Heme/Oncology I

Question 1

heparin

Answer 1

activator of antithrombin

decreased thrombin and factor Xa - anticoagulant

Question 2

immediate anticoagulation

Answer 2

heparin

Question 3

monitor with heparin

Answer 3

PTT

Question 4

HIT

Answer 4

heparin induce thrombocytopenia

IgG Abs against heparin bound platelet factor 4 (PF4)

Ab-heparin-HP4 - activate platelet - thrombosis and thrombocytopenia

Question 5

argatroban

Answer 5

thrombin inhibitor

Question 6

bivalirudin

Answer 6

thrombin inhibitor

Question 7

dabigatran

Answer 7

thrombin inhibitor

Question 8

protamine sulfate

Answer 8

reversal of heparin

positive charbe - binds negative heparin

Question 9

enoxaparin

Answer 9

LMWH

Question 10

dalteparin

Answer 10

LMWH

Question 11

fondaparinux

Answer 11

LMWH

Question 12

LMWH

Answer 12

act more on factor Xa
-better bioavailability

longer half life

no lab monitoring
not reversible

Question 13

warfarin

Answer 13

interfere with gamma carboxylation vit K factors

II, VII, IX, X, protein C and S

Question 14

monitor with warfarin

Answer 14

PT and INR

Question 15

chronic anticoag

Answer 15

warfarin

Question 16

warfarin pregnancy

Answer 16

no - teratogen

Question 17

transient hypercoag with warfarin

Answer 17

protein C and S - shorter half lives

-so get hypercoag when start warfarin therapy

Question 18

reversal of warfarin

Answer 18

vit K

Question 19

rapid reversal of warfarin

Answer 19

fresh frozen plasma

Question 20

heparin bridging

Answer 20

heparin used when starting warfarin

-to get anticoag during transient hypercoag of warfarin use

Question 21

apixaban

Answer 21

direct factor Xa inhibitor

Question 22

rivaroxaban

Answer 22

direct factor Xa inhibitor

Question 23

alteplase

Answer 23

thrombolytic

Question 24

reteplase

Answer 24

thrombolytic

Question 25

streptokinase

Answer 25

thrombolytic

Question 26

tenecteplase

Answer 26

thrombolytic

Question 27

thrombolytics

Answer 27

aid conversion plasminogen to plasmin plasmin - cleaves thrombin and fibrin clots

Question 28

changes with thrombolytic therapy

Answer 28

increased PT and PTT | no change platelet count

Question 29

adverse thrombolytic

Answer 29

bleeding CI if pt with recent bleeding

Question 30

aminocaproic acid

Answer 30

tx of thrombolytic toxicity | -inhibitor of fibrinolysis

Question 31

aspirin

Answer 31

irreversible COX inhibitor covalent acetylation

Question 32

changes with aspirin therapy

Answer 32

increased bleeding time decreased TXA2 and PGs no effect PT and PTT

Question 33

adverse aspirin

Answer 33

tinnitus - CN VIII gastric ulcer upper GI bleed interstitial nephritis reye syndrome

Question 34

reye syndrome

Answer 34

child with viral infection - takes aspirin

Question 35

acid-base status with aspirin OD

Answer 35

hyperventilation - respiratory alkalosis eventual mixed with metabolic acidosis

Question 36

clopidogrel

Answer 36

ADP receptor inhibitor

Question 37

prasugrel

Answer 37

ADP receptor inhibitor

Question 38

ticagrelor

Answer 38

ADP receptor inhibitor

Question 39

ticlopidine

Answer 39

ADP receptor inhibitor

Question 40

ADP receptor inhibitors

Answer 40

inhibit platelet aggregation - irreversible block ADP receptor - prevent expression glycoprotein IIb/IIIa

Question 41

adverse ticlopidine

Answer 41

neutropenia

Question 42

cliostazol

Answer 42

phosphodiesterase inhibitor - increased cAMP in platelets - inhibit platelet aggregation vasodilator

Question 43

dipyrimadole

Answer 43

phosphodiesterase inhibitor vasodilator

Question 44

adverse of phosphodiesterase inhibitors

Answer 44

nausea, headache, flushing, hypotension, abdomen pain

Question 45

abciximab

Answer 45

GP IIb/IIIa inhibitor

Question 46

eptifibatide

Answer 46

GP IIb/IIIa inhibitor

Question 47

tirofiban

Answer 47

GP IIb/IIIa inhibitor

Question 48

GP IIb/IIIa inhibitor

Answer 48

prevent platelet aggregation