ANTICOAGULATION EXAM QUESTIONS AND ANSWERS
NEW VERSION WITH PASS GUARANTEE
INR above therapeutic range but <4.5 - ANSWER Reduce or skip warfarin
dose. Monitor INR. Resume warfarin when INR is therapeutic.
INR 4.5-10 with no bleeding - ANSWER Hold 1-2 doses. monitor INR.
Resume at lower dose when INR therapeutic. Vitamin K can be used if
emergent surgery
Patients with INR>10 without bleeding - ANSWER Hold. Give K 2.5-5.0 mg
even if NOT bleeding
For patients with bleeding from warfarin - ANSWER Hold warfarin. Give
vitamin K 5-10 m SLOW IV push with IV injection and 4-factor FFP (PCC).
Preferred over FFP due to allergic reaction risk
TL was admitted to the local hospital for a knee replacement. Orthopedic
surgery is considered high risk for venous thromboembolism (VTE) but TL did
not receive any VTE prophylaxis. He developed a deep vein thrombosis and
was discharged on warfarin. This was his first incidence of VTE. Normally, TL
is thin and active. How long should he receive warfarin? - ANSWER 3 months
A pharmacist working in an inpatient medical ward of the local hospital is
responsible for monitoring anticoagulation therapy. She routinely obtains
laboratory parameters and adjusts the doses of low molecular weight heparins
(LMWHs), as needed. In which of the following clinical situations is it
appropriate to monitor the level of anticoagulation with LMWH therapy? -
ANSWER Significant renal impairment
Pregnancy
Mechanical heart valves
NEW VERSION WITH PASS GUARANTEE
INR above therapeutic range but <4.5 - ANSWER Reduce or skip warfarin
dose. Monitor INR. Resume warfarin when INR is therapeutic.
INR 4.5-10 with no bleeding - ANSWER Hold 1-2 doses. monitor INR.
Resume at lower dose when INR therapeutic. Vitamin K can be used if
emergent surgery
Patients with INR>10 without bleeding - ANSWER Hold. Give K 2.5-5.0 mg
even if NOT bleeding
For patients with bleeding from warfarin - ANSWER Hold warfarin. Give
vitamin K 5-10 m SLOW IV push with IV injection and 4-factor FFP (PCC).
Preferred over FFP due to allergic reaction risk
TL was admitted to the local hospital for a knee replacement. Orthopedic
surgery is considered high risk for venous thromboembolism (VTE) but TL did
not receive any VTE prophylaxis. He developed a deep vein thrombosis and
was discharged on warfarin. This was his first incidence of VTE. Normally, TL
is thin and active. How long should he receive warfarin? - ANSWER 3 months
A pharmacist working in an inpatient medical ward of the local hospital is
responsible for monitoring anticoagulation therapy. She routinely obtains
laboratory parameters and adjusts the doses of low molecular weight heparins
(LMWHs), as needed. In which of the following clinical situations is it
appropriate to monitor the level of anticoagulation with LMWH therapy? -
ANSWER Significant renal impairment
Pregnancy
Mechanical heart valves
