ANTICOGULANT PHARMACOLOGY MCQ AND NPC EXAM DAILY SERIES 36

ANTICOGULANT MCQ DAILY SERIES

1. Which preparation of Vitamin K should not be injected in the new born ?

(a) Phytonadione

(b) Menadione

(c) Menadione sodium diphosphate

(d) Both (b) and (c)

2. Unfractionated heparin binds to antithrombin III and inactivates clotting factor(s).

(a) Xa

(b) IXa

(c) IIa

(d) All of the above

3. Low concentrations of heparin selectively interfere with the following coagulation pathway:

(a) Intrinsic pathway

(b) Extrinsic pathway

(c) Common pathway

(d) Both (a) and (c)

4. Low doses of heparin prolong:

(a) Bleeding time

(b) Activated partial thromboplastin time

(c) Prothrombin time

(d) Both (b) and (c)

5. Low molecular weight heparins differ from conventional heparin in that:

(a) They selectively inhibit factor Xa

(b) They do not significantly prolong clotting time

(c) They are metabolized slowly and have longer duration of action

(d) All of the above

6. Which of the following can be used to antagonize the action of heparin in case of overdose ?

(a) Heparin sulfate 

(b) Dextran sulfate

(c) Protamine sulfate 

(d) Ancrod

7. Blood level of which clotting factor declines most rapidly after the initation of warfarin therapy

(a) Factor VII 

(b) Factor IX

(c) Factor X 

(d) Prothrombin

8. The following drug reduces the effect of oral anticoagulants

(a) Broad spectrum antibiotic

(b) Cimetidine

(c) Aspirin

(d) Oral contraceptive

9. The most definite beneficial results are obtained in the use of anticoagulants for the following purpose

(a) Prevention of recurrences of myocardial infarction

(b) Prevention of venous thrombosis and pulmonary embolism

(c) Cerebrovascular accident

(d) Retinal artery thrombosis

10. Anticoagulants are indicated in

(a) Immobilized elederly patients

(b) Buerger’s disease

(c) Stroke due to cerebral thrombosis

(d) All of these

11. Which of the following tests are used to monitor antithrombotic therapy?

I. International normalized ratio (INR)

II. Activated partial thromboplastin time (APTT)

III. Heparin assay

(a) If I only is correct

(b) If III only is correct

(c) If I and II are correct

(d) If II and III are correct

12. Which fibrioolytic drug(s) is/are antigenic

(a) Streptokinase 

(b) Urokinase

(c) Alteplase 

(d) Both (a) and (b)

13. The most important complication of streptokinase therapy is

(a) Hypotension 

(b) Bleeding

(c) Fever

(d) Anaphylaxis

14. A patient to be commenced on oral anticoagulant therapy for DVT would be treated with:

I. Oral anticoagulant therapy with warfarin for a goal international normalized ratio (INR) of 2–3

II. Oral anticoagulant therapy with warfarin for a goal INR of 2.5–3.5

III. Oral anticoagulant therapy with aspirin for a goal INR of 2–3

(a) If I only is correct

(b) If III only is correct

(c) If I and II are correct

(d) If II and III are correct

15. Thrombolytic therapy instituted within 3- 6 hours of onset of acute myocardial infarction affords the following benefit:

(a) Reduces mortality

(b) Reduces area of myocardial necrosis

(c) Preserves ventricular function

(d) All of these

16. The preferred route of administration of streptokinase in acute myocardial infarction is

(a) Intravenous

(b) Subcutaneous

(c) Intracoronary 

(d) Intracardiac

17. Aspirin prolongs bleeding time by inhibiting the synthesis of

(a) Clotting factors in liver

(b) Prostacyclin in vascular endothelium

(c) Cyclic AMP in platelets

(d) Thromboxane A2 in platelets

18. Route of heparin administration is

(a) Oral

(b) Subcutaneous

(c) Intramuscular 

(d) Sublingual

19. The anticoagulant effects of heparin can be promptly arrested by administration of

(a) Epsilon amino caproic acid

(b) Protamine sulfate

c) Adrenaline

(d) Vitamin K

20. Severe cases of bleeding due to fibrinolytic agents are treated with

(a) Aspirin

(b) Heparin

(c) EACA (Epsilon Amino Caproic Acid)

(d) Vitamin K

21. If a patient has an INR greater than 20 and active bleeding that is clinically significant (i.e. hematuria), the pharmacist

should

I. Hold the drug therapy

II. Administer vitamin K

III. Administer fresh frozen plasma

(a) If I only is correct

(b) If III only is correct

(c) If I and II are correct

(d) If II and III are correct

ANSWERS:

1. d

2. b

3. a

4. b

5. d

6. c

7. a

8. d

9. b

10. a

11. c

12. a

13. b

14. b

15. d

16. a

17. d

18. b

19. b

20. c

21. b

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