Multiple Choice Question on Anticoagulants, Thrombolytics and Antiplatelet Drug

Overview of the Topics

Multiple Choice Practice Questions 

Anticoagulants 

1) Identify the class of drug prescribed for acute management of deep vein thrombosis:
a) Anticoagulants, eg. warfarin
b) Thrombolytics, eg. tPA
c) Antiplatelets, eg. Aspirin
d) All of the above

2) Identify the class of drug prescribed for the long term management of deep vein thrombosis
a) Anticoagulants eg. warfarin
b) Thrombolytics eg. tPA
c) Antiplatelets eg Aspirin
d) All of the above

3) Standard unfractionated Heparin is now replaced by the low molecular weight heparin. Standard unfractionated heparin is still the preferred anticoagulant in deep vein thrombotic patients with a coincidence of 
a) Liver abnormalities
b) Renal Dysfunction
c) Cardiovascular disorder
d) Myocardial Infarction 

4) The following is the mechanism of action of heparin
a) Heparin inhibit the hepatic synthesis of clotting factors 
b) Heparin binds to antithrombin III and increases the inactivation of clotting factors
c) Heparin inhibit the vitamin K dependent carboxylation of glutamate residue of clotting factors
d) All of the above 

5) In addition to the anticoagulant action, which of the following are other pharmacological effects of heparin
a) Antilipimeic Effect
b) Decrease Platelet Activation
c) Anti-proliferative effect of smooth cells
d) All of the above

6) The following is the mechanism of action of Warfarin
a) Warfarin inhibit the hepatic synthesis of clotting factors 
b) Warfarin binds to antithrombin III and increases the inactivation of clotting factors
c) Warfarin inhibit the vitamin K dependent carboxylation glutamate residue of clotting factors
d) All of the above 

7) Identify the correct statement regarding Warfarin
a) Warfarin is a vitamin K antagonist
b) Warfarin specifically inhibits epoxide reductase enzyme 
c) Warfarin is metabolized by the microsomal P450 enzyme 
d) All of the above

8) Warfarin should not be given to the thrombotic patients with coexisting  ...................
a) Renal Dysfunction
b) Hepatic Dysfunction
c) Pregnancy 
d) None of the above

9) Warfarin shows interaction with numerous other drugs. Which of the following is the inhibitor drugs?
a) Barbiturates
d) Carbamazepine
c) Cimetidine
d) Rifampin

Thrombolytics 

10) Choose the correct statements on the characteristic features of thrombolytic drugs 
a) Thrombolytics have enzymatic activity 
b) Thrombolytics are administered for acute management of embolism and stroke
c) Thrombolytics are given for the management of active bleeding
d) Patients may have preexisting antibodies against thrombolytics

11) Identify the correct statement regarding the mechanism of thrombolytic drugs
a) Thrombolytics inhibit the hepatic synthesis of clotting factors 
b) Thrombolytics binds to antithrombin III and increases the inactivation of clotting factors
c) Thrombolytics inhibit the vitamin K dependent carboxylation glutamate residue of clotting factors
d) Thrombolytics activates plasminogen, and cleaves & remove the fibrin clots arteries/veins

12)  Streptokinase is the first generation thrombolytics used. The streptokinase is a 
a) naturally occurring plasminogen activator in human plasma
b) naturally occurring plasminogen activation in beta-hemolytic streptococcus
c) synthetic plasminogen activator obtained from chemical synthesis 
d) None of the above

13) Which of the following is the second generation thrombolytic drugs
a) Urokinase
b) Alteplase
c) Retavase 
d) Tenecteplase

14) Identify the correct statements regarding the third-generation thrombolytic drugs
a) Acts on bound and free plasminogen 
b) Improved fibrin specificity
c) Improved pharmacokinetics
d) High preexisting antibodies

Antiplatelet Agents

15) The ......................... drug inhibits platelet aggregation by inhibiting the enzyme cycloxygenase and formation of thromboxane A2
a) Aspirin
b) Abciximab
c) Clopidogrel
d) Warfarin

16) The ......................... drug inhibits platelet aggregation by inhibiting the purinergic receptor and interfere ADP -receptor interaction
a) Aspirin
b) Abciximab
c) Clopidogrel
d) Warfarin

17) The ......................... drug inhibits platelet aggregation by binding to integrin receptor GPIIb/IIIA and inhibit the interaction of fibrinogen and von Willebrand's factor to the integrin receptor
a) Aspirin
b) Abciximab
c) Clopidogrel
d) Warfarin

18) Abciximab is a 
a) Fibrin cleaving enzyme
b) Chimeric monoclonal antibodies
c) Small Molecular Inhibitor 
d) None of the above

19) Identify the correct clinical indication of antiplatelet agents 
a) Prophylaxis of arterial thrombosis
b) Therapeutic management of myocardial infarction and stroke
c) generally infused within 2 hours of myocardial infarction or stroke for significant benefit
d) Hemorrhage and Internal bleeding 


Answers for MCQ on Anticoagulant, Thrombolytics, and Antiplatelet Drug

1-b) Thrombolytics eg. tPA
2-a) Anticoagulants eg. warfarin
3- b) Renal Dysfunction
4- b) Heparin binds to antithrombin III and increases the inactivation of clotting factors
5- d) All of the above
6- c) Warfarin inhibit the vitamin K dependent carboxylation glutamate residue of clotting factors
7- d) All of the above
8- b) Hepatic Dysfunction & c) Pregnancy 
9- c) Cimetidine
10- Statement a), b), & d) are correct
11- d) Thrombolytics activates plasminogen, and cleaves & remove the fibrin clots arteries/veins
12- b) naturally occurring plasminogen activation in beta-hemolytic streptococcus
13)- b) Alteplase
14 - Correct statements are b) Improved fibrin specificity & c) Improved pharmacokinetics
15- a) Aspirin
16)-c) Clopidogrel
17-b) Abciximab
18- b) Chimeric monoclonal antibodies
19- a), b), c)