Cardio Lecture 1
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Questions and Answers

Which of the following is a type of antithrombotic drug?

  • Anticoagulants
  • Antiplatelet agents
  • Fibrinolytic agents
  • All of the above (correct)

What is the function of heparin within the secretory granules of mast cells?

  • To enhance the activity of antithrombin
  • To inhibit coagulation enzymes
  • To breakdown fibrin clots
  • To store specific granule proteases (correct)

Which factor is required for an activated coagulation factor to cleave and activate the next coagulation factor?

  • Gamma carboxyglutamate (correct)
  • Factor Xa
  • Factor Va
  • Calcium

Which natural anticoagulant molecule enhances the activity of antithrombin by about 1000-fold?

<p>Heparan sulfate proteoglycans (B)</p> Signup and view all the answers

Which of the following is NOT one of the principal players of the clotting factor cascade?

<p>Xa (A)</p> Signup and view all the answers

What is the difference between the Intrinsic and Extrinsic pathways?

<p>The Intrinsic pathway is activated by trauma to the blood vessel wall, while the Extrinsic pathway is activated by trauma to the surrounding tissue. (B)</p> Signup and view all the answers

Which anticoagulant agent cannot be reversed with a reversal agent?

<p>Direct oral anticoagulants (DOACs) (A)</p> Signup and view all the answers

Which of the following is NOT a direct factor Xa inhibitor?

<p>Betrixaban (C)</p> Signup and view all the answers

Which of the following is a unique characteristic of Rivaroxaban?

<p>It has limited aqueous solubility (B)</p> Signup and view all the answers

What is the function of Andexanet alfa?

<p>It acts as a decoy receptor to bind and sequester direct factor Xa inhibitors (C)</p> Signup and view all the answers

Which of the following is a method used in the manufacturing process of low molecular weight heparins (LMWHs)?

<p>Nitrous acid depolymerization (D)</p> Signup and view all the answers

Which of the following is a major advantage of LMWHs over unfractionated heparin (UFH)?

<p>Fixed dosage administration (D)</p> Signup and view all the answers

Which of the following is true about the molecular weight (MW) of LMWHs and UFH?

<p>LMWHs have a lower average MW than UFH (B)</p> Signup and view all the answers

Which of the following can cause heparin-induced thrombocytopenia (HIT)?

<p>Full length heparin (UFH) (A)</p> Signup and view all the answers

Which of the following drugs blocks the gama-carboxylation of glutamate residues in prothrombin and factors II, VII, IX, X and the endogenous anticoagulant protein C?

<p>Warfarin (D)</p> Signup and view all the answers

What is the mechanism of action of warfarin?

<p>Blocks the reduction of Vitamin K epoxide to its active hydroquinone form (B)</p> Signup and view all the answers

Which of the following drugs can cause prolonged resistance to warfarin when taken in high doses?

<p>Vitamin K1 (B)</p> Signup and view all the answers

Which of the following drugs directly inhibits thrombin?

<p>Hirudin (D)</p> Signup and view all the answers

Which of the following is true about heparin chains?

<p>All of the above (D)</p> Signup and view all the answers

What is the significance of the antithrombin-binding pentasaccharide in heparin?

<p>All of the above (D)</p> Signup and view all the answers

What is the main mechanism of action of low molecular weight heparin (LMWH)?

<p>Activation of antithrombin (B)</p> Signup and view all the answers

What is the average molecular weight of low molecular weight heparin (LMWH)?

<p>5,000 (B)</p> Signup and view all the answers

Which of the following is a direct inhibitor of thrombin that binds both the catalytic site and the anion binding exosite of circulating and clot-bound thrombin?

<p>Bivalirudin (A)</p> Signup and view all the answers

Which of the following is a direct oral anticoagulant that is a factor Xa inhibitor?

<p>Rivaroxaban (A)</p> Signup and view all the answers

Which of the following is a unique formulation of Dabigatran?

<p>Dabigatran Etexilate (D)</p> Signup and view all the answers

Which drug is used as a reversal agent for Dabigatran to reverse/block its anticoagulant activity?

<p>Idarucizumab (A)</p> Signup and view all the answers

Which of the following is a direct oral anticoagulant that is a factor Xa inhibitor?

<p>Rivaroxaban (C)</p> Signup and view all the answers

What is the average molecular weight of low molecular weight heparin (LMWH)?

<p>10000 Da (B)</p> Signup and view all the answers

What is the main mechanism of action of warfarin?

<p>Inhibition of vitamin K epoxide reductase (D)</p> Signup and view all the answers

Which of the following is a major advantage of low molecular weight heparins (LMWHs) over unfractionated heparin (UFH)?

<p>Fixed Dose administration (D)</p> Signup and view all the answers

Which of the following is NOT a consequence of LMWH structural variability?

<p>Inhibition of formed TF (C)</p> Signup and view all the answers

What is the molecular weight range of unfractionated heparin (UFH)?

<p>3000 - 5000 Da (A)</p> Signup and view all the answers

What is the ratio of Anti-Xa to Anti-IIa (thrombin) activity for fondaparinux (synthetic pentasaccharide)?

<p>Xa only (B)</p> Signup and view all the answers

Which of the following is NOT a type of antithrombotic drug in clinical use?

<p>Thrombolytic agents (B)</p> Signup and view all the answers

What is the function of antithrombin in the coagulation cascade?

<p>Inhibit coagulation enzymes (D)</p> Signup and view all the answers

Which factor is required for an activated coagulation factor to cleave and activate the next coagulation factor?

<p>Calcium (B)</p> Signup and view all the answers

What is the mechanism of action of heparin within the secretory granules of mast cells?

<p>Storage of specific granule proteases (A)</p> Signup and view all the answers

Which of the following is a characteristic of low molecular weight heparin (LMWH)?

<p>LMWH promotes anticoagulation primarily by inhibiting thrombin. (A)</p> Signup and view all the answers

What is the average molecular weight of unfractionated heparin (UFH)?

<p>12,000 to 14,000 (B)</p> Signup and view all the answers

Which of the following is a method used in the manufacturing process of low molecular weight heparins (LMWHs)?

<p>Depolymerization (A)</p> Signup and view all the answers

What is the main mechanism of action of unfractionated heparin (UFH)?

<p>Binding to antithrombin and inhibiting thrombin (A)</p> Signup and view all the answers

Which of the following is a direct inhibitor of thrombin that binds both the catalytic site and the anion binding exosite of circulating and clot-bound thrombin?

<p>Bivalirudin (D)</p> Signup and view all the answers

Which of the following is an orally active direct thrombin inhibitor?

<p>Dabigatran (C)</p> Signup and view all the answers

Which of the following is a unique formulation of Dabigatran?

<p>Dabigatran etexilate mesylate (A)</p> Signup and view all the answers

Which of the following is a major P-gp drug-drug interaction (DDI) with Dabigatran?

<p>Amiodarone (B)</p> Signup and view all the answers

Which of the following is a direct factor Xa inhibitor that competitively binds and blocks the active site of FXa, but does not inhibit thrombin and therefore has no direct effects on platelets?

<p>Edoxaban (B)</p> Signup and view all the answers

Which of the following is a reversal agent for direct FXa inhibitors, designed to bind and sequester the factor Xa inhibitors so that they can no longer bind and inhibit endogenous factor Xa?

<p>Andexanet alfa (B)</p> Signup and view all the answers

Which of the following direct FXa inhibitors has a unique absorption and PK profile, with a mandatory food requirement for higher doses due to its lipophilic structure and limited aqueous solubility?

<p>Rivaroxaban (Xarelto) (B)</p> Signup and view all the answers

Which of the following is true about the mechanism of action of Vitamin K antagonists such as warfarin?

<p>They block the reduction of Vitamin K epoxide to its active hydroquinone form. (C)</p> Signup and view all the answers

Which of the following drugs can promote bleeding by displacing warfarin from albumin?

<p>Aspirin (C)</p> Signup and view all the answers

Which of the following drugs can inhibit the degradation of warfarin and lead to an increase in its effect?

<p>Rifampin (D)</p> Signup and view all the answers

Which of the following drugs can decrease the synthesis of clotting factors and result in a decrease in warfarin's anticoagulant effect?

<p>Oral contraceptives (B)</p> Signup and view all the answers

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