Blood and Immune System (BIS 105) - Delta University PDF

Level 1 Semester 2 Module : Blood and Immune System (BIS 105) Fibrinolytic Drugs And Hemostatic Agents  Case (1) A 71-year-old man is brought to the emergency department 30 min after the onset of right-sided weakness and aphasia (difficu...

Level 1 Semester 2 Module : Blood and Immune System (BIS 105) Fibrinolytic Drugs And Hemostatic Agents  Case (1) A 71-year-old man is brought to the emergency department 30 min after the onset of right-sided weakness and aphasia (difficulty speaking). Imaging studies ruled out cerebral hemorrhage as the cause of his acute symptoms of stroke. Prompt administration of which of the following drugs is most likely to improve this patient’s clinical outcome? (A) Abciximab. (B) Alteplase. (C) Factor VIII. Answer: B (D) Streptokinase. (E) Vitamin K. Alteplase improves the clinical outcome in patients with ischemic stroke if given within 3 h after the onset of symptoms, after ruling out hemorrhagic stroke. Use of streptokinase results in unacceptably high rates of bleeding. Glycoprotein IIb/IIIa receptor inhibitors like abciximab have not been tested in ischemic stroke. The answer is B.  Case (2) A patient was started on warfarin. Two months later, she returned after a severe nosebleed. Laboratory analysis revealed an INR (international normalized ratio) of 7.0 (INR value in such a warfarin-treated patient should be 2.0–3.0). To prevent severe hemorrhage, the warfarin should be discontinued and this patient should be treated immediately with which of the following? (A) Aminocaproic acid (B) Desmopressin Answer: D (C) Protamine (D) Vitamin K1  Case (3) A 56-year-old patient who is prescribed dabigatran is admitted to the hospital with an intracranial hemorrhage. Which agent can be used to reverse bleeding? A. Factor Xa. B. Heparin. C. Idarucizumab. D. Vitamin K. E. Protamine sulfate. Answer: C  Case (4) Which of the following drugs accelerates the conversion of plasminogen to plasmin? (A) Aminocaproic acid. (B) Heparin. (C) Lepirudin. (D) Reteplase. (E) Warfarin. Answer: D  Case (5) Which of the following drugs is a non-fibrin-specific fibrinolytic agent? (A) Aminocaproic acid. (B) Alteplase. (C) Aspirin. (D) Reteplase. (E) Streptokinase. Answer: E  Case (6) Which of the following drugs is the antidot for apixaban, a direct Factor Xa inhibitor? (A) Aminocaproic acid. (B) Alteplase. (C) Factor Xa. (D) Protamine sulphate. Answer: C (E) Vitamin K1. E. Pravastatin A. Atorvastatin. B. Fenofibrate. C. Colestipol. D. Niacin. E. Gemfibrozil. Answer: A  Formative Assessment Which one of the following is a hypolipidemic agent that can cause flushing and itching? A. Atorvastatin. B. Colestipol. C. Fenofibrate. D. Gemfibrozil. E. Niacin. Answer: E