Coagulation Disorders

Question 1

Platelet activator and powerful vasoconstrictor

Answer 1

Thromboxane A2

Question 2

Potent endothelium derived vasoconstrictor

Answer 2

Endothelin

Question 3

Platelet adhesion is mediated by

Answer 3

vWF

Question 4

What receptor is responsible for platelet adhesion?

Answer 4

gp1b

Question 5

What receptor is responsible for platelet aggregation ?

Answer 5

gp2b3a

Question 6

Proaggregation factors:

Answer 6

TXA2
Serotonin
ADP

Question 7

Anti aggregation factors

Answer 7

PGI2- prostacyclin
cAMP
PGE1

Question 8

Problems with gp1b receptor leads to this disease

Answer 8

Bernard-Soulier

Question 9

Problems with gp2b3a receptor leads to this disease

Answer 9

Glansman disease

Question 10

Factors in intrinsic pathway

Answer 10

5,8,9,10,11,12
Prothrombin
Fibrinogen

Question 11

Factors in extrinsic pathway

Answer 11

5,7,10 prothrombin, fibrinogen

Question 12

Nonselective, irreversible COX inhibitor that reduces TXA2

Answer 12

Aspirin
Salsalate
Na salicylate

Question 13

Associated with Reye syndrome

Answer 13

Aspirin

Question 14

Toxic dose of aspirin

Answer 14

150mg/kg

Question 15

Lethal dose of aspirin

Answer 15

500mg/kg

Question 16

Triad of asprin hypersensitivity

Samter Triad

Answer 16

Asthma
Aspirin sensitivity
Nasal polyps

Question 17

What is the expected acid base abnormality in salicylate poisoning?

Answer 17

Respiratory alkalosis with HAGMA

Question 18

gp2b3a inhibitor used during PCI to prevent thrombosis and adjunct to thrombolysis and ACS

Answer 18

Abciximab
Eptifibatide
Tirofiban

Question 19

Thienopyridine, ADP inhibitor that reduces platelet aggregation

Answer 19

Clopidogrel
Ticlopidine
Prasugrel

Question 20

PDE3 inhibitor that increases cAMP in platelets and blood vessels and causes vasodilation

Answer 20

Cilostazol

Dipyridamole

Question 21

Antiplatelet drug used for prevention of thromboembolic complications of caridac valve replacement, intermittent claudication

Answer 21

Cilostazol

Dipyridamole

Question 22

Contraindicated in heart failure

Answer 22

Cilistazol

Question 23

Heparin or Warfarin?

Site of action- liver

Answer 23

Warfarin

Question 24

Heparin or Warfarin?

Activates antithrombin III

Answer 24

Heparin

Question 25

Heparin or Warfarin? Monitored by PT INR

Answer 25

Warfarin

Question 26

Heparin or Warfarin? Monitored by PTT

Answer 26

Heparin

Question 27

Heparin or Warfarin? Can be used in pregnancy

Answer 27

Heparin

Question 28

Heparin or Warfarin? Slow onset (days)

Answer 28

Warfarin

Question 29

Antidote for heparin

Answer 29

Protamine sulfate

Question 30

Antidote for warfarin

Answer 30

Vitamin K

Question 31

Anticoagulant thay can cause osteoporosis with prolonged use

Answer 31

Heparin

Question 32

Indirect thrombin inhibitor that binds antithrombin III on factor 10a Does not require monitoring

Answer 32

``` Enoxaparin Danaparoid Fondaparinux Dalteparin Tinzaparin ```

Question 33

Direct thrombin inhibitor that inhibits its enzymatic action used in heparin induced thrombocytopenia

Answer 33

Lepirudin Dabigatran Argatroban

Question 34

Direct thrombin inhibitors should be monitored with

Answer 34

PTT

Question 35

Oral direct factor 10a inhibitor used in prevention of venous thromboembolism and prevention of stroke in patients with AF

Answer 35

Rivaroxiban | Apixaban

Question 36

Rapid onset and shorter half life than warfarin No monitoring required Used especially after hip or knee surgery

Answer 36

Rivaroxiban | Apixaban

Question 37

Side effect of warfarin

Answer 37

Warfarin induced skin necrosis Protein C and S deficiency Teratogen

Question 38

How to avoid skin necrosis in warfarin?

Answer 38

Anticoagulant overlap with heparin

Question 39

Cytochrome P450 inducers Ethel Booba takes Phen Phen and Refuses Greasy Carb Shakes

Answer 39

``` Ethanol Barbiturates Phenytoin Rifampicin Griseofulvin Carbamazepine Smoking/ St. John's Wort ```

Question 40

Cytochrome P450 inhibitors Inhibitors Stop Cyber Kids from Eating GRApefruit Q

Answer 40

``` Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Grapefruit juice Ritonavir Amiodarone Quinidine ```

Question 41

Thrombolytic (tissue plasminogen activator analog) that converts plasminogen to plasmin

Answer 41

``` Alteplase Anistreplase Streptokinase Reteplase Tenecteplase Urokinase ```

Question 42

Antidote for streptokinase

Answer 42

Aminocaproic acid

Question 43

Contraindications to thrombolysis

Answer 43

``` Cerebral hemorrhage at any time Cerebrovascular event within the past year Marked HTN suspicious aortic dissection Active internal bleeding ```

Question 44

Competitively inhibits plasminogen activation by inhibiting tPA

Answer 44

Tranexamic acid

Question 45

Prothrombotic contraindicated in DIC

Answer 45

Tranexamic acid

Question 46

ADH agonist that increases factor 8 activity on patients with mild hemophilia A or vWF

Answer 46

Desmopressin

Question 47

Where does desmopressin act?

Answer 47

Vasopressin V2 receptor