Font size
WorksheetsCardio IPC Exam 2
Total questions: 117
Worksheet time: 1hrs 7mins
Which of the following is an intrinsic pathway of blood coagulation?
Coagulation pathway upon contact activation or trauma within a vessel
Coagulation pathway upon trauma to vessel surface that activates TF
Which of the following factors are common in both intrinsic and extrinsic pathways?
X
V
II
VIII
VII
Which proteins interact in the Extrinsic pathway?
TF
VII
VIII
IX
Why is Factor V important to thrombin activation
It directly cleaves IIa thrombin to activate fibrinogen
It allows Xa to activate and cleave prothrombin in the presence of Ca2+ into thrombin via y-carboxy glutamate
It allows Y-carboxyglutamate to bind Ca2+ and cleave X into Xa
Order in the correct steps of Hemostasis from Extrinsic pathway: 1) Circulating VIIa binds TF and forms complex. 2) Factor Xa cleaves prothrombin into thrombin. 3) Vessel injury exposes free TF. 4) TF-VIIa complex activates X. 5) Platelet releases active thrombin to cleave fibrinogen into fibrin. 6) Fibrin activates platelets and ties aggregates together
1-2-3-4-5-6
3-1-4-2-5-6
6-2-1-4-3-5
6-5-4-3-2-1
What does Antithrombin do as a natural anticoagulant?
Inhibits Factors, or proteases, from cleaving and activating the rest of the cascade factors
Degrade factor Va and VIIIa to decrease activation of II and X to decrease IIa
Bind Heparin sulfate proteoglycan chains to increase activity of inactivating thrombin and Xa
Heparin has a long monosaccharide chain which can have high MW, a specific pentasaccharide region binds to _______ that inhibits serine proteases by cleaving an ____-_____ peptide to form an inactive covalent complex.
Thrombin; Arg-Ser
Antithrombin; Glu-Asp
Antithrombin; Arg-Ser
Prothrombin; Lys-Cys
True or False: Heparin can bind antithrombin and bring AT and thrombin together but also can conformationally change AT to bind to coagulation factors
True
False
If you have a long heparin pentasaccharide bound to Antithrombin will it inhibit Thrombin, Factor Xa, or both
Thrombin
Factor Xa
Both
True or False: LMWH binds antithrombin and inhibits thrombin
True
False
Unfractionated heparin comes as a long chain from a natural source of what animal?
(a)
LMWH is prepared by depolymerization of UFH and varies in short to intermediate length but still do not effectively inhibit _________
Thrombin
Prothrombin
Xa
LMWH will (increase/decrease) bioavailability and make for (more/less) predictable variability in patient response
Increase; less
Increase; more
Decrease; less
Decrease; more
Is fondaparinux a specific synthetic UFH or a LMWH
UFH
LMWH
HIT is an immunological reaction to PF4, Heparin, or PF4-Heparin complex that can also cause ______ on top of thrombocytopenia
Coagulation
Anticoagulation
Protamine is the reversal agent that forms ionic bonds with polysacc groups on heparin. Pick the correct order of greatest to least reversal effect on heparin, fondaparinux, and LMWH
Heparin > LMWH > Fondaparinux
Fondaparinux > heparin > LMWH
LMWH > Fondaparinux > heparin
Which heparin anticoagulant product would you most likely use in a patient on dialysis or with severe renal failure?
Heparin
LMWH
Fondaparinux
True or False: Lovenox and generic enoxaparin are approved bioequivalents with the same PK/PD profiles
True
False
Vitamin K helps aid the biosynthesis of Prothrombin by carboxylating Glutamate which goes on to bind Ca2+ to cleave prothrombin into active Thrombin. Vitamin K antagonists do what effect on this?
Blocks the reductases needed to recycle Vit-K epoxide back into useable Vitamin K
Blocks the Vit-K depended carboxylase needed for glutamate to make active prothrombin
Blocks Vitamin K entry into vasculature to stop biosynthesis of Prothrombin
Blocks the oxidases needed to recycle Vit-K epoxide back into useable Vit K
Which of the following are Factors that Warfarin (a VKA) blocks carboxylation of glutamate in?
Xa
X
VII
IX
IIa
Why does warfarin's anticoagulation effect have such a long onset of action?
The warfarin target Factors have extremely long T1/2 and are already gamma-carboxylated, they have to turnover production
Warfarin has poor bioavailability and is slow to produce effect
It does not have as high affinity for targets as heparin does
VKORC1 is the Vit-K epoxide reductase resides in the liver which works to synthesize Warfarin sensitive coagulation Factors. This can create a variable patient response due to pharmacogenomics. What else in the liver causes patient variability with warfarin?
CYP3A4
CYP2C9
CYP2D6
CYP2C19
True or False: The R enantiomer of warfarin is the more potent anticoagulant
True
False
What is the elimination of Warfarin?
Hepatic
Renal
Would a CYP inducer increase or decrease warfarin effects?
Increase
Decrease
What is the primary reversal agent of Warfarin?
Protamine
Vitamin K1
Phytonadione
Praxbind
Bivalirudin/AngioMax is a hirudin like thrombin inhibitor peptide that binds the catalytic site and the anion binding exosite of clot-bound thrombin. What is the MOA of this drug?
Reversibly inhibits thrombin from cleaving fibrinogen to fibrin
Irreversibly inhibits thrombin from cleaving fibrinogen to fibrin
Remains partially bound to thrombin exosite after hydrolysis to continue inhibiting thrombin activity
Is a peptide mimetic of Phe-Pro-Arg sequence in fibrinogen
Argatroban is a peptide mimetic of Phe-Pro-Arg sequence of fibrinogen that thrombin cleaves and inhibits thrombin directly similarly to Bivalirudin, are Argatroban and Bivalirudin orally or intravenously dosed?
Orally
Intravenously
Can you use Argatroban in someone with hepatic failure?
Yes; it is renally cleared
No; it is hepatically cleared
Dabigatran/Pradaxa is an oral direct thrombin inhibitor, what is a major effect of Pradaxa that is not shared with Xarelto or Eliquis DOACs?
It inhibits Thrombin, Eliquis and Xarelto inhibit Xa
It is less safe as it inhibits all Thrombin, not just thrombin bound to antithrombin, and Eliquis/Xarelto only effect cascade
It is safer than Eliquis/Xarelto as it is a pro-drug
It does not have inter-patient variability to response due to esterase cleavage of prodrug and not metabolism
What are unique aspects of Dabigatran's reversal agent Praxbind?
It is an IV monoclonal antibody
It is both a coagulant and anticoagulant depending on use similar to Vit-K and Warfarin
It is only an anticoagulant, unlike Vit-K and warfarin
It is an oral reversal agent that activates Thrombin and has higher affinity
If a drug inhibits PgP will this increase or decrease a DOAC effect of anticoagulation?
Increase
Decrease
Do DOACs that inhibit factor Xa have an effect on platelets?
No; it does not directly inhibit thrombin and will have no platelet effect
Yes; it also inhibits thrombin which has a platelet effect
What is the MOA of the DOAC Factor Xa inhibitor reversal agent Andexanet Alfa?
Acts as a decoy Xa that has high affinity for the DOACs
It occupies Xa binding sites and inhibits DOACs from binding
It is a monoclonal antibody that directly inhibits the DOACs but does not cause coagulation
Which Factor Xa inhibitor DOAC requires doses to be taken with food?
Rivaroxaban
Eliquis
Edoxaban
Dabigatran
What Factors does Warfarin effect in the clotting cascade?
2
7
9
10
3
True or False: Warfarin inhibits Protein C and S which are the natural anticoagulants of the body
True
False
What are some initial dosing considerations when starting warfarin?
Age
Diet
Alcohol
Weight
Financial
What's the standard starting dose of warfarin in a normal patient?
5mg
2.5mg
10mg
20mg
When is the best time to bring a patient in after initiating warfarin to check INR?
2 weeks
2-3 days
10 days
1 month
If a patient's INR goes from 1.8 on day 6 to 2.8 on day 9 is this an ideal change/too fast/too slow
Ideal
Fast
Slow
Which 2 of the following green vegetables has the most Vitamin K content?
Kale
Cucumbers
Iceberg lettuce
Brussel sprouts
A patient comes in and their INR has increased since last time where they were stable. Which factors can increase INR
Alcohol binge
Acute Illness
Increased VitK in diet
Weight gain
A patient comes in with an INR at 3.5 (no bleeding) when their goal range is 2-3. Which of the following would be best for their warfarin dosing?
Decrease the dose 5-15%
Hold 1 dose
Hold 2 doses
Administer Vitamin K
If a patient's INR is at 1.8 and their goal is 2-3 due to them consistently eating more kale salad at lunchtime, what would be an appropriate change?
Increase dose 5-15%
Give 2 doses in one day
Give bridging parenteral therapy Enoxaparin x 5 days
Decrease dose 5-15%
If a patient has an INR of 8.0, would you need to give them vitamin K?
Yes
No
Which of the following are CYP inducers that can decrease INR and increase risk of clotting?
Phenytoin
Rifampin
Bactrim
Amiodarone
Which of the following are CYP inhibitors which increase warfarin levels and increase INR?
Carbamazepine
Dicloxacillin
Metronidazole
Ketoconazole
Penicillin
Which CYP effect has a faster onset effect Inducer or Inhibitor?
Inhibition
Induction
Which thyroid disorder will increase catabolism of clotting factors and increase INR?
Hypothyroidism
Hyperthyroidism
If a person is taking ASA 325mg QD, will this increase their INR or their bleeding risk?
INR
Bleeding Risk
A patient comes in to have their INR checked and it is slightly increased from last time. Which one of these supplements could impact this?
CBD
St. John's Wort
CoQ10
Green Tea leaf
Which lab measurement can aid in diagnosing VTE?
BNP
D-Dimer
Troponin
ACTH
Who has higher risk of recurrent VTE?
Men
Women
When is anticoagulation indicated in AFib according to CHADSVASC score?
>1 Men
>2 Women
>1 Women
>2 Men
True or False: Mechanical valve replacement patients only need 3-6 months of anticoagulation therapy post surgery
True
False
True or False: DOACs are not to be given in mechanical valve replacement patients
True
False
What's the difference in INR goals for Aortic valve replacements with no risk factors and Mitral valve replacements?
Mitral valve 2-3, Aortic 2.5-3.5
Aortic 2-3, Mitral 2.5-3.5
Which DOACs are not metabolized by CYP enzymes?
Dabigatran
Apixaban
Edoxaban
Rivaroxaban
Which DOAC has the best bioavailability?
Dabigatran
Apixaban
Edoxaban
Rivaroxaban
Which 2 DOACs have more renal clearance than the others?
Rivaroxaban
Dabigatran
Edoxaban
Apixaban
True or False: Dabigatran is indicated in both hip and knee replacements and Apixaban is only indicated in hip replacements
True
False
Which DOAC has the most limited use and indications?
Dabigatran
Rivaroxaban
Edoxaban
Apixaban
Which is the only DOAC indicated for PAD/CAD with aspirin?
Dabigatran
Rivaroxaban
Apixaban
Edoxaban
Which 2 DOACs do not require Parenteral LMWH therapy for VTE when starting
Dabigatran
Apixaban
Edoxaban
Rivaroxaban
What's the correct dosing for Apixaban for VTE initiation therapy?
10mg BID x 7 days
5mg QD x 7 days
15mg BID x 21 days
20mg QD x 21 days
What's the correct dosing for Rivaroxaban initiation in VTE?
15mg BID x 7 days
15mg BID x 21 days
20mg BID x 21 days
20mg BID x 7 days
Which DOAC should be completely avoided in severe hepatic impairment?
Rivaroxaban
Apixaban
Dabigatran
Edoxaban
Dabigatran is usually dosed 150mg BID in AFib unless CrCL is _____ then it moves to 75mg BID
<15
15-30
>95
45
Which DOACs have the most avoidance in CrCL <30
Rivaroxaban
Dabigatran
Apixaban
Edoxaban
Which DOACs can be used in obese patients effectively?
Rivaroxaban
Edoxaban
Dabigatran
Apixaban
At what INR can warfarin be stopped and Rivaroxaban started?
3
2.5
2
3.5
When switching from Rivaroxaban or Apixaban TO warfarin, is a parenteral anticoagulant needed?
Yes
No
Which of the following is a decoy Factor Xa for anticoagulant reversal?
Praxxbind
Andexxa
FEIBA
KCENTRA
Which DOAC can take the longest to clear when stopping prior to a major surgery?
Dabigatran
Rivaroxaban
Apixaban
Edoxaban
LMWH is 100% bioavailable when administered SQ, it is cleared (renally/hepatic)
Renal
Hepatic
You are using anticoagulants on a patient with AFib also trying to prevent a stroke from occurring. Would this be prophylactic dosing or therapeutic dosing
Prophylactic
Therapeutic
What are some reasons BID dosing may be better in LMWH for PK parameters
Once daily dosing may have subtherapeutic clearance
BID dosing has higher peak Cmax
BID dosing can reach steady state
QD dosing can reach steady state but not therapeutic levels
You are prescribing a patient LMWH Enoxaparin, they weigh 100kg - what would their BID and QD dosing be?
100mg BID
150mg BID
150mg QD
100mg QD
When would you not use LMWH for anticoagulation?
A patient just received an epidural anesthesia for a procedure
A patient needs therapeutic VTE treatment
A patient who needs to start Warfarin therapy
A patient starting Dabigatran therapy
True or False: Enoxaparin can be used safely in pregnancy as it does not cross the placenta
True
False
What would be appropriate usage of LMWH for a patient with CrCL 30-50ml/min
Rounding down to next lowest dose
Rounding up to next highest dose
Using once daily dosing
Using twice daily dosing
True or False: UFH elimination is cleared renally and shouldn't be used in patients with CKD
True
False
What's the therapeutic goal using UFH?
INR 2-3
INR 2.5-3.5
1.5-2.5x normal control of 30s
10x normal control of 30s
aPTT should be monitored every (a) hours on UFH therapy in order to adjust
What is standard dosing for bolus UFH in normal patients __ U/kg
16
18
80
60
What is normal IV infusion dosing for UFH in normal patients in __ U/kg/hr?
60
80
18
20
What is prophylactic dosing of Enoxaparin?
30-40mg BID
1mg/kg BID
1.5mg/kg QD
30-40mg QD
What is prophylactic dosing of UFH?
5000U BID
5000U QD
80U/kg
18U/kg/hr
You are giving an inpatient Heparin for diagnosed VTE, suddenly their SBP drops to 82mmhg. What would be the correct treatment to use to stabilize hemodynamics?
tPA Alteplase 100mg
Hold Heparin
Increase Heparin +2U/kg/hr
Start Andexxa anticoagulation reversal
Which of the following would Heparin be better used for?
High Risk PE
Renal Failure
High Bleed Risk
HIT
True or False: DOACs are non-inferior to warfarin in VTE/PE treatment efficacy but were superior in all-cause bleed outcomes
True
False
True or False: Enoxaparin and DOAC first dose have similar onset and PK
True
False
Cancer can increase risk of clots in many patients, DOACs are preferred in VTE of cancer patient except in which type?
GI Cancer
Lung
Osteosarcoma
Leukemia
HIT is more common in UFH use in patients and is an immune-mediated reaction caused by the PF4-Heparin Complex. Which of the following is a diagnostic test that has a good negative predictive value but has higher false positive rates?
ELISA
Optical Density
D-Dimer
Serotonin Release Assay
Which of the following is the gold standard HIT test?
ELISA
Optical Density
Serotonin Release Assay
What should be done for treatment of HIT from UFH?
D/c all heparin product
Give platelet transfusion
Immediately start warfarin while platelets <100K
Start DOAC or Hirudin type anticoagulants
One treatment for anticoagulation while a patient has a HIT reaction is Argatroban. Which of the following is true about argatroban usage?
IV dosing is 2.0mcg/kg/min
aPTT should be monitored every 2 hours
Renal Elimination, do not use in CKD
Hepatic metabolism, safe for use in CKD
INR should be monitored every 2 hours
When Argatroban and warfarin are administered together in patients, what is a therapeutic INR level?
4
2-3
1-2
INR cannot be measured therapeutically with argatroban use
True or False: When using DOACs for HIT patients, the dosing is the same as VTE treatment
True
False
Fondaparinux has off label usage for HIT patients, is it renally eliminated and contraindicated in CKD?
Yes
No
Which of the following anticoagulants requires bridging with parenteral therapy to transition to oral use full time?
Warfarin
Apixaban
Dabigatran
Edoxaban
DOACs like apixaban, edoxaban, and rivaroxaban can be procedurally bridge 24-48 hours prior to surgery, why does Dabigatran have longer bridge time?
It is predominately renally cleared
Must hold 2-3 t1/2 lives
Dabigatran has a t1/2 of 8-12 hrs
Dabigatran can be toxic when used with anesthesia and needs to be entirely cleared
True or False: When transitioning from Enoxaparin to a DOAC like rivaroxaban, you can give the PO dose at the next scheduled dose time (Q12 hours) due to similar PK profiles
True
False
True or False: When transitioning from infusion heparin to DOAC PO, you can do a simultaneous stop of heparin and start of doac
True
False
Match the cell type to its correct life span
RBC: 3months
Platelets: 3 months
Platelets: 7-10 days
WBC: hours to years
What is the hemoglobin concentration cutoff for when RBC transfusion should be initiated?
<7gm/dl
<12gm/dl in women
<13 gm/dl in men
<10gm/dl
True or False: 1U of RBC transfusion will raise hemoglobin by 1gm/dl
True
False
Fresh Frozen plasma is useful in some cases of supertherapeutic warfarin anticoagulation. What will INR never fall below when administering FFP
1.7
2
3
1
True or False: You can use type B+ FFP in patients who have O+ blood
True
False
What is the FFP Units to use for high risk or active bleeding on warfarin?
4-6U
2U
1 U
True or False: Cryoprecipitate (Cryo) contains Vitamin K dependent factors
True
False
True or False: Protamine dosing in heparin reversal is 1mg per 1mg enoxaparin. What should you not exceed in a single dose?
50mg
100mg
500mg
PCC KCentra has a concentrated mixture of coagulation factors, what should be given prior to use?
Vitamin K
FEIBA
FFP
DOACs
True or False: Since Andexxa is very expensive in DOAC reversal, usually KCentra or FEIBA PCC can be given instead
True
False
Which ROA of Vitamin K has the worst absorption
SQ
IV
PO
Which of the following are Antifibrinolytic agents used to prevent degradation of clots by blocking plasmin?
Transexamic Acid
Idarucizumab
Aminocaproic Acid
FEIBA
