Anticoagulants, antiplatelets and thrombolytics
DOCTOR-DOCTOR
-
- Zaid
Q1.Mr Tanay is showing internal bleeding due to
administration of warfarin, which other condition or conditions he suffers from
that lead to this?
A.
Obstructive jaundice
B.
Undergoing treatment with broad spectrum
antibiotics
C.
Hypothyroidism
D.
Both a and b
Answer- warfarin is a vitamin k analogue, If the absorption of vitamin k is hampered then the action of vitamin k analogue that is warfarin will be increased, as most warfarin will get bound due to lack of vitamin k at binding site. vitamin k is a fat soluble vitamin, thus in obstructive jaundice its absorption will be hampered thanks to no bile for its emulsification. similarly most broad spectrum antibiotics kill useful bacteria too that help in vitamin k absorption. warfarin action is increased in case of hyperthyroidism not hypothyroidism thus answer is D
Answer- warfarin is a vitamin k analogue, If the absorption of vitamin k is hampered then the action of vitamin k analogue that is warfarin will be increased, as most warfarin will get bound due to lack of vitamin k at binding site. vitamin k is a fat soluble vitamin, thus in obstructive jaundice its absorption will be hampered thanks to no bile for its emulsification. similarly most broad spectrum antibiotics kill useful bacteria too that help in vitamin k absorption. warfarin action is increased in case of hyperthyroidism not hypothyroidism thus answer is D
Q2. Mrs. Neha is pregnant (3rd trimester)
she is also needs anticoagulants for prevention of myocardial infarction. Which
of the following should be prescribed?
A.
Aspirin
B.
Low molecular weight heparin
C.
Warfarin
D.
dicumerol
Answer- aspirin causes blockage of ductus arteriosus of fetus , warfarin and dicumerol is teratogenic, but Low molecular weight heparin can be used as its not polar and cant harm fetus thus
answer is B
Answer- aspirin causes blockage of ductus arteriosus of fetus , warfarin and dicumerol is teratogenic, but Low molecular weight heparin can be used as its not polar and cant harm fetus thus
answer is B
Q3. The activated prothrombin
time of Mr suresh was found to be elevated greatly. Which of the following lead
to this?
A.
warfarin overdose
B.
heparin overdose
C.
heamophilia A nad B
D.
both b and c could lead to the problem
Answer- prothrombin time is a measure of extrinsic pathway of coagulation. elevated prothrombin time indicates warfarin overdose.answer A
Answer- prothrombin time is a measure of extrinsic pathway of coagulation. elevated prothrombin time indicates warfarin overdose.answer A
Q4. During performing the prothrimbin time (Pt)
and partial thromboplastin time(PTT) of Mr Ajay the laboratory guy forgot to
add citrate (or any other chelating agent). What could be the change in result
obtained?
A.
Decreased Pt and ptt
B.
Increased Pt and ptt
C.
Increased pt but decreased ptt
D.
Doesn’t matter
Answer- cheleating agents form complex with calcium preventing coagulation to obtain accurate coagulation time. if chelating agent not added then ptt and pt will be reduced. answer A
Q5. Kalpesh is heartbroken because he failed in his exams. In
the washroom he was found coughing up blood. His friends took him immediately
to the doctor. They also found rat poison bottle beside him which was empty. What
possibly should the doctor do ?
A.
Administer protamine sulphate
B.
Administer vit K in excess
C.
Administer activated plasma
D.
Administer aminocaproic acid
Answer- rat poison contains warfarin hence vitamin k can be given. protamine sulphate is used in case of warfarin overdose. aminocaproic acid is used in streptokinase overdose. but activated plasma should be given as vitmin k action is slow hence Ans C
