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1、1. A 20-year-old woman is found to have an activated partial thromboplastin time (APTT)of 78/32 on routine testing prior to cholecystectomy .Further investigation reveals a prothrobin time (PT) of 13/12 (patient/control),a template bleeding time of 13 min,and a platelet count of 350*100/uL,which one
2、 of the following characteristics of this womans coagulopathy is true?a. Infusion of purified factor VIII is usually required to normalized its concentration prior to surgeryb. Infusion of cryoprecipitate will not be followed by an improvement in coagulationc. Most of these patients are ,or become,s
3、eropositive for HVd. Epistaxis or menorrhagia is uncommone. Lack of platelet aggregation in response to ristocetin is a common feature of this disease2. A victim of blunt abdominal trauma requires a partial hepatectomy. He is rapidly transfused with 8 units of appropriately crossmathed packed red bl
4、ood cells from the blood bank. He is noted in the recovery room to be bleeding from intravenous. His coagulopathy is likely due to thrombocytopenia and deficiencies of which clotting factors?a. II onlyb. II and VIIc. V and VIIId. IX and Xe. XI and XII3. A 65-year-old woman has a life-threatening pul
5、monary embolus 5 days following removal of a uterine malignancy .She is immediately heparinized and maintained in good therapeutic range for the next 3 days, then passes gross blood from her vagina and develops tachycardia,hypotension,and oliguria. Following resuscitation ,an abdominal CT scan revea
6、ls a major retroperitoneal hematoma. You should nowa. Immediately reverse heparin by a calculated dose of protamine and place a vena cava filter (e.g, a Greenfiled filter)b. Reverse heparin with protamine,explore and evacuate the hematoma,and ligate the vena cava below the renal veinsc. Switch to lo
7、w-dose heparind. Stop heparin and observe closelye. Stop heparin ,give fresh frozen plasma (FFP),and begin warfarin therapy4.Signs and symptoms of hemolytic transfusion reactions includea. Hypothermiab. Hypertensionc. Polyuriad. Abnormal bleeding e. Hypesthesia at the transfusion site5. A patient su
8、spected of having a hemolytic transfusion reaction should be managed witha. Removal of nonessential foreign body irritants,e.g.,Foley catheterb. Fluid restrictionc. 0.1M HCL infusiond. Steroidse. Fluids and mannitol6.The surgeon should be particularly concerned about which coagulation function in pa
9、tients receiving anti-inflammatory or analgesic medications?a. APTTb. PTc. Reptilase timed. Bleeding timee. Thrombin time7.In a hemolytic reaction caused by an incompatible blood transfusion, the treatment that is most likely to be helpful is a. Promoting a diuresis with 250 ml of 50% mannitolb. Treating anuria with fluid and potassium replacementc. Acidifying the urine to prevent hemoglobin precipitation in the renal tubulesd. Removing foreign bodies, such as Foley catheters, which may cause hemorrhagic complicationse. Stopping the transfusion immediately
