Anticoagulation

Question 1

Components of CHA2DS2VASc score

Answer 1

C - congestive heart failure (1)
H - hypertension (1)
A2 - age >74 (2)
D - DM (1)
S2 - previous stroke / TIA (2)
V - vascular disease (1)
A - age 65-74 (1)
Sc - sex category (1)

Question 2

HASBLED Score components

Answer 2

H - hypertension (1)
A - abnormal renal / liver function (1/2)
S - previous stroke (1)
B - history of major bleeding (1)
L - labile INRs (1)
E - elderly (1)
D - drug therapy (NSAIDs, antiplatelets) (1)
/ drunks >8/week (1)

Question 3

MOA of Heparin

Answer 3

Inhibition of thrombin and factor Xa

Question 4

MOA of Warfarin

Answer 4

Inhibits vitamin K epoxide reductase, preventing reactivation of vit K and coagulation factor synthesis

Question 5

MOA of DOACs

Answer 5

Targeted inihibition of FXa / thrombin

Question 6

Indications for Heparin

Answer 6

VTE

Question 7

Indication for warfarin

Answer 7

VTE

AF and heart valve replacement

Question 8

Indication for DOACs

Answer 8

AF
Rx of VTE / 2o prevention of VTE
ACS

Question 9

Which anticoagulant is contraindicated in pregnancy?

Which can be used in pregnancy?

Answer 9

CI: warfarin

LMWH is safe in pregnancy.

Question 10

Acute risks in blood transfusion

Answer 10

ABO incompatibility

TACO (transfusion associated circulatory overload)

TRALI (transfusion-related acute lung injury)

Allergy / anaphylaxis

Question 11

Which acute risk of blood transfusion presents with hypotension

Answer 11

TRALI

Question 12

Infections from blood transfusion

Answer 12

Hep B/C
Human T lymphotrophic virus
HIV
CJF
HV8
West Nile virus

Question 13

Delayed risks with blood transfusion

Answer 13

Delayed haemolytic transfusion reaction
Iron overload
Microcimerism
Over / under transfusion 
GVHD - when immunocompetent stem cells in the transplanted organ