[MCQs] Antiplatelet, Anticoagulant, and Fibrinolytic Drugs - Part 2

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Antiplatelet, Anticoagulant, and Fibrinolytic Drugs- Part 2

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Congratulations - you have completed Antiplatelet, Anticoagulant, and Fibrinolytic Drugs- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Most serious complication of GPIIb/IIIa antagonist therapy is ?

A	Anemia
B	Leucopenia
C	Thrombocytopenia
D	All of the above

Question 1 Explanation:

Immune-mediated thrombocytopenia is the most serious complication of GPIIb/IIIa therapy

Question 2

Which of the following can be administered orally ?

A	Heparin
B	Low-molecular-weight heparin (LMWH)
C	Dabigatran etexilate
D	Fondaparinux

Question 2 Explanation:

Parenteral anticoagulants include heparin, low-molecular-weight heparin (LMWH), and fondaparinux. Only available oral anticoagulant is warfarin. Dabigatran etexilate is an oral thrombin inhibitor, and rivaroxaban is an oral Factor Xa inhibitor.

Question 3

Commercial unfractionated heparin (UFH) is obtained from which of the following sources ?

A	Porcine lung
B	Porcine intestinal mucosa
C	Porcine liver
D	Porcine bone marrow

Question 3 Explanation:

Heparin is a sulfated polysaccharide and is isolated from mammalian tissues rich in mast cells. Most commercial heparin is derived from porcine intestinal mucosa and is a polymer of alternating D-glucuronic acid and N-acetyl-d-glucosamine residues.

Question 4

Which unique sequence of UFH molecule binds to antithrombin ?

A	Pentasaccharide
B	Hexasaccharide
C	Heptasaccharide
D	Decasaccharide

Question 4 Explanation:

Heparin acts as an anticoagulant exclusively by activating antithrombin III. Presence of Antithrombin III is mandatory for its action. Heparin binds to Antithrombin III via a unique pentasaccharide sequence that is found on one-third of the chains of commercial heparin.

Question 5

Antithrombin is a member of ?

A	Ornithine protease inhibitor
B	Cystine protease inhibitor
C	Glycine protease inhibitor
D	Serine protease inhibitor

Question 5 Explanation:

Antithrombin is a plasma cofactor for heparin. It is a member of serine protease inhibitor (serpin) superfamily

Question 6

Antithrombin is synthesized in ?

A	Kidney
B	Liver
C	Intestinal mucosa
D	Lung

Question 6 Explanation:

Antithrombin is synthesized in liver and acts as a suicide substrate for its target enzymes.

Question 7

UFH-antithrombin complex inactivates which of the following ?

A	Factor IX
B	Factor X
C	Factor Xa
D	Factor I

Question 7 Explanation:

Factor I

Question 8

For thrombin inhibition, heparin of what nature simultaneously binds to antithrombin and thrombin ?

A	At least 16 saccharide units, molecular weight 5400
B	At least 17 saccharide units, molecular weight 5400
C	At least 18 saccharide units, molecular weight 5400
D	At least 19 saccharide units, molecular weight 5400

Question 8 Explanation:

For thrombin inhibition, heparin chain of at least 18 saccharide units (molecular weight 5400) simultaneously binds to antithrombin and thrombin.

Question 9

What is the mean molecular weight of heparin ?

A	15,000
B	20,000
C	25,000
D	30,000

Question 9 Explanation:

Heparin has a mean molecular weight of 15,000

Question 10

What is the mean molecular weight of LMWH ?

A	2500 - 4000
B	4500 - 5000
C	5000 - 6000
D	6000 - 7500

Question 10 Explanation:

LMWH have a mean molecular weight of 4500 - 5000

Question 11

Which of the following statements about tissue factor pathway inhibitor (TFPI) ?

A	Derived from endothelium
B	Factor Xa–dependent
C	Contribute to antithrombotic activity of heparin
D	None of the above

Question 12

In the circulation, heparin binds to ?

A	Endothelium
B	Macrophages
C	Platelet factor 4 (PF4)
D	All of the above

Question 12 Explanation:

In the circulation, heparin binds to the endothelium, antithrombin, macrophages, acute-phase reactants, platelet factor 4 (PF4)

Question 13

Plasma half-life of heparin given as IV bolus (100 U/kg) is ?

A	60 minutes
B	120 minutes
C	180 minutes
D	180 minutes

Question 13 Explanation:

180 minutes

Question 14

Which of the following internalize & depolymerize long heparin chains & secrete shorter chains back into the circulation ?

A	Endothelium
B	Macrophages
C	Platelets
D	RBC’s

Question 14 Explanation:

Heparin binds to macrophages, which internalize and depolymerize the long heparin chains and secrete shorter chains back into the circulation

Question 15

Heparin-binding domain in thrombin is ?

A	Active site or catalytic site
B	Exosite 1
C	Exosite 2
D	All of the above

Question 15 Explanation:

Thrombin-inhibiting drugs can block the action of thrombin by binding to three domains: the active site or catalytic site and two exosites. Exosite 1 acts as a dock for substrates such as fibrin. Exosite 2 serves as the heparin-binding domain

Question 16

Which of the following statements about heparin is false ?

A	Heparin must be given parenterally
B	Clearance is mainly renal
C	Platelet factor 4 can neutralize anticoagulant activity of heparin
D	Anti-factor Xa levels is used to monitor heparin therapy

Question 16 Explanation:

Clearance of heparin is mainly extrarenal.

Question 17

For therapeutic anticoagulation, after IV bolus of 70 units/ kg, heparin is infused at rate of ?

A	12 - 15 units/kg per hour
B	25 - 30 units/kg per hour
C	30 - 50 units/kg per hour
D	50 - 65 units/kg per hour

Question 17 Explanation:

For therapeutic anticoagulation, after IV bolus of 70 units/kg, heparin is infused at rate of 12– 15 units/kg per hour.

Question 18

One USP unit of heparin is defined as the concentration of heparin that prevents 1 mL of citrated sheep plasma from clotting for 1 hour after addition of ?

A	Calcium
B	Sodium
C	Potassium
D	Citrate

Question 18 Explanation:

One USP unit of heparin is defined as the concentration of heparin that prevents 1 mL of citrated sheep plasma from clotting for 1 hour after addition of calcium.

Question 19

Which of the following is not a side effect of heparin ?

A	Thrombocytopenia
B	Osteoporosis
C	Elevated levels of transaminases
D	Leucopenia

Question 19 Explanation:

The most common side effect of heparin is bleeding. Other complications include thrombocytopenia, osteoporosis, and elevated levels of transaminases.

Question 20

Protamine sulfate is isolated from ?

A	Horse urine
B	Horse serum
C	Salmon sperm
D	Bovine urine

Question 20 Explanation:

Protamine sulfate, a mixture of basic polypeptides isolated from salmon sperm. Protamine binds heparin with high affinity, and the resultant protamine-heparin complexes are then cleared

Question 21

1 mg of protamine sulfate neutralizes how many units of heparin ?

A	100
B	200
C	300
D	400

Question 21 Explanation:

1 mg of protamine sulfate neutralizes 100 units of heparin

Question 22

Mode of administration of protamine sulfate is ?

A	S/C
B	IM
C	IV
D	Any of the above

Question 22 Explanation:

Protamine sulfate is given as a slow IV infusion. Anaphylactoid reactions can occur

Question 23

“True” heparin resistance results from nonspecific heparin binding to ?

A	White blood cells
B	Vascular endothelial cells
C	Acute-phase proteins
D	All of the above

Question 24

“Apparent” heparin resistance is a result of elevation of which factor ?

A	Factor II
B	Factor VII
C	Factor VIII
D	Factor X

Question 25

Which of the following is a type of immunologic thrombocytopenia ?

A	Viral or bacterial infections
B	Heparin
C	Idiopathic thrombocytopenic purpura (ITP
D	All of the above

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See all quizzes of the Antiplatelet, Anticoagulant, and Fibrinolytic Drugs at here:

Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 1 | Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 2

Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 3 | Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 4

II. Preview all questions below:

1. Most serious complication of GPIIb/IIIa antagonist therapy is ?
A. Anemia
B. Leucopenia
C. Thrombocytopenia
D. All of the above

2. Which of the following can be administered orally ?
A. Heparin
B. Low-molecular-weight heparin (LMWH)
C. Dabigatran etexilate
D. Fondaparinux

3. Commercial unfractionated heparin (UFH) is obtained from which of the following sources ?
A. Bovine lung
B. Bovine intestinal mucosa
C. Bovine liver
D. Bovine bone marrow

4. Commercial unfractionated heparin (UFH) is obtained from which of the following sources ?
A. Porcine lung
B. Porcine intestinal mucosa
C. Porcine liver
D. Porcine bone marrow

5. Which unique sequence of UFH molecule binds to antithrombin ?
A. Pentasaccharide
B. Hexasaccharide
C. Heptasaccharide
D. Decasaccharide

6. Antithrombin is a member of ?
A. Ornithine protease inhibitor
B. Cystine protease inhibitor
C. Glycine protease inhibitor
D. Serine protease inhibitor

7. Antithrombin is synthesized in ?
A. Kidney
B. Liver
C. Intestinal mucosa
D. Lung

8. UFH-antithrombin complex inactivates which of the following ?
A. Factor IX
B. Factor X
C. Factor Xa
D. Factor II

9. For thrombin inhibition, heparin of what nature simultaneously binds to antithrombin and thrombin ?
A. At least 16 saccharide units, molecular weight 5400
B. At least 17 saccharide units, molecular weight 5400
C. At least 18 saccharide units, molecular weight 5400
D. At least 19 saccharide units, molecular weight 5400

10. What is the mean molecular weight of heparin ?
A. 15,000
B. 20,000
C. 25,000
D. 30,000

11. What is the mean molecular weight of LMWH ?
A. 2500 – 4000
B. 4500 – 5000
C. 5000 – 6000
D. 6000 – 7500

12. Which of the following statements about tissue factor pathway inhibitor (TFPI) ?
A. Derived from endothelium
B. Factor Xa–dependent
C. Contribute to antithrombotic activity of heparin
D. None of the above

13. In the circulation, heparin binds to ?
A. Endothelium
B. Macrophages
C. Platelet factor 4 (PF4)
D. All of the above

14. Plasma half-life of heparin given as IV bolus (100 U/kg) is ?
A. 60 minutes
B. 120 minutes
C. 180 minutes
D. 240 minutes

15. Which of the following internalize & depolymerize long heparin chains & secrete shorter chains back into the circulation ?
A. Endothelium
B. Macrophages
C. Platelets
D. RBC’s

16. Heparin-binding domain in thrombin is ?
A. Active site or catalytic site
B. Exosite 1
C. Exosite 2
D. All of the above

17. Which of the following statements about heparin is false ?
A. Heparin must be given parenterally
B. Clearance is mainly renal
C. Platelet factor 4 can neutralize anticoagulant activity of heparin
D. Anti-factor Xa levels is used to monitor heparin therapy

18. For therapeutic anticoagulation, after IV bolus of 70 units/kg, heparin is infused at rate of ?
A. 12 – 15 units/kg per hour
B. 25 – 30 units/kg per hour
C. 30 – 50 units/kg per hour
D. 50 – 65 units/kg per hour

19. One USP unit of heparin is defined as the concentration of heparin that prevents 1 mL of citrated sheep plasma fromclotting for 1 hour after addition of ?
A. Calcium
B. Sodium
C. Potassium
D. Citrate

20. Which of the following is not a side effect of heparin ?
A. Thrombocytopenia
B. Osteoporosis
C. Elevated levels of transaminases
D. Leucopenia

21. Protamine sulfate is isolated from ?
A. Horse urine
B. Horse serum
C. Salmon sperm
D. Bovine urine

22. 1 mg of protamine sulfate neutralizes how many units of heparin ?
A. 100
B. 200
C. 300
D. 400

23. Mode of administration of protamine sulfate is ?
A. S/C
B. IM
C. IV
D. Any of the above

24. “True” heparin resistance results from nonspecific heparin binding to ?
Harrison’s 16th Ed. 688
A. White blood cells
B. Vascular endothelial cells
C. Acute-phase proteins
D. All of the above

[MCQs] Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 2

I. Start the exam by click the “Start” button

Antiplatelet, Anticoagulant, and Fibrinolytic Drugs- Part 2

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[MCQs] Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 1

[MCQs] Antiplatelet, Anticoagulant, and Fibrinolytic Drugs – Part 3

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