3 - anti-coagulants mcqs

Question 1
Anticoagulants are indicated for an indefinite period in patients with:
Atrial fibrillation------------
Venous thromboembolism
High risk of myocardial infarction
All of the above

Question 2
Which of the following sentence is true with regard to warfarin?
Is a vitamin K antagonist------------
Is a thrombin inhibitor
Activates fibrinolysis
Binds to antithrombin III

Question 3
Which of the following is not an approved indication for warfarin therapy?
Atrial fibrillation
Heart valve replacement
Deep vein thrombosis
Peripheral artery disease--------------

Question 4
Time taken for observable anticoagulant effect of warfarin is:
6-12 hours
24-36 hours
2-7 days--------------
8-10days

Question 5
Which of the following is the recommended test to monitor the effect of oral anticoagulant therapy?
Thrombin time
International normalized ratio (INR)----------------
Bleeding time
Partial thromboplastin time (PTT)

Question 6
What is the most acceptable frequency of INR monitoring in a patient taking warfarin?
Initially thrice daily, then twice daily, then daily, then weekly, and then monthly
Initially twice daily, then daily, then weekly, and then monthly
Initially daily, then weekly, and then monthly
Initially twice per week, then weekly, then every two or three weeks, and then monthly----------

Question 7
What is the value of International normalized ratio (INR) above which warfarin does not provide any additional therapeutic benefit in most patients, but is associated with a higher risk of bleeding?
4.0----------
3.5
3.0
2.5

Question 8
Which of the following is used for reversal of anticoagulant effect of warfarin in case of life-threatening bleeding?
Platelets
Protamine
Vitamin K or Vitamin K dependant coagulation factors-----------
Any of the above

Question 9
Which of the following statement(s) concerning heparin is/are true?
It binds to antithrombin III leading to anticoagulant effect
It exhibits varying anticoagulant response
Heparin therapy is monitored with activated partial thromboplastin time (APTT)
All of the above-----------

Question 10
Which of the following is an advantage of low molecular weight heparin (LMWH) over unfractionated heparin?
Does not require monitoring of activated partial thromboplastin time
Has a greater bioavailibility
Given subcutaneously therefore can be administered in “out of hospital setting”
All of the above------------

Question 11
Low molecular weight heparins (LMWHs) do not require monitoring, but when necessary, which of the following is measured?
Anti-factor Xa level-------------
Thrombin time
Prothrombin time
Activated partial thromboplastin time (APTT)

Question 12
The anticoagulant effect of heparin is rapidly reversed with:
Protamine----------------
Infusion of vitamin K dependant coagulation factors
Packed red blood cells
Platelets

Question 13
Which of the following anticoagulant should not be given during pregnancy?
Warfarin-------------
Low molecular weight heparins (LMWHs)
Unfractionated heparin
All of the above

Question 14
Which of the following is correct with regard to patients taking warfarin undergoing surgery with minimal risk of bleeding?
Do not stop warfarin but check INR prior to surgery----------------
Switch over to heparin two days prior to surgery and restart warfarin after surgery
Switch over to heparin five days prior to surgery and restart warfarin after surgery
Switch over to heparin seven days prior to surgery and restart warfarin after surgery

Question 15
Anticoagulation in warfarin users at high risk of thromboembolism, undergoing surgery associated with high risk of bleeding involves:
Stop warfarin 4-5 days prior to surgery
Start with full dose unfractionated heparin or LMWH 2-3 days preoperatively
Restart regular warfarin therapy after surgery once adequate haemostasis is achieved
All of the above-----------