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Antithrombotic and Anticoagulant Drugs Worksheet

Total questions: 70

Worksheet time: 35mins

Name
Class
Date
1.

Which class of drugs interferes with platelet aggregation?

a)

Anticoagulants

b)

Thrombolytics

c)

Antiplatelet agents

d)

Fibrinolytics

2.

Anticoagulant medications primarily act by:

a)

Dissolving existing clots

b)

Inhibiting the clotting cascade

c)

Activating plasminogen

d)

Breaking down fibrin

3.

Thrombolytic medications are best described as drugs that:

a)

Prevent platelet adhesion

b)

Suppress thrombosis

c)

Lyse existing thrombi

d)

Inhibit vitamin K

4.

Which condition is commonly treated with antiplatelet or anticoagulant therapy?

a)

Hypertension

b)

Deep vein thrombosis

c)

Asthma

d)

Hypothyroidism

5.

Combining multiple antithrombotic agents primarily increases the risk of:

a)

Infection

b)

Hypotension

c)

Bleeding

d)

Bradycardia

6.

Drug interactions that increase serum levels of antithrombotic agents increase the risk of:

a)

Clot formation

b)

Bleeding

c)

Arrhythmias

d)

Renal failure

7.

Drug interactions that decrease serum levels of anticoagulants increase the risk of:

a)

Stroke

b)

Bleeding

8.

Antiplatelet and anticoagulant drugs do NOT:

a)

Prevent thrombosis

b)

Dissolve existing clots

c)

Increase bleeding risk

d)

Reduce clot formation

9.

Aspirin irreversibly inhibits which enzyme in platelets?

a)

COX-2

b)

COX-1

c)

CYP2C19

d)

Thrombin

10.

Aspirin’s antiplatelet effect lasts for the life of the platelet because platelets:

a)

Have slow metabolism

b)

Lack a nucleus

c)

Cannot bind aspirin

d)

Are rapidly replaced

11.

Inhibition of COX-1 by aspirin prevents the formation of:

a)

Prostacyclin (PGI₂)

b)

Thrombin

c)

Thromboxane A₂

d)

Plasmin

12.

Low-dose aspirin is preferred for long-term prevention of MI because it:

a)

Inhibits COX-2 more strongly

b)

Preserves prostacyclin activity

c)

Completely blocks inflammation

d)

Eliminates bleeding risk

13.

Which prostaglandin inhibits platelet aggregation and causes vasodilation?

a)

Thromboxane A₂

b)

Prostacyclin (PGI₂)

c)

Leukotriene B₄

d)

Prostaglandin E₂

14.

Why is aspirin chewed during suspected acute MI?

a)

To reduce GI irritation

b)

To increase renal clearance

c)

To speed absorption

d)

To reduce bleeding risk

15.

Aspirin should be avoided in suspected stroke until imaging because:

a)

It increases clot formation

b)

The stroke may be hemorrhagic

c)

It worsens ischemia

d)

It causes hypotension

16.

Clopidogrel blocks which platelet receptor?

a)

COX-1

b)

GP IIb/IIIa

c)

ADP (P2Y12)

d)

Thrombin receptor

17.

Clopidogrel is considered a prodrug because it:

a)

Is inactive until metabolized

b)

Has a long half-life

c)

Acts directly on platelets

d)

Is eliminated unchanged

18.

Which enzyme primarily activates clopidogrel?

a)

CYP3A4

b)

CYP2C9

c)

CYP2C19

d)

CYP1A2

19.

Poor CYP2C19 metabolizers receiving clopidogrel will likely experience:

a)

Increased bleeding

b)

Reduced drug effectiveness

c)

Faster platelet inhibition

d)

No adverse effects

20.

Omeprazole reduces clopidogrel effectiveness by:

a)

Increasing platelet turnover

b)

Inhibiting CYP2C19

c)

Enhancing renal clearance

d)

Activating thrombin

21.

Cannabis may reduce clopidogrel activation primarily by inhibiting:

a)

COX-1

b)

VKORC1

c)

CYP2C19

d)

CYP2C9

22.

Warfarin reduces clot formation by inhibiting regeneration of:

a)

Thrombin

b)

Antithrombin

c)

Active vitamin K

d)

Factor Xa

23.

Which clotting factors are affected by warfarin?

a)

I, V, VIII, XI

b)

II, VII, IX, X

c)

III, V, XII

d)

VIII, IX, XI

24.

Warfarin has a delayed onset because it:

a)

Does not affect existing clotting factors

b)

Requires IV administration

c)

Acts only on platelets

d)

Has poor absorption

25.

Warfarin therapy is monitored using which laboratory test?

a)

aPTT

b)

PT/INR

c)

Platelet count

d)

Anti-Xa level

26.

The usual therapeutic INR range for most patients is:

a)

0.8–1.2

b)

1.5–2.0

c)

2.0–3.0

d)

3.5–4.5

27.

Warfarin is contraindicated in pregnancy primarily because it is:

a)

Ineffective

b)

Nephrotoxic

c)

Teratogenic

d)

Poorly absorbed

28.

VKORC1 gene variants typically result in:

a)

Higher warfarin dose requirements

b)

Lower warfarin dose requirements

c)

Faster elimination

d)

Resistance to warfarin

29.

CYP2C9 variants affect warfarin by:

a)

Increasing vitamin K absorption

b)

Decreasing warfarin metabolism

c)

Increasing clotting factor synthesis

d)

Blocking platelet receptors

30.

The most common antidote for warfarin toxicity is:

a)

Protamine sulfate

b)

Idarucizumab

c)

Vitamin K

d)

Andexanet alfa

31.

Heparin increases anticoagulation by enhancing the activity of:

a)

Thrombin

b)

Protein C

c)

Antithrombin

d)

Plasmin

32.

Unfractionated heparin inhibits which clotting factors?

a)

Xa only

b)

IIa only

c)

IIa and Xa

d)

VII and IX

33.

The primary laboratory test used to monitor heparin therapy is:

a)

INR

b)

PT

c)

aPTT

d)

Platelet count

34.

Heparin is considered a high-alert medication because it:

a)

Has no antidote

b)

Causes frequent allergic reactions

c)

Has a high risk of serious harm if misused

d)

Is poorly absorbed

35.

Heparin-induced thrombocytopenia (HIT) is caused by:

a)

Bone marrow suppression

b)

Platelet destruction from antibodies

c)

Vitamin K deficiency

d)

Liver dysfunction

36.

HIT is considered prothrombotic because it causes:

a)

Platelet depletion only

b)

Increased platelet activation

c)

Reduced thrombin formation

d)

Decreased coagulation

37.

Which factor is preferentially inhibited by enoxaparin?

a)

Factor IIa

b)

Factor VII

c)

Factor Xa

d)

Factor IX

38.

Enoxaparin has less effect on thrombin because it:

a)

Is rapidly metabolized

b)

Has a shorter molecular chain

c)

Does not bind antithrombin

d)

Is orally administered

39.

Routine lab monitoring is usually unnecessary with enoxaparin because it has:

a)

No anticoagulant effect

b)

Predictable pharmacokinetics

c)

Rapid elimination

d)

No bleeding risk

40.

Protamine sulfate reverses enoxaparin:

a)

Completely

b)

Partially

c)

Not at all

d)

Indirectly

41.

Dabigatran directly inhibits:

a)

Factor Xa

b)

Thrombin (Factor IIa)

c)

Vitamin K

d)

Antithrombin

42.

Dabigatran capsules should not be crushed because this increases:

a)

Renal clearance

b)

Bleeding risk

c)

Drug inactivation

d)

Platelet aggregation

43.

Dabigatran is primarily eliminated through the:

a)

Liver

b)

Lungs

c)

Kidneys

d)

Skin

44.

The specific reversal agent for dabigatran is:

a)

Vitamin K

b)

Protamine sulfate

c)

Idarucizumab

d)

Andexanet alfa

45.

Rivaroxaban inhibits which clotting factor?

a)

A. IIa

b)

B. VII

c)

C. IX

d)

D. Xa

46.

Rivaroxaban is contraindicated in severe renal impairment because it:

a)

Accumulates and increases bleeding risk

b)

Loses effectiveness

c)

Causes nephrotoxicity

d)

Induces thrombosis

47.

Andexanet alfa works by acting as a:

a)

Vitamin K analog

b)

Thrombin inhibitor

c)

Factor Xa decoy protein

d)

Platelet stabilizer

48.

Thrombolytic medications act by activating:

a)

Thrombin

b)

Antithrombin

c)

Plasminogen

d)

Platelet receptors

49.

Plasmin’s role is to:

a)

Form fibrin

b)

Break down fibrin clots

c)

Activate platelets

d)

Inhibit vitamin K

50.

Alteplase is most effective when administered:

a)

Several days after clot formation

b)

Within hours of symptom onset

c)

Only after anticoagulation

d)

As long-term therapy

51.

The primary adverse effect of thrombolytic therapy is:

a)

Hypotension

b)

Infection

c)

Bleeding

d)

Arrhythmia

52.

A prior hemorrhagic stroke is a contraindication to thrombolytic therapy because of increased risk of:

a)

Stroke recurrence

b)

Fatal bleeding

c)

Thrombosis

d)

Hypertension

53.

Statins lower LDL cholesterol primarily by:

a)

Increasing bile excretion

b)

Increasing LDL receptor expression

c)

Blocking dietary absorption

d)

Enhancing triglyceride clearance

54.

Statins inhibit which enzyme in cholesterol synthesis?

a)

ACL

b)

PCSK9

c)

HMG-CoA reductase

d)

Lipoprotein lipase

55.

A common adverse effect associated with statins is:

a)

Bradycardia

b)

Myalgias

c)

Hypoglycemia

d)

Hypertension

56.

Grapefruit juice increases statin levels by inhibiting:

a)

CYP2C9

b)

CYP3A4

c)

P-glycoprotein

d)

VKORC1

57.

Bempedoic acid lowers LDL by inhibiting:

a)

HMG-CoA reductase

b)

ATP-citrate lyase

c)

PCSK9

d)

Lipoprotein lipase

58.

Compared with statins, bempedoic acid has a lower risk of:

a)

Hepatotoxicity

b)

Tendon rupture

c)

Muscle toxicity

d)

Hyperuricemia

59.

Ezetimibe lowers cholesterol by:

a)

Increasing LDL receptor breakdown

b)

Blocking intestinal cholesterol absorption

c)

Inhibiting triglyceride synthesis

d)

Activating PCSK9

60.

Fibrates primarily reduce:

a)

LDL cholesterol

b)

HDL cholesterol

c)

Triglycerides

d)

Total cholesterol

61.

Nitrates reduce myocardial oxygen demand primarily by decreasing:

a)

Heart rate

b)

Contractility

c)

Preload

d)

Afterload

62.

Nitroglycerin causes vasodilation mainly in the:

a)

Arterioles

b)

Veins

c)

Capillaries

d)

Coronary microcirculation only

63.

Tolerance to nitroglycerin patches is prevented by:

a)

Increasing the dose

b)

Using continuous therapy

c)

Allowing patch-free intervals

d)

Combining with beta blockers

64.

Nitroglycerin should never be combined with which drug class?

a)

Beta blockers

b)

ACE inhibitors

c)

PDE-5 inhibitors

d)

Calcium channel blockers

65.

The primary goal in stable angina treatment is to:

a)

Dissolve coronary clots

b)

Reduce myocardial oxygen demand

c)

Increase heart rate

d)

Prevent platelet aggregation

66.

PCI is preferred over thrombolytic therapy in STEMI because it:

a)

Is cheaper

b)

Has fewer bleeding risks

c)

Reduces mortality and reinfarction

d)

Requires less time

67.

In ACS, antiplatelet and anticoagulant therapy is used to:

a)

Dissolve existing clots

b)

Prevent clot progression

c)

Increase coronary vasoconstriction

d)

Reduce lipid levels

68.

Morphine in ACS helps reduce myocardial oxygen demand by causing:

a)

A. Vasoconstriction

b)

B. Venodilation

c)

C. Increased preload

d)

D. Increased heart rate

69.

ACE inhibitors are started after MI primarily to:

a)

Reduce pain

b)

Prevent arrhythmias

c)

Limit ventricular remodeling

d)

Increase blood pressure

70.

Nitroglycerin in acute STEMI is mainly used to:

a)

Reduce mortality

b)

Lyse clots

c)

Relieve chest pain

d)

Prevent reinfarction

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