Searching...
Flashcards in this deck (30)
  • What are the two common methods used to measure fibrinogen in a coagulation laboratory?

    • Nephelometric methods
    • Clauss method
    coagulation fibrinogen methods
  • How does the nephelometric method measure fibrinogen?

    It measures the decrease in optical density of plasma as fibrinogen is converted to fibrin by thrombin.

    coagulation fibrinogen nephelometric
  • What does the intensity of light scattered in the nephelometric method indicate?

    It indicates the rate of fibrin formation and total clottable fibrinogen.

    coagulation fibrinogen nephelometric
  • What is a critical aspect of the nephelometric method?

    The delta light scatter is compared to a calibration curve based on known fibrinogen concentrations.

    coagulation fibrinogen nephelometric
  • What is the primary function of the Clauss method in fibrinogen determination?

    Diluted thrombin is added to plasma to convert fibrinogen to fibrin.

    coagulation fibrinogen clauss
  • In the Clauss method, how is fibrinogen concentration related to clotting time?

    The clotting time is inversely proportional to the fibrinogen concentration.

    coagulation fibrinogen clauss
  • What is used to establish a reference curve in the Clauss method?

    Several dilutions of calibration plasma are plotted against the clot formation time.

    coagulation fibrinogen clauss
  • The nephelometric method relies on measuring the decrease in optical density of plasma as fibrinogen is converted to fibrin by thrombin, leading to increased opacity from insoluble fibrin strands. The scatter of light is measured at 90°.

    coagulation fibrinogen nephelometric
  • In the Clauss method of fibrinogen determination, clotting time is inversely proportional to fibrinogen concentrations, meaning that a faster clotting time indicates a higher level of fibrinogen.

    coagulation fibrinogen clauss
  • What is a reasonable critical value for fibrinogen?

    A reasonable critical value is yet to be specified in the text.

    coagulation fibrinogen
  • What is a reasonable reference range for fibrinogen?

    A reasonable reference range is not provided in the text.

    coagulation fibrinogen
  • What forms the primary structure of stabilized fibrin?

    Fibrin polymers cross-linked via their {{c1::D domains}} by {{c2::XIIIa}}.

    biology fibrin
  • What are formed when plasmin breaks down stabilized fibrin?

    D-dimer and other {{c1::fibrin degradation products}}.

    biology fibrin
  • Will D-dimer be formed if fibrinogen is broken down by plasmin?

    No, D-dimer will {{c1::not be formed}}.

    biology fibrin
  • What types of assays can be performed on D-Dimer?

    Both {{c1::qualitative}} and {{c2::quantitative}} assays.

    laboratory testing
  • What method is used for qualitative D-Dimer screening?

    The plasma {{c1::D-Dimer method}} using latex particles coated with anti-D-Dimer.

    laboratory testing
  • In qualitative screening, if D-Dimer is present, the latex particles will agglutinate due to a reaction with anti-D-Dimer.

    biology fibrin
  • Why are qualitative screens being phased out?

    They are being replaced by {{c1::quantitative assays}}.

    laboratory testing
  • How is the most common quantitative D-Dimer measurement performed?

    Using latex particles coated with {{c1::anti-human D-Dimer}}.

    laboratory testing
  • The agglutination of particles in the quantitative assay causes a change in optical density that is proportional to D-Dimer concentration.

    laboratory testing
  • What units can D-Dimer be reported in?

    In {{c1::fibrinogen equivalent units (FEUs)}} or {{c2::D-Dimer units}}.

    laboratory units
  • How are FEUs related to D-Dimer units?

    2 FEUs = {{c1::1 D-Dimer unit}}.

    laboratory units
  • What does an increased D-Dimer indicate?

    It indicates abnormality; no critical value exists.

    _d-dimer abnormality
  • When is D-Dimer elevated?

    • DIC
    • Thromboembolic disease
    • Normal pregnancy
    • Eclampsia
    • Pre-eclampsia
    • Thrombolytic agents
    • Inflammation/sepsis
    • Post-surgery/trauma
    • Severe liver disease
    • Renal disease
    d-dimer elevation
  • What is the significance of a normal D-Dimer?

    It has a very high negative predictive value when ruling out VTE.

    d-dimer vte negative_predictive_value
  • Can an elevated D-Dimer always confirm VTE?

    No, an elevated D-Dimer can occur in numerous conditions besides VTE.

    d-dimer vte diagnosis
  • Elevated D-Dimer will be present when there is active clot formation or dissolution in the body.

    d-dimer clot_formation dissolution
  • Conditions that can elevate D-Dimer include DIC, venous thromboembolic disease, and renal disease.

    d-dimer conditions
  • Which of the following conditions does NOT typically elevate D-Dimer?

    None

    DIC

    Severe liver disease

    Eclampsia

    d-dimer elevation conditions
  • What is a characteristic of a normal D-Dimer?

    Always elevated

    Indicates VTE

    High negative predictive value for VTE

    No significance

    d-dimer vte negative_predictive_value
Study Notes

Fibrinogen Assay: Principle, Procedure, and Use

Fibrinogen Assay Overview

Two primary methods are used to measure fibrinogen:

  1. Nephelometric Method:
  2. Measures changes in plasma's optical density as fibrinogen converts to fibrin.
  3. Light scatter is assessed at 90°, with increased opacity indicating fibrin formation.
  4. Change in light scatter correlates to total clottable fibrinogen.
  5. Comparison against a calibration curve with known fibrinogen concentrations.

  6. Clauss Method:

  7. Involves adding diluted thrombin to plasma, converting fibrinogen to fibrin.
  8. Clotting time inversely correlates to fibrinogen concentration; shorter time = higher fibrinogen.
  9. Reference curve constructed from timed clot formation across various known dilutions.

Reference Ranges

  • Reasonable reference range for fibrinogen: _____
  • Critical value for fibrinogen: _____

D-Dimer Test: Principle and Use

D-Dimer Test Overview

Principle

  • D-dimer results from the breakdown of cross-linked fibrin by plasmin.
  • Not formed when fibrinogen is degraded directly by plasmin.

Testing Methods

  • Qualitative Screens:
  • Manual plasma D-Dimer method with latex agglutination upon D-Dimer presence.

  • Quantitative Assays:

  • Automated measurement using latex particles coated with anti-D-Dimer.
  • Agglutination leads to changes in optical density, indicating D-Dimer concentration.

Reference Ranges

  • D-Dimer can be represented in FEUs or D-dimer units: 2 FEUs = 1 D-dimer unit.
  • Reasonable reference range for D-Dimer: _______
  • No critical value; any increase indicates an abnormality.

Clinical Significance of D-Dimer

Elevated D-Dimer Indications

Elevated levels suggest ongoing clot formation and dissolution in the body, commonly seen in: * Disseminated Intravascular Coagulation (DIC) * Thromboembolic disease (arterial/venous) * Pregnancy (normal, eclampsia, pre-eclampsia) * Use of thrombolytics * Infections/inflammation * Post-surgery/trauma * Severe liver or renal disease

Diagnostic Utility

  • A normal D-Dimer result has high negative predictive value for ruling out VTE.
  • Elevated D-Dimer may not specifically confirm VTE and can arise from various other conditions.