Exertional Heat Stroke Quiz
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Questions and Answers

Which organ is most affected in exertional heat stroke?

  • GI tract
  • Kidneys
  • Liver
  • Brain (correct)

    • Which condition can exertional heat stroke trigger?

  • Hypothermia
  • Hypertension
  • Hypoglycemia
  • Disseminated intravascular coagulation (DIC) (correct)

    • What happens to tissue oxygen demand and metabolic rate in exertional heat stroke?

  • They decrease
  • They increase (correct)
  • They stay the same
  • They fluctuate

    • What can severe hyperthermia in exertional heat stroke lead to?

    <p>Increased tissue oxygen demand</p> Signup and view all the answers

    What can the release of procoagulant proteins in exertional heat stroke trigger?

    <p>Disseminated intravascular coagulation (DIC)</p> Signup and view all the answers

    Which coagulation cascade is excessively activated in DIC?

    <p>Extrinsic coagulation cascade</p> Signup and view all the answers

    What is generated in DIC as a result of the excessive activation of the coagulation cascade?

    <p>Cross-linked fibrin clots</p> Signup and view all the answers

    What happens to plasminogen in DIC?

    <p>It is converted to plasmin</p> Signup and view all the answers

    Which laboratory finding is characteristic of acute DIC?

    <p>Prolonged PT/PTT and elevated D-dimer</p> Signup and view all the answers

    What is a common clinical manifestation of acute DIC?

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

    What is the underlying cause of thrombocytopenia in acute DIC?

    <p>Increased platelet Consumption</p> Signup and view all the answers

    Which factor do direct factor Xa inhibitors block to reduce conversion of prothrombin to thrombin?

    <p>Activated Factor X</p> Signup and view all the answers

    How are direct factor Xa inhibitors administered?

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

    Do direct factor Xa inhibitors require drug level monitoring?

    <p>No</p> Signup and view all the answers

    What converts plasminogen to plasmin?

    <p>Tissue plasminogen activator</p> Signup and view all the answers

    What is the primary use of tissue plasminogen activator?

    <p>To dissolve blood clots in acute ischemic strokes</p> Signup and view all the answers

    What is the role of tissue plasminogen activator in fibrinolysis?

    <p>To increase plasmin levels</p> Signup and view all the answers

    Which clotting factors are prevented from gamma carboxylation by the action of warfarin?

    <p>Factor VII</p> Signup and view all the answers

    How long does it take for the therapeutic effect of warfarin to occur?

    <p>3-5 days</p> Signup and view all the answers

    What is the primary site of action of warfarin?

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

    How long does it take for the therapeutic effect of warfarin to occur?

    <p>3-5 days</p> Signup and view all the answers

    What is the mechanism of action of warfarin?

    <p>Blocks the activation of NEW clotting factors</p> Signup and view all the answers

    Which patient population is at increased risk for developing lower extremity deep venous thrombosis (DVT)?

    <p>Nonambulatory hospitalized patients</p> Signup and view all the answers

    When is DVT prophylaxis usually initiated in patients undergoing certain orthopedic procedures such as hip and knee replacement?

    <p>Within hours of wound closure</p> Signup and view all the answers

    Which type of heparin does not require laboratory monitoring when given therapeutically?

    <p>Low molecular weight heparin</p> Signup and view all the answers

    What is the primary target of LMWH when it activates antithrombin III (AT III)?

    <p>Factor Xa</p> Signup and view all the answers

    What is the mechanism of action of unfractionated heparin when it binds to antithrombin III (AT III)?

    <p>Inhibits factor Xa PRIMARILY</p> Signup and view all the answers

    Which medication is useful for inhibiting ADP-mediated platelet aggregation?

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

    What is the primary use of clopidogrel and ticlopidine?

    <p>Inhibiting platelet aggregation</p> Signup and view all the answers

    Which factor does low-molecular-weight heparin (LMWH) primarily act on?

    <p>Factor Xa</p> Signup and view all the answers

    What is the main function of antithrombin III (AT III) when activated by Enoxaparin?

    <p>Binds to factor Xa</p> Signup and view all the answers

    How does Enoxaparin differ from heparin in terms of molecular weight?

    <p>Enoxaparin has a lower molecular weight</p> Signup and view all the answers

    Which fat-soluble vitamin deficiency is most likely causing the patient's symptoms?

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

    What is the primary cause of increased risk of vitamin K deficiency in patients with CF?

    <p>Reduced secretion of pancreatic enzymes</p> Signup and view all the answers

    Which of the following symptoms is NOT consistent with EARLY vitamin K deficiency in patients with CF?

    <p>Prolonged aPTT</p> Signup and view all the answers

    Which of the following statements about Andexanet alfa is correct?

    <p>Andexanet alfa is a factor Xa decoy that has no proteolytic effect.</p> Signup and view all the answers

    Which of the following is a use for Andexanet alfa?

    <p>To reverse the anticoagulation effect of factor Xa inhibitors</p> Signup and view all the answers

    Which of the following medications is commonly reversed by Andexanet alfa?

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

    Which enzyme is specifically targeted by direct oral anticoagulants?

    <p>Factor Xa</p> Signup and view all the answers

    What is the primary target of heparin when it activates antithrombin III (AT III)?

    <p>Factor Xa</p> Signup and view all the answers

    What is the effect of heparin on thrombin time/partial thromboplastin time?

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

    Which laboratory finding is commonly seen in patients with antiphospholipid antibody syndrome?

    <p>Positive RPR test</p> Signup and view all the answers

    What is a characteristic feature of antiphospholipid antibody syndrome?

    <p>Recurrent pregnancy loss</p> Signup and view all the answers

    What can antiphospholipid antibodies in systemic lupus erythematosus cause?

    <p>Elevated PTT</p> Signup and view all the answers

    Which laboratory finding is commonly seen in patients with disseminated intravascular coagulation (DIC)?

    <p>Elevated prothrombin time (PT)</p> Signup and view all the answers

    What is the primary cause of disseminated intravascular coagulation (DIC)?

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

    Which of the following is a characteristic sign of disseminated intravascular coagulation (DIC)?

    <p>Bleeding from venipuncture sites</p> Signup and view all the answers

    Which of the following medications is a potent enhancer of the cytochrome P-450 pathway and can decrease the efficacy of warfarin?

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

    Which of the following medications can inhibit warfarin metabolism and increase the risk of bleeding?

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

    Which of the following medications does NOT affect the metabolism or efficacy of warfarin?

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

    Which of the following is a manifestation of vitamin C deficiency?

    <p>Gingival bleeding</p> Signup and view all the answers

    What is the main role of vitamin C in the body?

    <p>Production of collagen</p> Signup and view all the answers

    Which of the following is/are characteristics of vitamin C deficiency?

    <p>Perifollicular keratosis</p> Signup and view all the answers

    Which of the following is a symptom of scurvy?

    <p>Poor wound healing</p> Signup and view all the answers

    Which of the following is a hemorrhagic complication of scurvy?

    <p>Gingival bleeding</p> Signup and view all the answers

    Which vitamin deficiency can cause perifollicular hyperkeratosis?

    <p>Vitamin C</p> Signup and view all the answers

    Which vitamin K-dependent coagulation factor has the shortest half-life?

    <p>Factor VII</p> Signup and view all the answers

    What does failure of prothrombin time to correct with vitamin K supplementation in liver disease indicate?

    <p>Factor VII deficiency</p> Signup and view all the answers

    What is the most common cause of factor VII deficiency?

    <p>Liver disease</p> Signup and view all the answers

    Which condition can lead to high-output heart failure in patients with severe cirrhosis?

    <p>Development of mesenteric and intrahepatic arteriovenous shunts</p> Signup and view all the answers

    What is the primary cause of high-output heart failure in severe cirrhosis?

    <p>Development of mesenteric and intrahepatic arteriovenous shunts</p> Signup and view all the answers

    Which of the following is a potential complication of starting patients on warfarin?

    <p>Skin necrosis</p> Signup and view all the answers

    What factor can further exacerbate the hypercoagulability seen in patients started on warfarin?

    <p>Protein C deficiency</p> Signup and view all the answers

    What is the primary cause of thrombotic occlusion in patients started on warfarin?

    <p>Transient hypercoagulable state</p> Signup and view all the answers

    Which of the following is a characteristic of acute disseminated intravascular coagulation (DIC)?

    <p>Elevation of D-dimer levels</p> Signup and view all the answers

    What is the most common cause of bleeding complications in acute disseminated intravascular coagulation (DIC)?

    <p>Consumption of platelets and clotting factors</p> Signup and view all the answers

    Which of the following is a consequence of widespread formation of microvascular thrombi in acute disseminated intravascular coagulation (DIC)?

    <p>Consumption of coagulation factors</p> Signup and view all the answers

    Which type of anticoagulant is used to treat heparin-induced thrombocytopenia (HIT)?

    <p>Direct thrombin inhibitors (DTIs)</p> Signup and view all the answers

    What should be avoided in patients with heparin-induced thrombocytopenia (HIT)?

    <p>Low molecular weight heparin (LMWH)</p> Signup and view all the answers

    What is the primary treatment for heparin-induced thrombocytopenia (HIT)?

    <p>Direct thrombin inhibitors (DTIs)</p> Signup and view all the answers

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