Week 5 Review for Final Exam Questions
With Solved Solutions.
Drug of choice to prevent and treat thromboembolism - Answer Warfarin
Titrate INR to this in order to prevent events listed - Answer 2-3
Initial dose of warfarin - Answer 10mg unless older than 75, has co-morbidities, poor nutrition,
elevated INR off warfarin, elevated liver tests, or changing thyroid status. Then start at 5mg per day
Initial treat of upper or lower extremity DVT - Answer Short term treatment with SC LMWH, SC
fondaparinux, or iv/SC Heparin for at least 5days & until INR is 2.0 for at least 24 hours
Preferred treatment of DVT - Answer LMWH & SC fondaparinux preferred over heparin
How long do we treat DVT d/t a reversible risk factor? - Answer 3 months
How many days of prophylaxis therapy is needed with fondaparinux or LMWH when a patient has
superficial vein thrombosis in the lower limb that is greater than 5cm? - Answer 45 days
What is the preferred drug (per ACCP) and dose when when patient has superficial vein thrombosis in
lower limb that is greater than 5cm? - Answer fondaparinux 2.5mg QD
For patients with DVT or PE along WITH cancer, ACCP recommends LMWH for how long? - Answer first
3-6 months of anticoagulation therapy
Dose of apixaban to treat DVT & PE - Answer 10 mg BID x 7 days and then 5 mg BID
Dose of apixaban to reduce risk of further DVT & PE - Answer 2.5 mg BID
, Patient education: Air travel >8 hours for patients at risk for DVT - Answer Wear loose-fitting clothing
(avoid tight areas waistline or lower extremities), good hydration, and frequent calf exercises. Mobility
and compression stockings with 15-30 mm Hg at the ankle.
Patient education: All patients regarding DVT prevention - Answer Wear loose-fitting clothing (avoid
tight areas waistline or lower extremities), good hydration, increased mobility, and wearing compression
stockings with 130-40 mm Hg of pressure at the ankle.
ACCP Guidelines: Patients with AF and a low risk of stroke (CHADS2 score of 0), recommended therapy is:
- Answer No treatment. However, patient may choose ASA 81-325 mg QD
ACCP Guidelines: Patients with AF and intermediate risk of stroke (CHADS2 score of 1), recommended
therapy is: - Answer Treat with warfarin. If patient refuses warfarin, ASA & Plavix can be substituted.
ACCP Guidelines: Patients with AF and high risk of stroke (CHADS2 score of 2+), recommended therapy
is: - Answer Dabigatran 150 mg BID preferred over warfarin.
Drug of choice for recurrent embolism or a prosthetic heart valve? - Answer warfarin. Therapy is
continued indefinitely for mechanical heart valves.
Long-term management of patients with bioprosthetic valves in SR are managed on - Answer ASA 75-
100mg/day
BLACK BOX WARNING: Ticagrelor (Brillenta) - Answer not for use in patients with active pathological
bleeding or history of intracranial bleed. Discontinue 5 days prior to surgery
BLACK BOX WARNING: Dabigatran (Pradaxa) - Answer Discontinuation of drug leads to increased
thrombotic events. No reversal agent is there is excessive bleeding
BLACK BOX WARNING: Vorapaxar - Answer Do not use in patients with a h/o stroke, TIA, intracranial
hemorrhage or an active pathological bleeding.
With Solved Solutions.
Drug of choice to prevent and treat thromboembolism - Answer Warfarin
Titrate INR to this in order to prevent events listed - Answer 2-3
Initial dose of warfarin - Answer 10mg unless older than 75, has co-morbidities, poor nutrition,
elevated INR off warfarin, elevated liver tests, or changing thyroid status. Then start at 5mg per day
Initial treat of upper or lower extremity DVT - Answer Short term treatment with SC LMWH, SC
fondaparinux, or iv/SC Heparin for at least 5days & until INR is 2.0 for at least 24 hours
Preferred treatment of DVT - Answer LMWH & SC fondaparinux preferred over heparin
How long do we treat DVT d/t a reversible risk factor? - Answer 3 months
How many days of prophylaxis therapy is needed with fondaparinux or LMWH when a patient has
superficial vein thrombosis in the lower limb that is greater than 5cm? - Answer 45 days
What is the preferred drug (per ACCP) and dose when when patient has superficial vein thrombosis in
lower limb that is greater than 5cm? - Answer fondaparinux 2.5mg QD
For patients with DVT or PE along WITH cancer, ACCP recommends LMWH for how long? - Answer first
3-6 months of anticoagulation therapy
Dose of apixaban to treat DVT & PE - Answer 10 mg BID x 7 days and then 5 mg BID
Dose of apixaban to reduce risk of further DVT & PE - Answer 2.5 mg BID
, Patient education: Air travel >8 hours for patients at risk for DVT - Answer Wear loose-fitting clothing
(avoid tight areas waistline or lower extremities), good hydration, and frequent calf exercises. Mobility
and compression stockings with 15-30 mm Hg at the ankle.
Patient education: All patients regarding DVT prevention - Answer Wear loose-fitting clothing (avoid
tight areas waistline or lower extremities), good hydration, increased mobility, and wearing compression
stockings with 130-40 mm Hg of pressure at the ankle.
ACCP Guidelines: Patients with AF and a low risk of stroke (CHADS2 score of 0), recommended therapy is:
- Answer No treatment. However, patient may choose ASA 81-325 mg QD
ACCP Guidelines: Patients with AF and intermediate risk of stroke (CHADS2 score of 1), recommended
therapy is: - Answer Treat with warfarin. If patient refuses warfarin, ASA & Plavix can be substituted.
ACCP Guidelines: Patients with AF and high risk of stroke (CHADS2 score of 2+), recommended therapy
is: - Answer Dabigatran 150 mg BID preferred over warfarin.
Drug of choice for recurrent embolism or a prosthetic heart valve? - Answer warfarin. Therapy is
continued indefinitely for mechanical heart valves.
Long-term management of patients with bioprosthetic valves in SR are managed on - Answer ASA 75-
100mg/day
BLACK BOX WARNING: Ticagrelor (Brillenta) - Answer not for use in patients with active pathological
bleeding or history of intracranial bleed. Discontinue 5 days prior to surgery
BLACK BOX WARNING: Dabigatran (Pradaxa) - Answer Discontinuation of drug leads to increased
thrombotic events. No reversal agent is there is excessive bleeding
BLACK BOX WARNING: Vorapaxar - Answer Do not use in patients with a h/o stroke, TIA, intracranial
hemorrhage or an active pathological bleeding.
