front 1 A clinician draws blood for a coagulation assay but wants to prevent clotting in the tube. Which additive is most appropriate? A. Tissue plasminogen activator | back 1 B. Calcium chelator |
front 2 A patient with persistent postoperative oozing is given aminocaproic acid. The drug most directly decreases formation of which enzyme? A. Thrombin | back 2 C. Plasmin |
front 3 Aminocaproic acid is best understood as a structural analogue of which amino acid? A. Lysine | back 3 A. Lysine |
front 4 The principal hemostatic process inhibited by aminocaproic acid is: A. Platelet adhesion | back 4 B. Fibrinolysis |
front 5 Which heparin preparation has the greater effect on thrombin inhibition? A. Fondaparinux | back 5 C. High-molecular-weight heparin |
front 6 Compared with high-molecular-weight heparin, low-molecular-weight heparin has less effect on: A. Platelet cyclooxygenase | back 6 B. Direct thrombin inhibition |
front 7 Heparin begins its anticoagulant action by binding to: A. Antithrombin III | back 7 A. Antithrombin III |
front 8 After binding its target protein, heparin most directly accelerates inactivation of: A. VIIa and IXa | back 8 B. II and Xa |
front 9 Which pattern most accurately describes high-molecular-weight heparin? A. Predominant Xa inhibition | back 9 C. II and Xa inhibition |
front 10 Which pattern most accurately describes low-molecular-weight heparin? A. Mainly factor Xa inhibition | back 10 A. Mainly factor Xa inhibition |
front 11 Which drug is a low-molecular-weight heparin? A. Argatroban | back 11 B. Enoxaparin |
front 12 A hospitalized patient on a continuous heparin infusion should be followed primarily with which laboratory study? A. PT | back 12 D. PTT |
front 13 Five days after starting heparin, a patient develops thrombocytopenia and a new painful swollen leg. Which complication is most likely? A. Disseminated fibrinolysis | back 13 B. Heparin-induced thrombocytopenia |
front 14 A patient develops heparin-induced thrombocytopenia with new thrombosis. Which alternative is most appropriate? A. Argatroban | back 14 D. Enoxaparin |
front 15 A major long-term adverse effect of prolonged heparin therapy is: A. Osteoporosis | back 15 A. Osteoporosis |
front 16 Another recognized long-term consequence of heparin exposure is: A. Hyperaldosteronism | back 16 B. Mineralocorticoid deficiency |
front 17 Which complication pair is classically associated with prolonged heparin therapy? A. Cataracts and glaucoma | back 17 C. Fractures and osteoporosis |
front 18 Heparin is generally contraindicated in a patient who has very recently undergone: A. Vaccination | back 18 B. Surgery |
front 19 Which drug is highly specific for factor Xa and is especially effective for prevention and treatment of venous thromboembolism? A. Dabigatran | back 19 C. Fondaparinux |
front 20 Which drug is an oral factor Xa inhibitor? A. Rivaroxaban | back 20 A. Rivaroxaban |
front 21 Which additional drug also belongs to the oral factor Xa inhibitor class? A. Prasugrel | back 21 B. Edoxaban |
front 22 Which agent is another oral factor Xa inhibitor? A. Betrixaban | back 22 A. Betrixaban |
front 23 Which drug directly binds the active site of thrombin? A. Apixaban | back 23 C. Bivalirudin Direct Dan Brought A Hot Mom |
front 24 Which additional agent is also a direct thrombin inhibitor? A. Melagatran | back 24 A. Melagatran Direct Dan Brought A Hot Mom |
front 25 A patient requires inhibition of ADP-induced platelet aggregation after arterial thrombosis. Which drug fits best? A. Abciximab | back 25 B. Clopidogrel ADP CTP |
front 26 Which additional drug shares that ADP-mediated antiplatelet mechanism? A. Ticlopidine | back 26 A. Ticlopidine ADP CTP |
front 27 Which platelet inhibitor works by blocking glycoprotein IIb/IIIa receptors? A. Prasugrel | back 27 C. Tirofiban GP2 is tired enough for ABCs |
front 28 Which additional drug works by the same glycoprotein IIb/IIIa mechanism? A. Abciximab | back 28 A. Abciximab GP2 is tired enough for ABCs |
front 29 A smoker with exertional calf pain is started on a phosphodiesterase inhibitor to improve symptoms. Which drug was most likely prescribed? A. Prasugrel | back 29 B. Cilostazol 3 CiDi |
front 30 A patient with warfarin excess develops active bleeding and marked overanticoagulation. Which treatment pair is most appropriate? A. Menadione and platelets | back 30 C. Phytonadione and fresh frozen plasma |
front 31 Which vitamin preparation should never be used to treat warfarin overdose? A. Vitamin K1 (Phytonadione) | back 31 C. Menadione (Vitamin K3) |
front 32 Which drug is also an oral factor Xa inhibitor? A. Argatroban | back 32 B. Apixaban |
front 33 Which drug directly inhibits thrombin? A. Tinzaparin | back 33 C. Dabigatran Direct Dan Brought A Hot Mom |
front 34 Which additional agent is also a direct thrombin inhibitor? A. Hirudin | back 34 A. Hirudin Direct Dan Brought A Hot Mom |
front 35 Which drug inhibits ADP-induced platelet aggregation? A. Fondaparinux | back 35 C. Prasugrel ADP CTP |
front 36 ticlopidine: which adverse effect is most classically associated with this drug? A. Hemolysis | back 36 B. Leukopenia |
front 37 Which drug is another example of a low-molecular-weight heparin? A. Dalteparin | back 37 A. Dalteparin |
front 38 Which additional drug also belongs to the low-molecular-weight heparin group? A. Tirofiban | back 38 B. Tinzaparin |
front 39 Which factor Xa inhibitor has a heparin-like mechanism yet does not cause HIT? A. Fondaparinux | back 39 A. Fondaparinux |
front 40 A patient receiving unfractionated heparin develops severe bleeding. Which agent is most appropriate for immediate reversal? A. Idarucizumab | back 40 C. Protamine sulfate |
front 41 Warfarin impairs γ-carboxylation of glutamate residues on which coagulation-related factor? A. Factor VIII | back 41 B. Factor VII |
front 42 Warfarin also decreases γ-carboxylation of which additional factor? A. Factor XI | back 42 C. Factor IX |
front 43 Warfarin decreases synthesis of functional clotting factors by inhibiting: A. Thrombin | back 43 B. VKORC1 |
front 44 Which endogenous anticoagulant protein is reduced by warfarin and contributes to its initial paradoxical hypercoagulability? A. Protein C | back 44 A. Protein C |
front 45 Which additional endogenous anticoagulant protein undergoes impaired γ-carboxylation with warfarin therapy? A. Protein A | back 45 C. Protein S |
front 46 A patient presents with an acute pulmonary embolism and needs immediate anticoagulation. Is warfarin the best initial monotherapy? A. Yes, because it is rapid | back 46 D. No, use heparin first |
front 47 Warfarin is avoided as sole initial therapy in acute thrombosis because it can transiently produce: A. Hypercoagulability | back 47 A. Hypercoagulability |
front 48 Which statement best describes warfarin use during pregnancy? A. Safe after first trimester | back 48 C. Contraindicated; crosses placenta |
front 49 A patient newly started on warfarin develops painful dark skin lesions. Which complication is most likely? A. Cholesterol embolization | back 49 B. Skin necrosis |
front 50 Warfarin therapy is followed primarily with which laboratory test? A. PTT | back 50 D. PT |
front 51 Which cytochrome P450 enzyme is most important in warfarin metabolism? A. CYP3A4 | back 51 B. CYP2C9 |
front 52 What INR range is expected for a patient therapeutically anticoagulated with warfarin, based on this material? A. 1.0–1.5 | back 52 C. 2.0–3.5 |
front 53 A patient on warfarin presents with major bleeding and marked overanticoagulation. Which reversal strategy is most appropriate? A. Vitamin K only | back 53 D. Plasma, vitamin K, factor VII |
front 54 Which oral anticoagulant directly inhibits factor Xa? A. Rivaroxaban | back 54 A. Rivaroxaban |
front 55 Rivaroxaban is primarily metabolized by which enzyme? A. CYP2C9 | back 55 B. CYP3A4 |
front 56 A patient wants an oral anticoagulant that usually does not require routine laboratory monitoring. Which class best fits? A. Direct thrombin inhibitors | back 56 C. Oral direct Xa inhibitors |
front 57 Which medication suffix most strongly suggests an oral direct factor Xa inhibitor? A. -parin | back 57 D. -xaban |
front 58 Direct factor Xa inhibitors are commonly used for which arrhythmia? A. Ventricular fibrillation | back 58 B. Atrial fibrillation |
front 59 Which direct factor Xa inhibitor is specifically noted here as not fitting that atrial fibrillation indication, especially with poor renal function? A. Rivaroxaban | back 59 C. Edoxaban |
front 60 Which feature uniquely distinguishes dabigatran among the direct thrombin inhibitors in this material? A. Causes HIT | back 60 C. Oral administration |
front 61 A patient with dabigatran-associated hemorrhage requires urgent reversal. Which agent should be used? A. Protamine sulfate | back 61 B. Idarucizumab |
front 62 what can we call strepokinase and urokinase? ______-busters | back 62 clot |
front 63 Streptokinase and urokinase exert their effects primarily by: A. Blocking thrombin | back 63 C. Activating plasmin |
front 64 Alteplase and tenecteplase are best classified as: A. Direct Xa inhibitors | back 64 B. Fibrinolytics |
front 65 Which description best distinguishes alteplase and tenecteplase from streptokinase and urokinase? A. Recombinant t-PAs | back 65 A. Recombinant t-PAs |
front 66 A patient with STEMI receives alteplase. The drug’s immediate therapeutic goal is: A. Lower factor VII | back 66 C. Accelerate fibrinolysis |
front 67 A patient with acute coronary syndrome is given an antiplatelet drug that irreversibly acetylates its target enzyme in platelets. Which drug was most likely administered? A. Clopidogrel | back 67 B. Aspirin |
front 68 The antiplatelet effect of aspirin is primarily due to inhibition of: A. COX | back 68 A. COX |
front 69 By inhibiting cyclooxygenase in platelets, aspirin most directly decreases release of: A. Prostacyclin | back 69 C. Thromboxane A2 |
front 70 Which pair shares the same principal mechanism of antiplatelet action? A. Aspirin and abciximab | back 70 B. Clopidogrel and ticlopidine |
front 71 Clopidogrel reduces platelet function primarily by blocking the: A. GPIIb/IIIa receptor | back 71 C. P2Y12 receptor |
front 72 Inhibition of the platelet P2Y12 receptor most directly reduces platelet: A. Adhesion | back 72 B. Aggregation |
front 73 A patient with unstable angina is started on an oral antiplatelet agent that blocks ADP signaling. Which drug best fits? A. Clopidogrel | back 73 A. Clopidogrel |
front 74 Which acute coronary syndrome is specifically included among the indications for clopidogrel in this material? A. Stable bradycardia | back 74 B. NSTEMI |
front 75 Which additional condition is listed here as an indication for clopidogrel? A. STEMI | back 75 A. STEMI |
front 76 Clopidogrel requires bioactivation predominantly through which enzyme? A. CYP3A4 | back 76 C. CYP2C19 |
front 77 A patient started on ticlopidine returns with fever and a low white blood cell count. Which adverse effect is most classically associated with this drug? A. Hemolysis | back 77 B. Leukopenia |
front 78 In addition to leukopenia, ticlopidine has also been associated with: A. DIC | back 78 B. TTP |
front 79 Thrombotic Thrombocytopenic Purpura, a rare, life-threatening blood disorder characterized by ___ ___ forming in small vessels throughout the body, causing low platelets, organ damage, and potential bleeding. | back 79 small clots |
front 80 Abciximab, eptifibatide, and tirofiban share which mechanism? A. P2Y12 blockade | back 80 C. GPIIb/IIIa blockade EAT GP2 |
front 81 The platelet receptor blocked by abciximab is best described as the receptor for: A. ADP | back 81 C. Fibrin |
front 82 GPIIb/IIIa signaling is considered the final common pathway for platelet: A. Production | back 82 C. Aggregation |
front 83 A child with lifelong mucocutaneous bleeding has absent platelet GPIIb/IIIa receptors. Which diagnosis is most likely? A. Bernard-Soulier syndrome | back 83 C. Glanzmann thrombasthenia |
front 84 Dipyridamole and cilostazol inhibit platelet aggregation primarily by inhibiting: A. PDE-3 | back 84 A. PDE-3 3 CiDi |
front 85 The platelet-inhibitory effect of dipyridamole and cilostazol is mediated by increased intracellular: A. cGMP | back 85 C. cAMP |
front 86 A patient with calf pain during walking is treated with a phosphodiesterase inhibitor that also impairs platelet aggregation. Which drug was most likely used? A. Ticlopidine | back 86 B. Cilostazol |
front 87 Hemophilia A results from deficiency of which clotting factor? A. IX | back 87 B. VIII |
front 88 Hemophilia B results from deficiency of which clotting factor? A. VII | back 88 C. IX |
front 89 Which treatment is matched correctly with hemophilia A? A. Alteplase | back 89 D. Eloctate |
front 90 Which treatment is matched correctly with hemophilia B? A. Idelvion | back 90 A. Idelvion |
front 91 A patient with mild hemophilia A needs a temporary increase in factor VIII activity before a minor procedure. Which drug is most appropriate? A. Clopidogrel | back 91 B. Desmopressin acetate |
front 92 Desmopressin acetate is also useful in which bleeding disorder listed here? A. Glanzmann thrombasthenia | back 92 B. von Willebrand disease |
front 93 A trauma patient with hyperfibrinolytic bleeding is treated with a synthetic drug that competitively inhibits plasminogen activation. Which drug fits best? A. Tranexamic acid | back 93 A. Tranexamic acid |
front 94 Aminocaproic acid and tranexamic acid are best classified as: A. Fibrinolytics | back 94 C. Fibrinolysis inhibitors |
front 95 The shared mechanism of aminocaproic acid and tranexamic acid is: A. Direct plasmin inhibition | back 95 B. Competitive plasminogen activation blockade |
front 96 A patient receiving abciximab still generates thromboxane A2 normally but cannot complete the final common pathway of platelet plug formation. Which step is being blocked? A. Platelet aggregation | back 96 A. Platelet aggregation |
front 97 -xaban → direct factor _____ _____ | back 97 Xa inhibitors |
front 98 -gatran → direct _____ _____ | back 98 thrombin inhibitors |
front 99 -plase → _____/_____ | back 99 fibrinolytics / thrombolytics |
front 100 -parin → _____ | back 100 heparins |