[MCQs] Disorders of Platelets and Vessel Wall- Part 1

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Disorders of Platelets and Vessel Wall- Part 1

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Question 1

Major regulator of platelet production - thrombopoietin (TPO) is synthesized in ?

A	Kidney
B	Liver
C	Muscle
D	Adipose tissue

Question 1 Explanation:

Thrombopoietin (TPO) is a hormone synthesized in liver that regulates platelet production

Question 2

Synthesis of thrombopoietin is increased specifically by ?

A	Interleukin 6
B	Prostaglandin D2
C	TNF alpha
D	Interferon beta

Question 2 Explanation:

Synthesis is increased with inflammation and specifically by interleukin 6.

Question 3

Average life span of platelets in circulation is ?

A	Average life span of platelets in circulation is ?
B	3 - 7 days
C	7 - 10 days
D	11 - 18 days

Question 3 Explanation:

Average life span of platelets in circulation is 7-10 days. Platelets were identified in 1865 and their function was elucidated by Giulio Bizzozero in 1882

Question 4

What proportion of platelets reside in the spleen ?

A	One - third
B	Half
C	Two - third
D	Three - fourth

Question 4 Explanation:

Approximately one-third of the platelets reside in the spleen

Question 5

Which of the following statements is false ?

A	TPO binds to its receptor on platelets
B	TPO binds to its receptor on megakaryocytes
C	Platelets are anucleate
D	None of the above

Question 5 Explanation:

TPO binds to its receptor on platelets and megakaryocytes and is thus removed from the circulation. Therefore, a reduction in platelet and megakaryocyte mass increases the level of TPO, which then stimulates platelet productio

Question 6

Which of the following statements is false ?

A	Nitric oxide is a platelet inhibitor
B	Endothelin is a platelet activator
C	Endothelin is a platelet activator
D	None of the above

Question 6 Explanation:

Endothelium-derived vasodilator nitric oxide is a platelet inhibitor. Endothelium-derived vasoconstrictor endothelin is a platelet activator.

Question 7

Pseudothrombocytopenia is due to ?

A	Exercise
B	Laboratory artifact
C	Cold weather
D	Fasting

Question 7 Explanation:

Pseudothrombocytopenia is an in vitro artifact resulting by blood collection

Question 8

Pseudothrombocytopenia is most likely when blood is collected with which of the following anticoagulants ?

A	EDTA
B	Sodium citrate
C	Heparin
D	All of the above

Question 8 Explanation:

Pseudothrombocytopenia is an in vitro artifact resulting from platelet agglutination via antibodies when the calcium content is decreased by blood collection in ethylenediamine tetraacetic (EDTA) anticoagulated blood tubes.

Question 9

Which of the following is the most common cause of thrombocytopenia ?

A	Inherited disorders
B	Myelodysplasia
C	Drugs
D	Pseudothrombocytopenia

Question 9 Explanation:

Drugs are the most common cause of thrombocytopenia.

Question 10

What is the platelet count required to maintain vascular integrity in the microcirculation ?

A	5000 - 10,000 / µL
B	15000 - 20,000 / µL
C	25000 - 40,000 / µL
D	50000 - 100,000 / µL

Question 10 Explanation:

A platelet count of ~5000 - 10,000 is required to maintain vascular integrity in microcirculation

Question 11

Which of the following statements about petechiae is false ?

A	Nonblanching hemorrhages
B	First appear in areas of increased venous pressure
C	Pinpoint
D	Sign of a platelet dysfunction

Question 11 Explanation:

Petechiae first appear in areas of increased venous pressure and are pinpoint, nonblanching hemorrhages and are usually a sign of a decreased platelet number and not platelet dysfunction. Excessive bruising is seen in disorders of both platelet number and function.

Question 12

In wet purpura, blood blisters form on ?

A	Sole
B	Palm
C	Oral mucosa
D	Scalp

Question 12 Explanation:

Wet purpura, blood blisters that form on the oral mucosa denote an increased risk of lifethreatening hemorrhage in the thrombocytopenic patient.

Question 13

Immune-mediated thrombocytopenia (ITP2) in children usually follows which of the following ?

A	Bacterial infection
B	Viral infection
C	Drug ingestion
D	Any of the above

Question 13 Explanation:

Immune-mediated thrombocytopenia (ITP2) in children usually follows a viral infection and almost always resolves spontaneously

Question 14

Which out of the following drugs is most capable of inducing drug-dependent antibodies ?

A	Amiadarone
B	Cephalosporin
C	Digoxin
D	Quinine

Question 14 Explanation:

Classic drug-dependent antibodies are antibodies that react with specific platelet surface antigens and result in thrombocytopenia only when the drug is present. They are more common with quinine, quinidine, rifampicin, and trimethoprim-sulphamethoxazole

Question 15

Drug induced thrombocytopenia usually resolves how many days after drug withdrawal ?

A	1 - 3 days
B	3 - 7 days
C	3 - 7 days
D	14 - 21 days

Question 15 Explanation:

Drug induced thrombocytopenia typically occurs after a period of initial exposure (median length 21 days), or upon reexposure, and usually resolves in 7-10 days after drug withdrawal

Question 16

Which of the following is false about Heparin-Induced Thrombocytopenia (HIT) ?

A	HIT is not usually severe
B	HIT is not usually severe
C	HIT markedly increases risk of thrombosis
D	None of the above

Question 17

In Heparin-Induced Thrombocytopenia (HIT), antibody formation is against which of the following ?

A	Platelet factor 4 (PF4)
B	Heparin
C	Platelet factor 4 (PF4) and heparin complex
D	Endothelial cells

Question 17 Explanation:

HIT results from antibody (IgG isotpe) formation against heparin-PF4 complex & to platelet Fc receptors

Question 18

As compared to LMWH, HIT is how many times more common with the use of UFH ?

A	Twice
B	Thrice
C	5 times
D	10 times

Question 18 Explanation:

HIT is about 10 times more common with the use of unfractionated heparin (UFH) than after exposure to low-molecular-weight heparin (LMWH).

Question 19

Most patients develop HIT after exposure to heparin for how many days ?

A	1 - 3 days
B	3 - 5 days
C	5 - 14 days
D	14 - 21 days

Question 19 Explanation:

Most patients develop HIT after exposure to heparin for 5 – 14 days.

Question 20

Which of the following statements about HIT is false ?

A	Occurs earlier if heparin given within past 3 months
B	More common in medical than in surgical patients
C	HIT is more frequent in females than in males
D	Platelet count rarely fall to <20000/µL

Question 20 Explanation:

HIT is more common in surgical patients than in medical patients

Question 21

Which of the following about HIT is false ?

A	Most specific diagnostic test is serotonin release assay
B	Venous thrombosis more common than arterial thrombosis
C	Platelet transfusions are not advised
D	None of the above

Question 22

Which of the following drugs is effective in the treatment of Heparin induced thrombocytopenia and thrombosis (HITT) ?

A	Argatroban
B	Lepirudin
C	Danaparoid
D	All of the above

Question 22 Explanation:

Early recognition, prompt discontinuation of heparin and use of alternative anticoagulants is key in treatment of HIT. Argatroban, Lepirudin, Danaparoid, Bivalirudin & Fondaparinux are effective in HITT.

Question 23

Secondary immune thrombocytopenic purpura is associated with which of the following diseases ?

A	Systemic lupus erythematosis (SLE)
B	HIV
C	Hepatitis C
D	All of the above

Question 23 Explanation:

Immune / idiopathic thrombocytopenic purpura ITP is termed secondary if it is associated with an underlying disorder like systemic lupus erythematosis (SLE), HIV and hepatitis C

Question 24

Evans’s syndrome refers to ?

A	Autoimmune hemolytic anemia with ITP
B	SLE with ITP
C	HIV with ITP
D	Hepatitis C with ITP

Question 24 Explanation:

Autoimmune hemolytic anemia with ITP is termed as Evans’s syndrome.

Question 25

Thrombocytopenia related mortality increases with platelet counts less than ?

A	30,000 / µL
B	50,000 / µL
C	75,000 / µL
D	100,000 / µL

Question 25 Explanation:

Patients with platelet counts >30,000/µL appear not to have increased mortality related to the thrombocytopenia

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II. See all quizzes of the Disorders of Platelets and Vessel Wall at here:

Disorders of Platelets and Vessel Wall- Part 1 |Disorders of Platelets and Vessel Wall- Part 2 |Disorders of Platelets and Vessel Wall- Part 3 |Disorders of Platelets and Vessel Wall- Part 4

1.Major regulator of platelet production – thrombopoietin (TPO) is synthesized in ?
A. Kidney
B. Liver
C. Muscle
D. Adipose tissue

2. Synthesis of thrombopoietin is increased specifically by ?
A. Interleukin 6
B. Prostaglandin D2
C. TNF alpha
D. Interferon beta

3. Average life span of platelets in circulation is ?
A. 1 – 3 days
B. 3 – 7 days
C. 7 – 10 days
D. 11 – 18 days

4. What proportion of platelets reside in the spleen ?
A. One – third
B. Half
C. Two – third
D. Three – fourth

5. Which of the following statements is false ?
A. TPO binds to its receptor on platelets
B. TPO binds to its receptor on megakaryocytes
C. Platelets are anucleate
D. None of the above

6. Which of the following statements is false ?
A. Nitric oxide is a platelet inhibitor
B. Endothelin is a platelet activator
C. Platelets adhere to exposed intimal surface through VWF
D. None of the above

7. Pseudothrombocytopenia is due to ?
A. Exercise
B. Laboratory artifact
C. Cold weather
D. Fasting

8. Pseudothrombocytopenia is most likely when blood is collected with which of the following anticoagulants ?
A. EDTA
B. Sodium citrate
C. Heparin
D. All of the above

9. Which of the following is the most common cause of thrombocytopenia ?
A. Inherited disorders
B. Myelodysplasia
C. Drugs
D. Pseudothrombocytopenia

10. What is the platelet count required to maintain vascular integrity in the microcirculation ?
A. 5000 – 10,000 / µL
B. 15000 – 20,000 / µL
C. 25000 – 40,000 / µL
D. 50000 – 100,000 / µL

11. Which of the following statements about petechiae is false ?
A. Nonblanching hemorrhages
B. First appear in areas of increased venous pressure
C. Pinpoint
D. Sign of a platelet dysfunction

12. In wet purpura, blood blisters form on ?
A. Sole
B. Palm
C. Oral mucosa
D. Scalp

13. Immune-mediated thrombocytopenia (ITP2) in children usually follows which of the following ?
A. Bacterial infection
B. Viral infection
C. Drug ingestion
D. Any of the above

14. Which out of the following drugs is most capable of inducing drug-dependent antibodies ?
A. Amiadarone
B. Cephalosporin
C. Digoxin
D. Quinine

15. Drug induced thrombocytopenia usually resolves how many days after drug withdrawal ?
A. 1 – 3 days
B. 3 – 7 days
C. 7 – 10 days
D. 14 – 21 days

16. Which of the following is false about Heparin-Induced Thrombocytopenia (HIT) ?
A. HIT is not usually severe
B. HIT is not associated with bleeding
C. HIT markedly increases risk of thrombosis
D. None of the above

17. In Heparin-Induced Thrombocytopenia (HIT), antibody formation is against which of the following ?
A. Platelet factor 4 (PF4)
B. Heparin
C. Platelet factor 4 (PF4) and heparin complex
D. Endothelial cells

18. As compared to LMWH, HIT is how many times more common with the use of UFH ?
A. Twice
B. Thrice
C. 5 times
D. 10 times

19. Most patients develop HIT after exposure to heparin for how many days ?
A. 1 – 3 days
B. 3 – 5 days
C. 5 – 14 days
D. 14 – 21 days

20. Which of the following statements about HIT is false ?
A. Occurs earlier if heparin given within past 3 months
B. More common in medical than in surgical patients
C. HIT is more frequent in females than in males
D. Platelet count rarely fall to <20000/µL

21.; Which of the following about HIT is false ?
A. Most specific diagnostic test is serotonin release assay
B. Venous thrombosis more common than arterial thrombosis
C. Platelet transfusions are not advised
D. None of the above

22. Which of the following drugs is effective in the treatment of Heparin induced thrombocytopenia and thrombosis (HITT) ?
A. Argatroban
B. Lepirudin
C. Danaparoid
D. All of the above

23. Secondary immune thrombocytopenic purpura is associated with which of the following diseases ?
A. Systemic lupus erythematosis (SLE)
B. HIV
C. Hepatitis C
D. All of the above

24. Evans’s syndrome refers to ?
A. Autoimmune hemolytic anemia with ITP
B. SLE with ITP
C. HIV with ITP
D. Hepatitis C with ITP

25. Thrombocytopenia related mortality increases with platelet counts less than ?
A. 30,000 / µL
B. 50,000 / µL
C. 75,000 / µL
D. 100,000 / µL

Disorders of Platelets and Vessel Wall

[MCQs] Disorders of Platelets and Vessel Wall- Part 1

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Disorders of Platelets and Vessel Wall- Part 1

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