1. Which of the following statements is TRUE about the presentation of hemophilia A and B?
A. Both are defined as factor activity of greater than 10%
B. Enhanced manufacturing processes have nearly eliminated hemarthroses
C. Diagnosis of hemophilia occurs sooner in patients who have severe disease than in patients with milder forms of the disease
D. Spontaneous bleeding is the hallmark symptom of hemophilia, regardless of severity level
2. Dividing by 2 when calculating the dose of factor VIII needed for treatment of hemorrhage in a patient with hemophilia A is necessary because:
A. For each unit of FVIII per kg of body weight, plasma FVIII levels are expected to increase by 2 international units/dL
B. For every 2 units of FVIII per kg of body weight, plasma FVIII levels are expected to increase by 0.5 international units/dL
C. Factor VIII is dosed twice daily
D. This accounts for its long half-life
3. Which of the following characteristics extends the half-life of a factor product?
A. B domain deletion
B. Albumin used in the manufacturing process
C. Fusion protein
D. Recombinant technique
4. JR is a 24-year-old man with hemophilia A who presents to clinic. His only major bleeds into large joints have occurred in the past 5 years, 1 in the elbow and 2 in the left knee. Joint disease has not yet been diagnosed. On the basis of this patient's presentation, which type of prophylaxis should be initiated at this point in time?
A. This patient should already have been initiated on continuous prophylaxis
B. Primary prophylaxis
C. Secondary prophylaxis
D. No prophylaxis is indicated at this time
5. At what titer level do inhibitors render treatment with factor concentrates ineffective, requiring the use of bypassing agents?
A. Greater than 0.6 Bethesda units (BU)/mL
B. Greater than 1 BU/mL
C. Greater than 2 BU/mL
D. Greater than 5 BU/mL
6. Which of the following is an advantage of continuous infusion of factor products?
A. Use of infusion pumps
B. Improvement of factor stability
C. Possibility of decreased use of factor product
D. Higher peak concentrations
7. In general, the goal factor VIII or factor IX level for bleeding prophylaxis is:
A. A peak of 50 to 80 international units/dL
B. A trough of greater than or equal to 5 international units/dL
C. A peak of 80 to 100 international units/dL
D. A trough of greater than or equal to 1 international unit/dL
8. Which of the following is NOT a potential concern for B domain–deleted recombinant factor products?
A. Increased inhibitor development
B. Decreased half-life
C. Increased risk of bleeding
D. Increased risk of viral contamination
9. Which of the following agents may be used for patients with hemophilia A with high inhibitor titers?
A. Recombinant factor VIIa
B. B domain–deleted recombinant factor VIII
C. Plasma-derived antihemophilic factor/von Willebrand factor complex
D. Recombinant factor VIII, Fc fusion protein
10. What is the most important indicator of achievement of hemostasis with factor products?
A. Trough level
B. Peak level
C. Area under the curve
D. Clearance
Evaluation Questions
11. To what extent did the program meet objective #1?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
12. To what extent did the program meet objective #2?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
13. To what extent did the program meet objective #3?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
14. To what extent did the program meet objective #4?
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
15. Rate the effectiveness of how well the program related to your educational needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
16. Rate how well the active learning strategies (questions, cases, discussions) were appropriate and effective learning tools:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
17. Rate the quality of the faculty:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
18. Rate the effectiveness and the overall usefulness of the material presented:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
19. Rate the appropriateness of the examination for this activity:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
20. Rate the effectiveness of how well the activity related to your practice needs:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
21. Rate the effectiveness of how well the activity will help you improve patient care:
A. Excellent
B. Very Good
C. Good
D. Fair
E. Poor
22. Will the information presented cause you to change your practice?
A. Yes
B. No
23. Are you committed to making these changes?
A. Yes
B. No
24. As a result of this activity, did you learn something new?
A. Yes
B. No
25. What is your practice setting or area of practice?
A. Community Pharmacy/Independent
B. Community Pharmacy/Chain
C. Hospital/Health Systems
D. Administrative/Pharmacy Director
E. Critical Care Pharmacy
F. Long-term Care
G. Managed Care/PBM
H. Oncology
I. Specialty Pharmacy
J. Industry/Manufacturing
26. How many years have you been in practice?
A. <5
B. 5 – 10
C. 11 – 20
D. >20
E. >20
