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

    Which anticoagulant agent cannot be reversed with a reversal agent?

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

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

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

    Which of the following is a unique characteristic of Rivaroxaban?

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

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

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

    Which of the following drugs directly inhibits thrombin?

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

    Which of the following is true about heparin chains?

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

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

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

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

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

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

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

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

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

    Which of the following is a unique formulation of Dabigatran?

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

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

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

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

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

    What is the main mechanism of action of warfarin?

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

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

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

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

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

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

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

    What is the function of antithrombin in the coagulation cascade?

    <p>Inhibit coagulation enzymes</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</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</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.</p> Signup and view all the answers

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

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

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

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

    Which of the following is a unique formulation of Dabigatran?

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

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

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

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

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

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