Hematology: Laboratory Evaluation of Secondary Hemostasis
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Questions and Answers

What is the purpose of evaluating clotting factors in Secondary Hemostasis?

  • Determine the presence of coagulation factors
  • Identify factor deficiencies (correct)
  • Check for platelet count abnormalities
  • Measure the amount of white blood cells

Which tube is checked first for clotting formation in the process described?

  • Tube #4
  • Tube #3
  • Tube #2
  • Tube #1 (correct)

What method is used to check clotting time in tube #3?

  • Dale and Laidlaw's Method
  • Capillary Tube Method
  • Slide/Drop Method (correct)
  • Lee and White Whole Blood Coagulation Time

Why is the Activated Clotting Time considered insensitive to factor deficiencies?

<p>It provides no information on specific clotting factors (D)</p> Signup and view all the answers

What issue makes the Capillary Tube Method unreliable for producing results?

<p>Too many errors in the timing process (B)</p> Signup and view all the answers

Which method can specify factor deficiency but is insensitive to identifying the exact deficient clotting factor?

<p>Dale and Laidlaw's Method (B)</p> Signup and view all the answers

What is the purpose of using a capillary tube with a blue mark (without anticoagulant) in a blood clotting test?

<p>To accelerate the clotting process (C)</p> Signup and view all the answers

Which clotting factor deficiency cannot be specifically identified using the test described in the text?

<p>Factor VIII deficiency (B)</p> Signup and view all the answers

What is the primary reason for the obsolescence of the Lee and White whole blood coagulation time method?

<p>It is too sensitive to factor deficiencies (A)</p> Signup and view all the answers

Which factor is NOT part of the common pathway in the laboratory evaluation of intrinsic and common pathways as stated in the text?

<p>Factor XIII (D)</p> Signup and view all the answers

What is the activator used in the activated clotting time test described in the text?

<p>Diatomaceous earth (D)</p> Signup and view all the answers

Why are problems related to intrinsic and common pathways often associated with liver diseases according to the text?

<p>As the liver produces most of the necessary clotting factors (B)</p> Signup and view all the answers

Flashcards

Purpose of Evaluating Clotting Factors

To identify deficiencies in clotting factors during Secondary Hemostasis.

First Tube for Clotting Check

Tube #1 is checked first for clot formation.

Clotting Time Method in Tube #3

The Slide/Drop Method is used to check clotting time in tube #3.

Activated Clotting Time Sensitivity

It is insensitive to specific factor deficiencies; gives no info on individual factors.

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Capillary Tube Method Issues

The method is unreliable due to timing errors in the process.

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Dale and Laidlaw's Method

Can specify factor deficiency but not the exact deficient factor.

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Capillary Tube with Blue Mark Purpose

Accelerates the clotting process without anticoagulant.

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Undetermined Deficiency

Factor VIII deficiency cannot be specifically identified using certain tests.

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Obsolescence of Lee and White Method

The method is too sensitive to factor deficiencies, making it outdated.

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Common Pathway Factor Exclusion

Factor XIII is NOT part of the common pathway examined.

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Activator in Activated Clotting Time Test

Diatomaceous earth is the activator used in this test.

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Intrinsic and Common Pathway Problems

Often linked to liver diseases since the liver produces many clotting factors.

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Study Notes

Laboratory Evaluation of Secondary Hemostasis

  • To evaluate clotting factors (coagulation factors) for Secondary Hemostasis, collect 4 mL of blood and divide it into three tubes.
  • Start timing as 1 mL of blood is transferred into tube #3, then 1 mL for tube #2 and tube #1, and incubate.

Clotting Time Methods

  • Slide/Drop Method: Useful for children, uses a small amount of blood, and is done by capillary puncture.
  • Capillary Tube Method/Dale and Laidlaw's Method: Uses a capillary tube with a blue mark, no anticoagulant; not usually performed due to skin puncture risk.
  • Lee and White Whole Blood Coagulation Time: An obsolete method, insensitive to factor deficiencies.

Activated Clotting Time (ACT)

  • Used for patients undergoing heparin therapy.
  • An activator, diatomaceous earth (12mg diatomide), is used to stimulate clotting factors.
  • Samples are incubated at 37℃; normal range: 75-120 secs, and 140-185 secs for patients undergoing heparin therapy.

Laboratory Evaluation of Intrinsic and Common Pathways

  • Intrinsic Pathway: Factors XII, XI, IX, VIII, HMWK, PK.
  • Common Pathway: Factors X, V, II, I, XIII (XIII not part of the common pathway).
  • Problems with intrinsic and common pathways are related to liver diseases since the liver produces clotting factors.
  • Affected by circulating anticoagulants (e.g., heparin, which prolongs clotting time) and hypofibrinogenemia (low fibrinogen levels).

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Description

Learn about the laboratory evaluation of secondary hemostasis in hematology, including collecting blood samples and assessing clotting factors. Understand the process of incubating blood samples, evaluating clot formation, and interpreting results for secondary hemostasis.

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