CHAPTER 43: ANTITHROMBOTIC THERAPIES AND THEIR LABORATORY ASSESSMENT Flashcards
(1) What is the PT/INR therapeutic range for Coumadin therapy when a patient has a mechanical heart valve?
a. 1 to 2
b. 2 to 3
c. 2.5 to 3.5
d. Coumadin is not indicated for patients with mechanical heart valves
c. 2.5 to 3.5
(2) Monitoring of a patient taking Coumadin showed that her anticoagulation results remained stable over a period of about 7 months. The frequency of her visits to the laboratory began to decrease, so the period between testing averaged 6 weeks. This new testing interval is:
a. Acceptable for a patient with stable anticoagulation results after 6 months
b. Unnecessary, because monitoring for patients taking oral anticoagulants can be discontinued entirely after 4 months of stable test results
c. Too long even for a patient with previously stable test results; 4 weeks is the standard
d. Acceptable as long as the patient performs self-monitoring daily using an approved home testing instrument and reports unacceptable results promptly to her physician
c. Too long even for a patient with previously stable test results; 4 weeks is the standard
(3) What is the greatest advantage of point-of-care PT testing?
a. It permits self-dosing of Coumadin
b. It is inexpensive
c. It is convenient
d. It is precise
c. It is convenient
(4) You collect a citrated whole-blood specimen to monitor UFH therapy. What is the longest it may stand before the plasma must be separated from the cells?
a. 1 hour
b. 4 hours
c. 24 hours
d. Indefinitely
a. 1 hour
(5) What test is used to monitor high-dose UFH therapy in the cardiac catheterization lab?
a. PT
b. PTT
c. Bleeding time
d. ACT
d. ACT
(6) What test is used most often to monitor UFH therapy in the central laboratory?
a. PT
b. PTT
c. ACT
d. Chromogenic anti-factor Xa heparin assay
b. PTT
(7) What test is used most often to monitor LMWH therapy in the central laboratory?
a. PT
b. PTT
c. ACT
d. Chromogenic anti-factor Xa heparin assay
d. Chromogenic anti-factor Xa heparin assay
(8) What is an advantage of LMWH therapy over UFH therapy?
a. It is cheaper
b. It causes no bleeding
c. It has a stable dose response
d. There is no risk of HIT
c. It has a stable dose response
(9) In what situation is an intravenous DTI used?
a. DVT
b. HIT
c. Any situation in which Coumadin could be used
d. Uncomplicated AMI
b. HIT
(10) What laboratory test may be used to monitor intravenous DTI therapy when PTT results are unreliable?
a. PT
b. ECT
c. Reptilase clotting time
d. Chromogenic anti-factor Xa heparin assay
b. ECT
(11) What is the reference method for detecting aspirin or clopidogrel resistance?
a. Platelet aggregometry
b. AspirinWorks
c. VerifyNow
d. PFA-100
a. Platelet aggregometry
(12) What is the name of the measurable platelet activation metabolite used in the AspirinWorks assay to monitor aspirin resistance?
a. 11-dehydrothromboxane B2
b. Arachidonic acid
c. Thromboxane A2
d. Cyclooxygenase
a. 11-dehydrothromboxane B2
(13) Which of the following is an intravenous antiplatelet drug used in the cardiac catheterization laboratory?
a. Abciximab
b. Ticagrelor
c. Prasugrel
d. Clopidogrel
a. Abciximab
(14) Which of the following is a newly developed oral anticoagulant?
a. Argatroban
b. Lepirudin
c. Bivalirudin
d. Rivaroxaban
d. Rivaroxaban
(15) Which of the following is not a point-of-care instrument for the measurement of PT?
a. CoaguChek XS PT
b. Gem PCL Plus
c. Cascade POC
d. Multiplate
d. Multiplate
