EDAIC Coagulation and Transfusion Medicine 4

Question 1

During liver transplantation, which coagulation abnormality is most expected during the anhepatic phase?

Accepted Answer

Fibrinolysis due to decreased clearance of tPA

Answer

During the anhepatic phase, tissue plasminogen activator (tPA) is not cleared, leading to hyperfibrinolysis.

Question 2

Which blood group antigen system is most clinically significant for transfusion reactions after ABO?

Accepted Answer

Rhesus (Rh) system

Answer

After ABO, the Rhesus system (particularly D antigen) is the most clinically significant for transfusion reactions and hemolytic disease.

Question 3

A patient receiving massive transfusion develops ionized hypocalcemia. What is the cause?

Accepted Answer

Citrate in stored blood chelating ionized calcium

Answer

Citrate is used as an anticoagulant in stored blood and chelates ionized calcium, causing hypocalcemia with massive transfusion.

Question 4

Which monitoring test is most appropriate for assessing direct thrombin inhibitor (e.g., dabigatran) effect?

Accepted Answer

Ecarin clotting time or diluted thrombin time

Answer

Ecarin clotting time and diluted thrombin time most reliably reflect dabigatran anticoagulant activity.

Question 5

What is the initial treatment of choice for von Willebrand disease type 1 in a bleeding patient?

Accepted Answer

Desmopressin (DDAVP)

Answer

DDAVP stimulates endothelial release of stored von Willebrand factor and is first-line for mild type 1 vWD.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test