Coagulation Modifying Agents Part 2: Flashcards
1
Q
is the following drugs use for Anti-platelets or Anticoagulant drugs?
Aspirin
Clopidogrel
A
Anti-platelets
2
Q
Which of the following are clotting factors?
a. Hgb
b. aPTT
c. INR
d. Plts
e. Hct
f. Pt
A
b. aPTT
c. INR
f. Pt
3
Q
The following clotting factors deal with:
aPTT
INR
Pt
a. Platelets
b. Anti-coagulants
A
b. Anti-coagulants
4
Q
aPTT?
Warfarin or Heparin
A
Heparin
5
Q
INR?
Warfarin or Heparin
A
Warfarin
6
Q
Pt?
Warfarin or Heparin
A
Warfarin
7
Q
Which of the following inhibits/blocks factor 10a (Xa)?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
b. apixaban
c. rivaroxaban
8
Q
Which of the following inhibits/blocks factor 2?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
d. dabigatran
9
Q
Which of the following does Warfarin inhibits/blocks? a. Factor 2 b. Factor 3 c. Factor 7 d. Factor 8 e. Factor 9 f. Factor 10 G. Protein C & S
A
a. Factor 2
c. Factor 7
e. Factor 9
f. Factor 10
G. Protein C & S
10
Q
Which of the following are Vitamin K Antagonist
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
11
Q
Which of the following is Coumadin
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
12
Q
Which of the following was the original rat killer?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
13
Q
Does A Fib (Atrial fibrillation) cause or prevent stokes?
A
It causes stokes
14
Q
Do cancer patients have a higher risk of clotting?
Yes or No?
A
Yes
15
Q
Which of the following -secondary prophylaxis/prevention,?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
16
Q
Which of the following - DVT/PE treatment?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
All
17
Q
Which the following - A.fib ( stroke prevention)?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
All
18
Q
Which of the following - DVT/PE treatment/prophylaxis?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
b. apixaban
c. rivaroxaban
d. dabigatran
19
Q
Which is used - Cancer patients (higher risk for clotting)?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
20
Q
Which of the following Heart failure with a prseident 1955?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
21
Q
Which of the following treat - CS, unstable angina, MI, stroke?
A
?
22
Q
The following are apart of which vitamin These factors are II, VII, IX, X and Protein C & S?
a. Vit C
b. Vit E
c. Vit K
A
c. Vit K
23
Q
Which is the opposite of Vit K and inhibits factors are II, VII, IX, X and Protein C & S?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
A
a. Warfarin
24
Q
How do you check the effectiveness of Warfarin?
a. Hgb
b. aPTT
c. INR
d. Plts
e. Hct
f. Pt
A
c. INR
f. Pt
25
Baseline PT ? seconds?
11-12.5
26
Goal PT- ? seconds (? times the baseline)
18-24
| 1.5-2
27
Baseline INR ?
1
28
INR goal ? for Most Conditions
2-3
29
INR goal ? for Mechanical Heart Valves
2.5-3.5
30
Which of the following is instantaneous?
a. Warfarin
b. Heparin
b. Heparin
31
Which of the following is slow ?
a. Warfarin
b. Heparin
a. Warfarin
32
Warfarin take ? days to work
3 to 5
33
For any anticoagulant when patients fall and hit their heads, they are at risk for?
a. Nothing
b. Blindness
c. Intracranial hemorrhage
c. Intracranial hemorrhage
34
Even though Skin Necrosis is rare which anticoagulant causes it?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
a. Warfarin
35
Which protein is a natural anticoagulant/
a. Protein L
b. Protein C
c. Protein S
b. Protein C
36
Which causes Warfarin to have an adverse side effect of Skin Necrosis?
a. Protein L
b. Protein C
c. Protein S
d. Cholesterol embolism
b. Protein C
37
Even though Purple Toe Syndrome is rare which anticoagulant causes it?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
a. Warfarin
38
Which causes Warfarin to have an adverse side effect of Purple Toe Syndrome?
a. Protein L
b. Protein C
c. Protein S
d. Cholesterol embolism
d. Cholesterol embolism
39
Which drug has a Pregnancy Category X - CONTRAINDICATION!
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
a. Warfarin
40
Vitamin K is the antidote for which drug?
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
a. Warfarin
41
If Vit. K is given to treat warfarin level what is it called as an IV
a. Phytonadione (Aquamephyton®)
b. Kcentra®-
a. Phytonadione (Aquamephyton®)
42
Antibiotics- ( ? Vit K- ? effectiveness of warfarin)
a. More, Increase
b. More, Decrease
c. Less, Increase
d. Less, Decrease
c. Less, Increase
43
Seizure medications big culprits are ? for Warfarin?
a. Inhibitor
b. Inducer
b. INDUCERS
44
St. John’s Wort (herbal- anti-depressant) are ? for Warfarin?
a. Inhibitor
b. Inducer
b. INDUCER
45
NSAIDs is the following ?
a. Aspirin
b. Acetaminophen
c. Ibuprofen
a. Aspirin
| c. Ibuprofen
46
Since NSAIDS causes bleeding risk which drug should you give a patient who is taking Warfarin?
a. Aspirin
b. Acetaminophen
c. Ibuprofen
b. Acetaminophen
47
Which of the following will cause a bleeding risk for a patient taking warfarin? (Herbs)
a. Gingko biloba
b. Ginger
c. Garlic
d. Fish Oil
e. Feverfew
f. Saw Palmetto
g. St. Johns Wort
All
48
Which of the following herbs decreases warfarin levels?
a. Gingko biloba
b. Ginger
c. Garlic
d. Fish Oil
e. Feverfew
f. Saw Palmetto
g. St. Johns Wort
g. St. Johns Wort
49
Which should a patient do when taking warfarin?
a. Avoid vitamin K in diet
b. Limit vitamin K in diet but be consistent
c. Smoke
d Avoid Smoking
e. Drink Alcohol
F. Avoid Alcohol
b. Limit vitamin K in diet but be consistent
d Avoid Smoking
F. Avoid Alcohol
50
Which of the flowing is true about Bridge Therapy?
a. You will give a patient heparin drip at (30-40 sec) until the patient warfarin level reach between 1-3 INR. Then you will take the patient off of heparin. (Take 3-5 days)
b. You will give a patient heparin drip at (60-80 sec) until the patient warfarin level reach between 2-3 INR. Then you will keep the patient on both heparin & warfarin. (Take 3-5 days)
c. You will give a patient heparin drip at (60-80 sec) until the patient warfarin level reach between 2-3 INR. Then you will take the patient off of heparin. (Take 3-5 days)
c. You will give a patient heparin drip at (60-80 sec) until the patient warfarin level reach between 2-3 INR. Then you will take the patient off of heparin. (Take 3-5 days)
51
Bridge therapy cannot be use in reverse?
| T/F. If not F why?
False
You can work slowly to take a patient off of warfarin by giving them heparin drip. Then use heparin only once warfarin level have reach base levels.
52
Reflex tachycardia-
(rapid or slow) beating of the heart, is an (increased or decreased) heart rate in response to the stimulus of (increased or decreased) blood pressure
rapid
increased
decreased
53
Reflex bradycardia-
(rapid or slow) beating of the heart, is an (increased or decreased) heart rate in response to the stimulus of (increased or decreased) blood pressure
slow
decreased
increased
54
Which is caused by taking warfarin?
a. Reflex bradycardia
b. Reflex tachycardia
b. Reflex tachycardia
55
if a patient decides to take rivaroxaban, apixaban, or Dabigatran which of the following is true?
a. INR checked weekly
b. INR isn't checked
c. Vitamin K issue and Vit. K diet needed
d. No Vitamin K issue and Vit. K diet needed
e. Herbals issues
f. No Herbals issues
b. INR isn't checked
d. No Vitamin K issue and Vit. K diet needed
e. Herbals issues
56
Which is a Novel/NEW Oral Anticoagulants (NOACs)
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
b. apixaban
| c. rivaroxaban
57
Which is a Direct Oral Anticoagulants (DOACs)
a. Warfarin
b. apixaban
c. rivaroxaban
d. dabigatran
d. dabigatran
58
Which anticoagulants do you avoid using with other anticoagulants
a. Apixaban
b. Heparin
c. Rivaroxaban
e. Enoxaparin
f. Warfarin
g. Argatroban
h. Dabigatran
a. Apixaban
c. Rivaroxaban
h. Dabigatran
59
Which drugs you have to be consistent with and not miss a dose? Is it true that if you miss a dose the drug will drop allot in your body? T/F
a. Apixaban
b. Heparin
c. Rivaroxaban
e. Enoxaparin
f. Warfarin
g. Argatroban
h. Dabigatran
a. Apixaban
c. Rivaroxaban
h. Dabigatran
True
60
Which drug has this antedote Andexxa® /Andexanet alfa?
a. Apixaban
b. Heparin
c. Rivaroxaban
e. Enoxaparin
f. Warfarin
g. Argatroban
h. Dabigatran
a. Apixaban
| c. Rivaroxaban
61
Which has this antedote Praxbind® (Idarucizumab)
a. Apixaban
b. Heparin
c. Rivaroxaban
e. Enoxaparin
f. Warfarin
g. Argatroban
h. Dabigatran
h. Dabigatran
62
Must be given with full glass of water. If GI upset occurs even with full glass of water, can give with meals. Which drug?
a. Apixaban
b. Heparin
c. Rivaroxaban
e. Enoxaparin
f. Warfarin
g. Argatroban
h. Dabigatran
h. Dabigatran
63
Which are the following is safe to use with Warfarin?
a. Grape Juice
b. Cranberry Juice
b. Cranberry Juice
64
Which antiplatelets drugs are The Originals?
a. Clopidogrel
b. Aspirin
c. Ticagrelor
b. Aspirin
65
Which antiplatelets drugs are The P2Y12 ADP Receptor Antagonists?
a. Clopidogrel
b. Aspirin
c. Ticagrelor
a. Clopidogrel
| c. Ticagrelor
66
Which of the following drugs: Work on preventing platelet aggregation?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
c. Ticagrelor
d. Clopidogrel
e. Aspirin
67
The following drugs stop which option?
c. Ticagrelor
d. Clopidogrel
e. Aspirin
Arterial thrombosis vs Venous thrombosis
Arterial thrombosis
68
Which drug stops Arterial thrombosis
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
c. Ticagrelor
d. Clopidogrel
e. Aspirin
69
```
Which drug is mostly used for
Coronary Stenting
Acute MI
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
```
e. Aspirin
70
Which drug used for pediatrics with Kawasaki only!
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
e. Aspirin
71
The cyclooxygenase pathway (COX I and COX II) starts (activation or aggregation) for platelets?
aggregation
72
Which drug Prevents synthesis and release of prostaglandins by interrupting the cyclooxygenase pathway (COX I and COX II) from starting aggregation for platelets?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
e. Aspirin
73
Aspirin effects on cyclooxygenase pathway (COX I and COX II) is ( reversible or irreversible) for plts~(4,5,6, or 7 days)
irreversible
| 7
74
Which is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
b. Respiratory acidosis
75
This occurs when you breathe too fast or too deep and carbon dioxide levels drop too low?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
a. Respiratory alkalosis
76
Which has this effect ringing in the ears, nausea, and vomiting?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
h. Reye's syndrome
c. Salicylism
77
This is a condition which you start to breathe very fast
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
h. Reye's syndrome
Hyperventilation
78
Which is a disease of the kidneys caused by damage to the small blood vessels or to the units in the kidneys
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
h. Reye's syndrome
Nephropathy
79
Which is a persistent opening between the two major blood vessels leading from the heart. This is suppose to close after birth but opens again?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
h. Reye's syndrome
d. Patent ductus arteriosus (PDA)
80
This is a rare but serious condition that causes confusion, swelling in the brain, and liver damage in children. This condition is why children should not take aspirin.
a. Respiratory alkalosis
b. Respiratory acidosis
c. Salicylism
d. Patent ductus arteriosus (PDA)
e. Hyperventilation
f. Nephropathy
h. Reye's syndrome
h. Reye's syndrome
81
Which of the following is Adverse side effect of Aspirin?
a. Asthma
b. Salicylism (N/V/D)
c. Rapid breathing
d. Slow Breathing
e. Hyperventilation
f. Hypoventilation
g. Premature closing of PDA
h. Platelet disaggregation
i. Peptic Ulcer Disease
j. Intestinal bleeding
k. Reye’s Syndrome
l. Ringing in the ears
m. Renal Impairment
n. Rapid Breathing
o. RESPIRATORY ALKALOSIS
p. RESPIRATORY ACIDOSIS
q. Noise (Tinnitus)
r. Nephropathy
s. Hepatic
a. Asthma
b. Salicylism (N/V/D)
c. Rapid breathing
e. Hyperventilation
g. Premature closing of PDA
h. Platelet disaggregation
i. Peptic Ulcer Disease
j. Intestinal bleeding
k. Reye’s Syndrome
l. Ringing in the ears
m. Renal Impairment
n. Rapid Breathing
o. RESPIRATORY ALKALOSIS
q. Noise (Tinnitus)
r. Nephropathy
82
Which of the following will cause GI upsets beside aspirin?
a. Smoking
b. Alcohol
c. Corticosteroids
d. NSaids
e. Ibuprofen
f. Acetaminophen
g. Tylenol
a. Smoking
b. Alcohol
c. Corticosteroids
d. NSaids
e. Ibuprofen
83
Do decrease GI upset a Patients can use ?
a. an enteric coated table
b. an enteric non- coated tablet
c. take with food or water/milk
d. Take on an empty stomach
a. an enteric coated table
| c. take with food or water/milk
84
Which can a child cannot have?
a. Pepto Bismol Calcium Carbonate Anticid
b. Pepto Bismol Bismuth Subsalicylate
b. Pepto Bismol Bismuth Subsalicylate
85
```
Which of the following drugs
Percutaneous Coronary Intervention (STENT placement)
Ischemic Stroke?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
```
c. Ticagrelor
| d. Clopidogrel
86
Which drugs Block P2Y12 ADP receptors on platelets which prevents ADP stimulated aggregation
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
c. Ticagrelor
| d. Clopidogrel
87
Percutaneous Coronary Intervention (PCI ) uses DAPT= Dual Anti-Platelet Therapy with which following drugs?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
e. Aspirin + c. Ticagrelor
| e. Aspirin + d. Clopidogrel
88
Which stop platelets from forming once stent is removed?
a. APT= Anti-Platelet Therapy
b. DAPT= Dual Anti-Platelet Therapy
b. DAPT= Dual Anti-Platelet Therapy
89
DAPT= Dual Anti-Platelet Therapy which are you on for a year?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
c. Ticagrelor
| d. Clopidogrel
90
DAPT= Dual Anti-Platelet Therapy which are you on for a res of your life?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
e. Aspirin
91
Aherence is important for which drugs?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
c. Ticagrelor
| d. Clopidogrel
92
Does Thrombolytic Therapy (Tissue Plasminogen Activator ) inhibit the growth of clots or is it a clot buster?
clot buster
93
Which is given treats Ischemic Stroke–Massive Pulmonary Embolism–Massive Myocardial Infarction–Central venous catheter clearance (tiny dose)
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
h. Tissue Plasminogen Activator
94
Alteplase “plase is what drug?
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
h. Tissue Plasminogen Activator
95
for Tissue Plasminogen Activator- Alteplase “plase
| Most STROKE guidelines allow within ? hours of symptom ONSET
3 to 4.5
96
```
Binds to plasminogen- forms a complex which causes conversion to plasmin
Plasmin digests the fibrin meshwork of clots (Factor 1)
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
```
h. Tissue Plasminogen Activator
97
```
Which can cause
Death (ASSENT-2 trial ) 30 days ,6.2%
Major Hemorrhage at 30 days, 5.9%
a. Apixaban
b. Heparin
c. Ticagrelor
d. Clopidogrel
e. Aspirin
f. Warfarin
g. Argatroban
h. Tissue Plasminogen Activator
```
h. Tissue Plasminogen Activator
98
DO NOT GIVE ANY ANTICOAGULANTS/ANTIPLATELETS FOR ? HOURS AFTER RECEIVING Tissue Plasminogen Activator
24
99
If a patient is taking anticoagulant med can they take Tissue Plasminogen Activator?
Yes/NO
No
100
When giving enipunctures and subcutaneous/IM injections on patient taking Alteplase (TPA) you should Hold direct pressure to injection site or ABG site for up to ? min until oozing stops
30
101
With a stoke TIME IS BRAIN- 2 million neurons die each ? ?, these do not rejuvenate
Minute
