70 Questions
Which organ is most affected in exertional heat stroke?
Brain
Which condition can exertional heat stroke trigger?
Disseminated intravascular coagulation (DIC)
What happens to tissue oxygen demand and metabolic rate in exertional heat stroke?
They increase
What can severe hyperthermia in exertional heat stroke lead to?
Increased tissue oxygen demand
What can the release of procoagulant proteins in exertional heat stroke trigger?
Disseminated intravascular coagulation (DIC)
Which coagulation cascade is excessively activated in DIC?
Extrinsic coagulation cascade
What is generated in DIC as a result of the excessive activation of the coagulation cascade?
Cross-linked fibrin clots
What happens to plasminogen in DIC?
It is converted to plasmin
Which laboratory finding is characteristic of acute DIC?
Prolonged PT/PTT and elevated D-dimer
What is a common clinical manifestation of acute DIC?
Tachycardia
What is the underlying cause of thrombocytopenia in acute DIC?
Increased platelet Consumption
Which factor do direct factor Xa inhibitors block to reduce conversion of prothrombin to thrombin?
Activated Factor X
How are direct factor Xa inhibitors administered?
Orally
Do direct factor Xa inhibitors require drug level monitoring?
No
What converts plasminogen to plasmin?
Tissue plasminogen activator
What is the primary use of tissue plasminogen activator?
To dissolve blood clots in acute ischemic strokes
What is the role of tissue plasminogen activator in fibrinolysis?
To increase plasmin levels
Which clotting factors are prevented from gamma carboxylation by the action of warfarin?
Factor VII
How long does it take for the therapeutic effect of warfarin to occur?
3-5 days
What is the primary site of action of warfarin?
Liver
How long does it take for the therapeutic effect of warfarin to occur?
3-5 days
What is the mechanism of action of warfarin?
Blocks the activation of NEW clotting factors
Which patient population is at increased risk for developing lower extremity deep venous thrombosis (DVT)?
Nonambulatory hospitalized patients
When is DVT prophylaxis usually initiated in patients undergoing certain orthopedic procedures such as hip and knee replacement?
Within hours of wound closure
Which type of heparin does not require laboratory monitoring when given therapeutically?
Low molecular weight heparin
What is the primary target of LMWH when it activates antithrombin III (AT III)?
Factor Xa
What is the mechanism of action of unfractionated heparin when it binds to antithrombin III (AT III)?
Inhibits factor Xa PRIMARILY
Which medication is useful for inhibiting ADP-mediated platelet aggregation?
Clopidogrel
What is the primary use of clopidogrel and ticlopidine?
Inhibiting platelet aggregation
Which factor does low-molecular-weight heparin (LMWH) primarily act on?
Factor Xa
What is the main function of antithrombin III (AT III) when activated by Enoxaparin?
Binds to factor Xa
How does Enoxaparin differ from heparin in terms of molecular weight?
Enoxaparin has a lower molecular weight
Which fat-soluble vitamin deficiency is most likely causing the patient's symptoms?
Vitamin K
What is the primary cause of increased risk of vitamin K deficiency in patients with CF?
Reduced secretion of pancreatic enzymes
Which of the following symptoms is NOT consistent with EARLY vitamin K deficiency in patients with CF?
Prolonged aPTT
Which of the following statements about Andexanet alfa is correct?
Andexanet alfa is a factor Xa decoy that has no proteolytic effect.
Which of the following is a use for Andexanet alfa?
To reverse the anticoagulation effect of factor Xa inhibitors
Which of the following medications is commonly reversed by Andexanet alfa?
Rivaroxaban
Which enzyme is specifically targeted by direct oral anticoagulants?
Factor Xa
What is the primary target of heparin when it activates antithrombin III (AT III)?
Factor Xa
What is the effect of heparin on thrombin time/partial thromboplastin time?
Prolonged
Which laboratory finding is commonly seen in patients with antiphospholipid antibody syndrome?
Positive RPR test
What is a characteristic feature of antiphospholipid antibody syndrome?
Recurrent pregnancy loss
What can antiphospholipid antibodies in systemic lupus erythematosus cause?
Elevated PTT
Which laboratory finding is commonly seen in patients with disseminated intravascular coagulation (DIC)?
Elevated prothrombin time (PT)
What is the primary cause of disseminated intravascular coagulation (DIC)?
Sepsis
Which of the following is a characteristic sign of disseminated intravascular coagulation (DIC)?
Bleeding from venipuncture sites
Which of the following medications is a potent enhancer of the cytochrome P-450 pathway and can decrease the efficacy of warfarin?
Phenobarbital
Which of the following medications can inhibit warfarin metabolism and increase the risk of bleeding?
Cimetidine
Which of the following medications does NOT affect the metabolism or efficacy of warfarin?
Amiodarone
Which of the following is a manifestation of vitamin C deficiency?
Gingival bleeding
What is the main role of vitamin C in the body?
Production of collagen
Which of the following is/are characteristics of vitamin C deficiency?
Perifollicular keratosis
Which of the following is a symptom of scurvy?
Poor wound healing
Which of the following is a hemorrhagic complication of scurvy?
Gingival bleeding
Which vitamin deficiency can cause perifollicular hyperkeratosis?
Vitamin C
Which vitamin K-dependent coagulation factor has the shortest half-life?
Factor VII
What does failure of prothrombin time to correct with vitamin K supplementation in liver disease indicate?
Factor VII deficiency
What is the most common cause of factor VII deficiency?
Liver disease
Which condition can lead to high-output heart failure in patients with severe cirrhosis?
Development of mesenteric and intrahepatic arteriovenous shunts
What is the primary cause of high-output heart failure in severe cirrhosis?
Development of mesenteric and intrahepatic arteriovenous shunts
Which of the following is a potential complication of starting patients on warfarin?
Skin necrosis
What factor can further exacerbate the hypercoagulability seen in patients started on warfarin?
Protein C deficiency
What is the primary cause of thrombotic occlusion in patients started on warfarin?
Transient hypercoagulable state
Which of the following is a characteristic of acute disseminated intravascular coagulation (DIC)?
Elevation of D-dimer levels
What is the most common cause of bleeding complications in acute disseminated intravascular coagulation (DIC)?
Consumption of platelets and clotting factors
Which of the following is a consequence of widespread formation of microvascular thrombi in acute disseminated intravascular coagulation (DIC)?
Consumption of coagulation factors
Which type of anticoagulant is used to treat heparin-induced thrombocytopenia (HIT)?
Direct thrombin inhibitors (DTIs)
What should be avoided in patients with heparin-induced thrombocytopenia (HIT)?
Low molecular weight heparin (LMWH)
What is the primary treatment for heparin-induced thrombocytopenia (HIT)?
Direct thrombin inhibitors (DTIs)
Test your knowledge on exertional heat stroke, a life-threatening condition characterized by extreme hyperthermia and seizures. Learn about its causes, symptoms, and potential complications.
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