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Quiz

L47 Anticoagulation

Gelöschter Nutzer 16 Fragen

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  1. 1An overview of the clotting cascade:
    1. Initiation:
    Platelets adhere to vessel and [blank_start]recruit[blank_end] more circulating platelets to [blank_start]aggregate[blank_end]. This provides a surface
    where clotting factors assemble. Some clotting factors are [blank_start]released[blank_end]. TF initiates coagulation. TF activates [blank_start]X and IX[blank_end], forming Xa and IXa.
    2. Amplification
    IXa amplifies the activation of [blank_start]X[blank_end]. The [blank_start]Xa/Va[blank_end] complex is a critical component, activating [blank_start]FIIa[blank_end] (thrombin)
    3. Propagation
    A burst of activated thrombin then converts [blank_start]fibrinogen to fibrin[blank_end], to form a mesh.
    1. Arecruit
    2. Baggregate
    3. Creleased
    4. DX and IX
    5. EX
    6. FFIIa
    7. GXa/Va
    8. Hfibrinogen to fibrin
  2. 2The clotting cascade has an "[blank_start]intrinsic[blank_end] pathway" activated by trauma inside the vascular system. It is [blank_start]slower[blank_end] than the “extrinsic pathway”. The initiation involves XII, XI, IX, VIII.
    1. Aintrinsic
    2. Bslower
  3. 3Warfarin is a Vitamin K “antagonist” that targets Vitamin K epoxide reductase in the liver.
    1. ARichtig
    2. BFalsch
  4. 4NOACs (novel oral anticoagulants) like dabigatran and rivaroxaban target thrombin and Xa.
    1. ARichtig
    2. BFalsch
  5. 5Choose the incorrect statement.
    1. AIt is a racemic mixture.
    2. BIt is highly protein bound (>99%) and well absorbed.
    3. CIt is renally metabolised.
    4. DS-warfarin has a greater clearance and shorter half life than R-warfarin.
  6. 6By inhibiting vitamin K epoxide reductase, warfarin increases the production of clotting factors II, VII, IX, X.
    1. ARichtig
    2. BFalsch
  7. 7The half-life of the FII is longer than warfarin and is the rate limiting step in the time course of the warfarin effect.
    1. ARichtig
    2. BFalsch
  8. 8Unfractionated heparin is found naturally in [blank_start]mast[blank_end] cells. It is a large [blank_start]polymer[blank_end] with alternating disaccharide units of variable lengths.
    - No [blank_start]intrinsic[blank_end] anticoagulant activity
    - Not [blank_start]orally[blank_end] available so given intravenously and subcutaneously
    - Half-life of about [blank_start]1[blank_end] hour
    The antidote is a reversal agent called [blank_start]protamine sulphate[blank_end].
    It binds to [blank_start]antithrombin II[blank_end]I, and induces a conformational change that enhances binding to [blank_start]activated[blank_end] clotting actors, helping to inhibit coagulation.
    1. Amast
    2. Bpolymer
    3. Cintrinsic
    4. Dorally
    5. E1
    6. Fprotamine sulphate
    7. Gantithrombin II
    8. Hactivated
  9. 9Low molecular weight heparins (LMWH)
    • Given [blank_start]subcutaneous[blank_end]
    • Enoxaparin halfe life ~ [blank_start]5hrs[blank_end]
    • Mainly [blank_start]renally[blank_end]-cleared
    • Effect [blank_start]partially[blank_end] reversed by giving protamine sulphate
    • Target is mostly anti-[blank_start]Xa[blank_end], some anti-IIa
    1. Asubcutaneous
    2. B5hrs
    3. Crenally
    4. Dpartially
    5. EXa
  10. 10Novel oral anticoagulants (NOACs):
    1. Dabigatran etexilate
    • Competitive and reversible inhibition of free and clot bound [blank_start]thrombin[blank_end]
    • Prodrug converted to active compound (dabigatran)
    • [blank_start]Low[blank_end] oral availability (~7%)
    • ~80% [blank_start]renally[blank_end] cleared, ~20% glucuronidation
    • Half life: ~12 hours
    2. Rivaroxaban
    • Competitive and reversible inhibition of free and clot bound [blank_start]Xa[blank_end]
    • [blank_start]Good[blank_end] oral availability (>80%)
    • ~35% renally cleared, ~65% [blank_start]metabolised[blank_end] (CYP3A4 and others)
    • Half life: ~7-10 hours
    1. Athrombin
    2. BXa
    3. CLow
    4. DGood
    5. Erenally
    6. Fmetabolised by liver

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Beschreibung
Der Nutzer hat seine Fachbereichs-Information gelöscht. Quiz am L47 Anticoagulation, erstellt von Gelöschter Nutzer am 26/05/2019.
Autor
Gelöschter Nutzer
Sprache
English
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