RXPREP: ANTICOAGULATION NEW EXAM QUESTIONS AND CORRECT
ANSWERS FOR TOP PERFORMANCE
Warfarin inhibits which factors? - ANSWER II, VII, IX, X
Protein C and S
What are the *direct* factor Xa inhibitors? - ANSWER RivaroXaban
ApiXaban
EdoXaban
BetriXaban
What are the *indirect* factor Xa inhibitors? - ANSWER Fondaparinux
UFH and LMWHs inhibit which clotting factors? - ANSWER UFH: equal anti-
Xa and anti-IIa activity
LMWHs: anti-Xa > anti-IIa
What DTIs are available? Which are IV and which are PO? - ANSWER IV:
Argatroban, Bivalirudin
PO: Dabigatran
What is the final step of the clotting cascade? - ANSWER Fibrinogen is
converted to *fibrin*
Warfarin MOA: - ANSWER Vitamin K antagonist
What anticoagulant class does NOT cross-react with heparin-induced
thrombocytopenia (HIT) antibodies? - ANSWER IV DTIs: Argatroban,
Bivalirudin
What is the anticoagulant of choice in a patient who develops HIT? - ANSWER
Argatroban!
Which anticoagulants bind to antithrombin (IIa)? - ANSWER UFH
LMWH
, Fondaparinux
What body weight should you use to dose UFH? - ANSWER TOTAL body
weight
Prophylaxis of VTE dosing for UFH: - ANSWER 5000 units SC Q8-12H
Treatment of VTE dosing for UFH: - ANSWER 80 u/kg IV bolus x1
18 u/kg/hr IV infusion
ACS/STEMI treatment dosing for UFH: - ANSWER 60 u/kg IV bolus x1 (max
4000 units)
12 u/kg/hr IV infusion (max 1000 u/hr)
HIT antibodies have cross sensitivity with? - ANSWER LMWHs
UFH side effects: - ANSWER Bleeding (epistaxis, eechymosis, gingival, GI)
Thrombocytopenia
HIT
*Alopecia*
*HYPERkalemia*
*Osteoporosis* (with long term use)
UFH monitoring: - ANSWER aPTT or anti-Xa
When should an aPTT be checked for UFH? - ANSWER 6 hours after initiation
and every 6 hours until therapeutic range of (1.5 - 2.5 x control), then every 24
hours
UFH antidote: - ANSWER Protamine
Prophylaxis of VTE dosing for enoxaparin: - ANSWER 30mg SC Q12H or
40mg SC QD
CrCl <30: 30mg SC QD
Treatment of VTE and UA/NSTEMI dosing for enoxaparin: - ANSWER
1mg/kg SC Q12H
(or 1.5mg/kg SQ Q24H only for inpatient VTE treatment)
CrCl <30: 1mg/kg SC QD
ANSWERS FOR TOP PERFORMANCE
Warfarin inhibits which factors? - ANSWER II, VII, IX, X
Protein C and S
What are the *direct* factor Xa inhibitors? - ANSWER RivaroXaban
ApiXaban
EdoXaban
BetriXaban
What are the *indirect* factor Xa inhibitors? - ANSWER Fondaparinux
UFH and LMWHs inhibit which clotting factors? - ANSWER UFH: equal anti-
Xa and anti-IIa activity
LMWHs: anti-Xa > anti-IIa
What DTIs are available? Which are IV and which are PO? - ANSWER IV:
Argatroban, Bivalirudin
PO: Dabigatran
What is the final step of the clotting cascade? - ANSWER Fibrinogen is
converted to *fibrin*
Warfarin MOA: - ANSWER Vitamin K antagonist
What anticoagulant class does NOT cross-react with heparin-induced
thrombocytopenia (HIT) antibodies? - ANSWER IV DTIs: Argatroban,
Bivalirudin
What is the anticoagulant of choice in a patient who develops HIT? - ANSWER
Argatroban!
Which anticoagulants bind to antithrombin (IIa)? - ANSWER UFH
LMWH
, Fondaparinux
What body weight should you use to dose UFH? - ANSWER TOTAL body
weight
Prophylaxis of VTE dosing for UFH: - ANSWER 5000 units SC Q8-12H
Treatment of VTE dosing for UFH: - ANSWER 80 u/kg IV bolus x1
18 u/kg/hr IV infusion
ACS/STEMI treatment dosing for UFH: - ANSWER 60 u/kg IV bolus x1 (max
4000 units)
12 u/kg/hr IV infusion (max 1000 u/hr)
HIT antibodies have cross sensitivity with? - ANSWER LMWHs
UFH side effects: - ANSWER Bleeding (epistaxis, eechymosis, gingival, GI)
Thrombocytopenia
HIT
*Alopecia*
*HYPERkalemia*
*Osteoporosis* (with long term use)
UFH monitoring: - ANSWER aPTT or anti-Xa
When should an aPTT be checked for UFH? - ANSWER 6 hours after initiation
and every 6 hours until therapeutic range of (1.5 - 2.5 x control), then every 24
hours
UFH antidote: - ANSWER Protamine
Prophylaxis of VTE dosing for enoxaparin: - ANSWER 30mg SC Q12H or
40mg SC QD
CrCl <30: 30mg SC QD
Treatment of VTE and UA/NSTEMI dosing for enoxaparin: - ANSWER
1mg/kg SC Q12H
(or 1.5mg/kg SQ Q24H only for inpatient VTE treatment)
CrCl <30: 1mg/kg SC QD
