Anticoagulants and Thrombolytics Quiz
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Questions and Answers

What is a contraindication for anticoagulants ?

  • Hypotension
  • History of stroke
  • Recent surgery (correct)
  • Migraine headaches

    • What is the therapeutic range for Partial Thromboplastin Time (PTT) when using heparins?

  • 45-70 seconds (correct)
  • 30-45 seconds
  • 110-130 seconds
  • 80-100 seconds

    • What is the antidote for low-molecular-weight heparins like enoxaparin?

  • Vitamin K
  • Alteplase
  • Warfarin
  • Protamine sulfate (correct)

    • What is the target International Normalized Ratio (INR) for vitamin K antagonists like warfarin?

    <p>2-3</p> Signup and view all the answers

    What can be used to reverse the effects of vitamin K antagonists?

    <p>Phytonadione</p> Signup and view all the answers

    What is a key advantage of direct-acting oral anticoagulants (DOACs) like dabigatran and rivaroxaban?

    <p>Less variability in drug effect</p> Signup and view all the answers

    In which conditions are thrombolytics like alteplase used to reestablish blood flow?

    <p>MI, PE, and CVA</p> Signup and view all the answers

    What is a contraindication for thrombolytics?

    <p>Aneurysms</p> Signup and view all the answers

    What is a potential adverse effect of thrombolytics?

    <p>Bleeding</p> Signup and view all the answers

    What should patients taking blood thinners do to prevent injury?

    <p>Implement safety precautions</p> Signup and view all the answers

    In the given patient scenario, what does pain and swelling in the leg after flying indicate?

    <p>Thrombotic event</p> Signup and view all the answers

    What sections of the Google Form need to be completed based on the patient scenario?

    <p>ER visit and re-hospitalization</p> Signup and view all the answers

    What is the normal range for platelet count in primary hemostasis?

    <p>130,000 – 400,000 uL</p> Signup and view all the answers

    Where does the activation of the intrinsic pathway of the coagulation cascade occur?

    <p>In the vascular system</p> Signup and view all the answers

    What is the normal range for Prothrombin Time (PT) in secondary hemostasis?

    <p>10 – 13 sec</p> Signup and view all the answers

    What is the potential adverse effect of heparin therapy that is a potentially life-threatening complication?

    <p>Heparin-induced thrombocytopenia (HIT)</p> Signup and view all the answers

    What is the goal of using heparins in patients with disseminated intravascular coagulation (DIC)?

    <p>To prevent blood coagulation long enough for clotting factors to be replenished</p> Signup and view all the answers

    What is the lifespan of platelets?

    <p>7-10 days</p> Signup and view all the answers

    What is the normal range for Activated partial Thrombin Time (aPTT) in secondary hemostasis?

    <p>28 – 38 sec</p> Signup and view all the answers

    What is the function of endothelial cells in hemostasis?

    <p>Vasoconstrict to minimize blood loss and release clotting factors</p> Signup and view all the answers

    What is the primary goal of hemostasis?

    <p>Prevent blood loss</p> Signup and view all the answers

    Where does the activation of the intrinsic pathway of the coagulation cascade occur?

    <p>Vascular system</p> Signup and view all the answers

    What is the normal range for activated partial thrombin time (aPTT)?

    <p>28 – 38 sec</p> Signup and view all the answers

    What is the potential complication associated with heparin use?

    <p>Decreased platelet count</p> Signup and view all the answers

    What is the role of endothelial cells in hemostasis?

    <p>Vasoconstrict to minimize blood loss and release clotting factors</p> Signup and view all the answers

    What is the function of D-dimer in hemostasis?

    <p>Indicate fibrin breakdown</p> Signup and view all the answers

    What is the lifespan of platelets in the blood?

    <p>7-10 days</p> Signup and view all the answers

    What is the main therapeutic goal in disseminated intravascular coagulation (DIC)?

    <p>Prevent blood coagulation long enough for clotting factors to be replenished</p> Signup and view all the answers

    Match the following components of hemostasis with their functions:

    <p>Primary hemostasis = Activation of platelets = platelet plug formation Secondary hemostasis = Coagulation cascade = fibrin clot formation Endothelial cells = Vasoconstriction to minimize blood loss and release of clotting factors Platelets = Activation and aggregation at the site of injury</p> Signup and view all the answers

    Match the following coagulation lab values with their normal ranges:

    <p>Platelet count = 130,000 – 400,000 uL Prothrombin time (PT) = 10 – 13 sec Activated partial thrombin time (aPTT) = 28 – 38 sec Fibrinogen = 175 - 400 mg/dL</p> Signup and view all the answers

    Match the following therapeutic uses with the corresponding conditions:

    <p>Major illness (acute MI) = Acute thromboembolic disorders Acute thromboembolic disorders = DVT, thrombophlebitis, PE DVT, thrombophlebitis, PE = Disseminated intravascular coagulation (DIC) Disseminated intravascular coagulation (DIC) = Widespread clotting = depletes blood of coagulation factors = widespread bleeding</p> Signup and view all the answers

    Match the following side/adverse effects of heparins with their descriptions:

    <p>Hemorrhage = Potential adverse effect of heparin therapy that is a potentially life-threatening complication Local irritation = Erythema and mild pain Erythema and mild pain = Common side effect of heparin therapy Heparin-induced thrombocytopenia (HIT) = Potentially life-threatening complication, immune-mediated reaction (~1-3%)</p> Signup and view all the answers

    Match the following terms with their descriptions:

    <p>Intrinsic pathway = Coagulation cascade pathway that occurs in the vascular system Extrinsic pathway = Coagulation cascade pathway that occurs in the tissues Clot lysis = Activation of plasmin leading to fibrinolysis D-dimer = Product of fibrin breakdown, elevated levels indicate recent fibrinolysis</p> Signup and view all the answers

    Match the anticoagulant with its antidote:

    <p>Heparins = Protamine sulfate Warfarin = Phytonadione Direct-acting oral anticoagulants (DOACs) = No specific antidote Low-molecular-weight heparins = Protamine sulfate</p> Signup and view all the answers

    Match the potential adverse effect with the corresponding anticoagulant/thrombolytic:

    <p>Bleeding = Vitamin K antagonists</p> Signup and view all the answers

    Match the contraindication with the corresponding anticoagulant/thrombolytic:

    <p>Active bleeding = Anticoagulants Recent surgery = Anticoagulants Severe hypertension = Anticoagulants Aneurysms = Thrombolytics</p> Signup and view all the answers

    Match the monitoring requirement with the corresponding anticoagulant:

    <p>Therapeutic PTT of 45-70 seconds = Heparins No need for blood coagulation monitoring = Low-molecular-weight heparins Target INR of 2-3 = Vitamin K antagonists Less variability in drug effect = Direct-acting oral anticoagulants (DOACs)</p> Signup and view all the answers

    Match the potential complication with the corresponding anticoagulant:

    <p>Interactions with medications and foods high in vitamin K = Vitamin K antagonists Require careful selection of recipients = Thrombolytics May become the first choice for oral anticoagulants = Direct-acting oral anticoagulants (DOACs) Require monitoring of labs = Heparins</p> Signup and view all the answers

    Study Notes

    Anticoagulants and Thrombolytics: Key Points

    • Anticoagulants like argatroban have contraindications including active bleeding, recent surgery, severe hypertension, and severe kidney or liver disease
    • Heparins have a narrow therapeutic window and require monitoring of labs, with a therapeutic PTT of 45-70 seconds
    • Low-molecular-weight heparins like enoxaparin have a more predictable response, no need for blood coagulation monitoring, and an antidote of protamine sulfate
    • Vitamin K antagonists like warfarin prevent synthesis of vitamin K-dependent clotting factors and have a narrow therapeutic window, with a target INR of 2-3
    • Vitamin K antagonists have interactions with medications and foods high in vitamin K and can be reversed with phytonadione or prothrombin complex concentrate
    • Direct-acting oral anticoagulants (DOACs) like dabigatran and rivaroxaban have advantages including less variability in drug effect and may become the first choice for oral anticoagulants
    • Thrombolytics like alteplase break unwanted blood clots and are used to reestablish blood flow in conditions such as MI, PE, and CVA
    • Thrombolytics have contraindications including aneurysms, known coagulopathy, or internal bleeding, and should be administered within 3-4.5 hours after onset of symptoms
    • Thrombolytics have adverse effects such as bleeding and require careful selection of recipients, with precautions for older patients, those taking anticoagulants, and those with hypertension
    • Thrombolytic therapy should be performed by experienced personnel, with monitoring of vital signs, bleeding symptoms, and laboratory tests
    • Patients taking blood thinners should implement safety precautions to prevent injury and report any signs of bleeding, and should take medication as directed to avoid complications
    • In the patient scenario, Mr. Phib presents with pain and swelling in his leg after flying, indicating a potential thrombotic event, and the ER visit and re-hospitalization sections of the Google Form need to be completed.

    Anticoagulants and Thrombolytics: Key Points

    • Anticoagulants like argatroban have contraindications including active bleeding, recent surgery, severe hypertension, and severe kidney or liver disease
    • Heparins have a narrow therapeutic window and require monitoring of labs, with a therapeutic PTT of 45-70 seconds
    • Low-molecular-weight heparins like enoxaparin have a more predictable response, no need for blood coagulation monitoring, and an antidote of protamine sulfate
    • Vitamin K antagonists like warfarin prevent synthesis of vitamin K-dependent clotting factors and have a narrow therapeutic window, with a target INR of 2-3
    • Vitamin K antagonists have interactions with medications and foods high in vitamin K and can be reversed with phytonadione or prothrombin complex concentrate
    • Direct-acting oral anticoagulants (DOACs) like dabigatran and rivaroxaban have advantages including less variability in drug effect and may become the first choice for oral anticoagulants
    • Thrombolytics like alteplase break unwanted blood clots and are used to reestablish blood flow in conditions such as MI, PE, and CVA
    • Thrombolytics have contraindications including aneurysms, known coagulopathy, or internal bleeding, and should be administered within 3-4.5 hours after onset of symptoms
    • Thrombolytics have adverse effects such as bleeding and require careful selection of recipients, with precautions for older patients, those taking anticoagulants, and those with hypertension
    • Thrombolytic therapy should be performed by experienced personnel, with monitoring of vital signs, bleeding symptoms, and laboratory tests
    • Patients taking blood thinners should implement safety precautions to prevent injury and report any signs of bleeding, and should take medication as directed to avoid complications
    • In the patient scenario, Mr. Phib presents with pain and swelling in his leg after flying, indicating a potential thrombotic event, and the ER visit and re-hospitalization sections of the Google Form need to be completed.

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    Coagulation Student Notes PDF

    Description

    Test your knowledge of anticoagulants and thrombolytics with this quiz covering key points such as contraindications, monitoring, antidotes, interactions, and adverse effects. Sharpen your understanding of medications like heparins, warfarin, and DOACs, as well as thrombolytic therapy, patient safety, and case scenarios.

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