antithrombin deficiency?
A) Normal antigen, low activity
B) Low antigen, low activity
C) Low antigen, normal activity
D) Normal antigen, normal activity - A patient on unfractionated heparin has a subtherapeutic aPTT, but suspected DVT. What is the most appropriate test to monitor therapy?
A) Anti-IIa assay
B) Platelet count
C) Anti-Xa assay
D) PT - Following a positive dRVVT screen, what test is used to confirm lupus anticoagulant?
A) Thrombin time
B) Hexagonal phase phospholipid assay
C) Fibrinogen assay
D) Mixing study - What is the modern standard for treating hemophilia A or B?
A) Fresh frozen plasma
B) Extended half-life factor concentrates
C) Desmopressin (DDAVP)
D) Antifibrinolytics only - In patients with COVID-19, which coagulation test correlates most strongly with mortality risk?
A) PT
B) aPTT
C) D-dimer
D) Bleeding time - According to the cell-based coagulation model, clotting is initiated on:
A) Activated platelet membranes
B) Endothelial cells
C) Subendothelial collagen
D) Tissue factor-bearing cells
Answer Key
Answer Key:
- B) PT
- B) Thromboplastin with calcium
- B) Factor VIII
- B) Platelet function defect
- C) Factor VII
- A) Fibrinogen to fibrin conversion
- C) Heparin contamination
- B) Mixing study (50:50 correction)
- C) Factor deficiency
- B) aPTT
- C) D-dimer
- D) Ristocetin cofactor activity
- C) Bernard-Soulier syndrome
- B) Platelet adhesion and aggregation
- C) 2–9 min
- C) Bleeding time
- C) Bernard-Soulier syndrome
- C) Factor VIII
- C) Factor X
- C) Lupus anticoagulant
- B) PT
- B) aPTT
- C) Thrombosis
- B) Factor V
- B) Cross-linked fibrin
- C) Cross-linked fibrin breakdown
- C) DIC
- C) von Willebrand factor
- C) Heparin
- C) Acute phase reaction
- B) Warfarin
- B) PT
- B) DIC
- B) Calcium and phospholipid
- B) Glanzmann thrombasthenia
- A) Glanzmann thrombasthenia
- A) Both PT and aPTT are prolonged
- B) Bernard-Soulier syndrome
- C) Factor XIII
- C) Liver disease
- C) aPTT primarily
- C) ATP release assay
- C) Platelet function analyzer (PFA-100)
- B) von Willebrand disease
- C) Inflammation
- B) Platelet contractile proteins
- A) Factor XIII
- B) Bernard-Soulier syndrome
- B) Lupus anticoagulant
- D) DIC
- C) Anti-Xa assay
- C) Factor VII
- B) Factor XIII
- C) Degradation of cross-linked fibrin
- B) aPTT
- C) PT
- C) Glanzmann thrombasthenia
- D) 5M urea solubility test
- A) Factor VIII
- C) Liver disease
- C) Lupus anticoagulant
- B) von Willebrand disease
- B) PT/INR
- B) Distinguish between inhibitor vs deficiency
- B) Lupus anticoagulant
- B) Glanzmann thrombasthenia
- C) Decreased aggregation with arachidonic acid
- C) D-dimer
- B) Vitamin K deficiency
- D) Recalcify plasma
- B) Thrombin time
- C) Factor II
- C) Bleeding time
- C) PT and aPTT
- B) PT
- A) Glanzmann thrombasthenia
- B) DIC
- D) PT
- A) Fibrinolysis
- B) Heparin presence
- D) ADP
- D) Minimal aggregation to ADP, epinephrine, and collagen
- B) PFA-100
- C) Enhanced aggregation with low-dose ristocetin
- D) Thromboxane A₂
- C) Glanzmann thrombasthenia
- D) Leukopenia
- D) Serotonin release assay
- C) Granule secretion
- B) Light transmission increases
- C) Coagulation factor deficiencies
- B) Type 2 von Willebrand disease
- C) Inadequate anticoagulation
- C) Factor VIII
- C) Factor XII
- D) Warfarin therapy
- C) Protein C deficiency
- C) Serine proteases
- B) Type I
- C) Factor V Leiden
- C) aPTT
- B) Circulating time-dependent inhibitor
- D) Protein C
- C) Thrombin time (TT)
- C) Thrombin
- C) Anti-Xa assay
- C) Shorten aPTT
- A) Factor V
- C) Factor V Leiden
- C) Severe protein C deficiency
- C) Antithrombin
- D) Antithrombin
- C) Low phospholipid content
- B) Factor Xa enzymatic activity using a colored substrate
- C) Bethesda assay
- C) Breakdown of crosslinked fibrin
- C) Thrombin
- C) Crosslinked fibrin
- C) Acute phase reaction
- A) Repeat sample
- D) Continue current dose
- B) More sensitive
- B) Polycythemia vera
- B) Therapeutic range
- B) Platelet contamination
- D) Low fibrinogen
- B) Factor VII
- B) Heparin-like anticoagulant
- B) Factor X
- C) Vitamin K deficiency
- D) Factor XII
- D) Irrelevant result
- C) Factor V Leiden mutation
- A) Hemophilia B has normal factor VIII activity
- C) DIC
- C) Factor VIII
- A) <1%
- D) Type 3
- B) 1.26
- B) 2.03
- C) Heparin therapy
- C) Type 2B
- B) Consanguineous families
- D) Decreased platelet count
- C) Vitamin K deficiency
- C) Factor VIII replacement therapy
- C) Caused by autoimmune antibodies
- C) Hemophilia A with inhibitor
- C) Fresh frozen plasma
- C) Low phospholipid
- C) Prolonged aPTT without bleeding
- C) Inhibitor presence
- B) Factor XIII deficiency
- C) Antibodies against prothrombin
- B) Low antigen, low activity
- C) Anti-Xa assay
- B) Hexagonal phase phospholipid assay
- B) Extended half-life factor concentrates
- C) D-dimer
- D) Tissue factor-bearing cells
Top 8 Medical Laboratory Scientist (MLS) Exams:
Top 8 Medical Laboratory Scientist (MLS) Exams that are recognized globally and can help professionals validate their credentials and enhance their career opportunities:
1. ASCP – American Society for Clinical Pathology (USA)
- Exam Name: MLS(ASCP)
- Eligibility: Bachelor’s degree with clinical laboratory experience.
- Global Recognition: High
- Purpose: Certifies Medical Laboratory Scientists in the United States and internationally.
2. AMT – American Medical Technologists (USA)
- Exam Name: MLT(AMT) or MT(AMT)
- Eligibility: Academic and/or work experience in medical laboratory technology.
- Global Recognition: Moderate
- Purpose: Credentialing for medical technologists and technicians.
3. AIMS – Australian Institute of Medical and Clinical Scientists
- Exam Name: AIMS Certification Exam
- Eligibility: Assessment of qualifications and work experience.
- Recognition: Required for practice in Australia.
- Purpose: Certification and registration in Australia.
4. CSMLS – Canadian Society for Medical Laboratory Science
- Exam Name: CSMLS General or Subject-specific Exams
- Eligibility: Graduation from a CSMLS-accredited program or equivalent.
- Recognition: Canada
- Purpose: Entry-to-practice certification in Canada.
5. IBMS – Institute of Biomedical Science (UK)
- Exam Name: Registration and Specialist Portfolio Assessment
- Eligibility: Accredited degree and lab experience.
- Recognition: UK and some Commonwealth countries.
- Purpose: Biomedical Scientist registration with the HCPC (UK).
6. HAAD / DOH – Department of Health, Abu Dhabi (UAE)
- Exam Name: DOH/HAAD License Exam
- Eligibility: Degree in medical laboratory science and experience.
- Recognition: UAE (Abu Dhabi)
- Purpose: Licensure for medical laboratory practice in Abu Dhabi.
7. DHA – Dubai Health Authority (UAE)
- Exam Name: DHA License Exam for Medical Laboratory Technologists
- Eligibility: Relevant degree and experience.
- Recognition: Dubai, UAE
- Purpose: Professional license for clinical laboratory practice in Dubai.
8. MOH – Ministry of Health (Gulf Countries like UAE, Saudi Arabia, Kuwait)
- Exam Name: MOH License Exam
- Eligibility: BSc/Diploma in Medical Laboratory + experience.
- Recognition: Varies by country.
- Purpose: Required for practicing in public and private sector labs.
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