EP.49 Silent Clots

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EP.49 Silent Clots

Anticoagulations and Thromboproflaxis

Which of the following is the primary mechanism of action of warfarin?

10 points

A. Inhibits factor Xa

B. Inhibits platelet aggregation

C. Antagonizes vitamin K epoxide reductase

D. Direct thrombin inhibitor

Clear selection

Which clotting factors are inhibited by warfarin?

10 points

A. II, V, VIII, X

B. II, VII, IX, X

C. VII, VIII, IX, XII

D. I, V, VIII, XIII

Clear selection

Which of the following anticoagulants is safe for use in pregnancy?

10 points

A. Warfarin

B. Apixaban

C. Unfractionated heparin

D. Rivaroxaban

Clear selection

A 65-year-old patient with atrial fibrillation is prescribed warfarin. Which of the following monitoring parameters is most important?

10 points

A. aPTT

B. INR

C. Bleeding time

D. Platelet count

Clear selection

What is the recommended therapeutic INR range for most patients on warfarin?

10 points

A. 1.0-1.5

B. 2.0-3.0

C. 2.5-3.5

D. 3.5-4.5

Clear selection

A patient on warfarin starts amiodarone. How might this affect their anticoagulation status?

10 points

A. Decreased INR

B. Increased INR

C. No effect on INR

D. Increased risk of thrombosis

Clear selection

Which of the following antibiotics is most likely to interact with warfarin and increase the risk of bleeding?

10 points

A. Amoxicillin

B. Azithromycin

C. Ciprofloxacin

D. Clindamycin

Clear selection

A patient taking warfarin consumes large quantities of spinach. How might this affect their INR?

10 points

A. Decrease INR

B. Increase INR

C. No effect on INR

D. Increase the risk of thrombosis

Clear selection

Which of the following medications can reduce the anticoagulant effect of warfarin?

10 points

A. Carbamazepine

B. Metronidazole

C. Trimethoprim-sulfamethoxazole

D. Ciprofloxacin

Clear selection

A patient on warfarin therapy presents with severe bleeding. Which of the following is the most appropriate antidote?

10 points

A. Protamine sulfate

B. Vitamin K

C. Fresh frozen plasma

D. Activated charcoal

Clear selection

Which of the following is a common adverse effect of low-molecular-weight heparins (LMWHs) like enoxaparin?

10 points

A. Thrombocytosis

B. Thrombocytopenia

C. Nephrotoxicity

D. Hepatotoxicity

Clear selection

Which of the following dietary recommendations should be given to a patient starting warfarin therapy?

10 points

A. Avoid all green leafy vegetables.

B. Maintain a consistent intake of vitamin K-rich foods.

C. Take with high-fat meals for better absorption.

D. Avoid all dairy products.

Clear selection

A patient on warfarin plans to start a new over-the-counter medication. Which of the following should be avoided due to the risk of increased bleeding?

10 points

A. Acetaminophen

B. Ibuprofen

C. Loratadine

D. Famotidine

Clear selection

A patient with a prosthetic heart valve is prescribed warfarin. What is the most appropriate therapeutic INR range for this patient?

10 points

A. 1.0-2.0

B. 2.0-3.0

C. 2.5-3.5

D. 3.5-4.5

Clear selection

A 70-year-old patient on enoxaparin therapy develops severe back pain and hypotension. What should be your primary concern?

10 points

A. Deep vein thrombosis

B. Heparin-induced thrombocytopenia (HIT)

C. Retroperitoneal bleeding

D. Pulmonary embolism

Clear selection

Which of the following directly inhibits factor Xa without requiring antithrombin?

10 points

A. Rivaroxaban

B. Fondaparinux

C. Enoxaparin

D. Heparin

Clear selection

In patients with renal impairment, which anticoagulant requires dose adjustment to prevent toxicity?

10 points

A. Dabigatran

B. Warfarin

C. Apixaban

D. Edoxaban

Clear selection

A patient on warfarin therapy presents with an INR of 5.0 but no signs of bleeding. What is the most appropriate action?

10 points

A. Administer oral vitamin K.

B. Administer fresh frozen plasma.

C. Withhold the next dose and recheck INR in 24 hours.

D. Continue the current dose and monitor symptoms.

Clear selection

What is the recommended duration of thromboprophylaxis for a patient undergoing knee replacement surgery?

10 points

A. 3 days

B. 7 days

C. 10-14 days

D. 1 month

Clear selection

Which of the following conditions is an indication for lifelong anticoagulation therapy?

10 points

A. Acute deep vein thrombosis

B. Atrial fibrillation with CHA2DS2-VASc score of 0

C. Pulmonary embolism with cancer

D. Isolated distal DVT

Clear selection

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