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42.1 Vitamin K is indicated for the treatment of bleeding occurring in patients:
A. Being treated with heparin
B. Being treated with streptokinase
C. Of obstructive jaundice
D. Of peptic ulcer
42.2 Choose the preparation(s) of vitamin K that should not be injected in the newborn:
A. Phytonadione
B. Menadione
C. Menadione sod.diphosphate
D. Both ‘B’ and ‘C’
42.3 Menadione (vitamin K3) can produce kernicterus in neonates by:
A. Inducing haemolysis
B. Inhibiting glucuronidation of bilirubin
C. Displacing plasma protein bound bilirubin
D. Both ‘A’ and ‘B’ are correct
42.4 Select the correct statement about ethamsylate:
A. It checks capillary bleeding
B. It inhibits platelet aggregation
C. It is an antifibrinolytic drug
D. It is used to fibrose bleeding piles
42.5 The primary mechanism by which heparin prevents coagulation of blood is:
A. Direct inhibition of prothrombin to thrombin conversion
B. Facilitation of antithrombin III mediated inhibition of factor Xa and thrombin
C. Activation of antithrombin III to inhibit factors IX and XI
D. Inhibition of factors XIIa and XIIIa
42.6 Low concentrations of heparin selectively interfere
with the following coagulation pathway(s):
A. Intrinsic pathway
B. Extrinsic pathway
C. Common pathway
D. Both ‘A’ and ‘C’
42.7 Low doses of heparin prolong:
A. Bleeding time
B. Activated partial thromboplastin time
C. Prothrombin time
D. Both ‘B’ and ‘C’
42.8 The following action(s) of heparin is/are essential for inhibition of factor Xa:
A. Facilitation of antithrombin III mediated inhibition of factor XIIa
B. Provision of scaffold for the clotting factor to interact with antithrombin III
C. Induction of a configurational change in antithrombin III to expose its interacting
sites
D. Both ‘A’ and ‘B’
42.9 The following is true of heparin except:
A. Sudden stoppage of continuous heparin therapy causes rebound increase in blood
coagulability
B. High doses of heparin inhibit platelet aggregation
C. Heparin is the physiologically active circulating anticoagulant
D. Heparin clears lipemic plasma in vivo but
not in vitro
42.10 Low molecular weight heparins differ from unfractionated heparin in that:
A. They selectively inhibit factor Xa
B. They do not significantly prolong clotting time
C. They are metabolized slowly and have longer duration of action
D. All of the above are correct
42.11 Low molecular weight heparins have the following
advantages over unfractionated heparin except:
A. Higher efficacy in arterial thrombosis
B. Less frequent dosing
C. Higher and more consistent subcutaneous bioavailability
D. Laboratory monitoring of response not required
42.12 Low dose subcutaneous heparin therapy is indicated for:
A. Prevention of leg vein thrombosis in elderly
patients undergoing abdominal surgery
B. Ischaemic stroke
C. Patients undergoing neurosurgery
D. Prevention of extention of coronary artery
thrombus in acute myocardial infarction
42.13 Heparin is contraindicated in patients suffering from the following diseases except:
A. Pulmonary tuberculosis
B. Bleeding due to defibrination syndrome
C. Subacute bacterial endocarditis
D. Large malignant tumours
42.14 The following can be used to antagonise the action of heparin in case of overdose:
A. Heparan sulfate
B. Dextran sulfate
C. Protamine sulfate
D. Ancrod
42.15 Blood level of which clotting factor declines most
rapidly after the initiation of warfarin therapy:
A. Factor VII
B. Factor IX
C. Factor X
D. Prothrombin
42.16 The following statements are true of oral anticoagulants except:
A. They interfere with an early step in the
synthesis of clotting factors
B. Irrespective of the dose administered, their anticoagulant effect has a latency of onset of
1-3 days
C. Their dose is adjusted by repeated measurement of prothrombin time
D. They are contraindicated during pregnancy
42.17 You are treating a patient of deep vein thrombosis
with warfarin. What value of International normalized
ratio (INR) will you attempt by adjusting dose of the
anticoagulant for an adequate therapeutic effect:
A. 1.2 – 1.5
B. 1.3 – 1.7
C. 1.5 – 2.0
D. 2.0 – 3.0
42.18 The following drug reduces the effect of oral anticoagulants:
A. Broad spectrum antibiotic
B. Cimetidine
C. Aspirin
D. Oral contraceptive
42.19 The most clear cut beneficial results are obtained in
the use of anticoagulants for the following purpose:
A. Prevention of recurrences of myocardial infarction
B. Prevention of venous thrombosis and pulmonary embolism
C. Cerebrovascular accident
D. Retinal artery thrombosis
42.20 Anticoagulant medication is indicated in:
A. Immobilized elederly patients
B. Buerger’s disease
C. Stroke due to cerebral thrombosis
D. All of the above
42.21 Use of anticoagulants in acute myocardial infarction
affords the following benefit(s):
A. Reduces short-term mortality
B. Prevents thrombus extension and subsequent attack
C. Prevents venous thromboembolism
D. All of the above
42.22 The most effective drug for prevention of stroke in atrial fibrillation patients is:
A. Aspirin
B. Warfarin
C. Low dose subcutaneous heparin
D. Digoxin
42.23 Select the fibrinolytic drug(s) that is/are antigenic:
A. Streptokinase
B. Urokinase
C. Alteplase
D. Both ‘A’ and ‘B’
42.24 Which fibrinolytic agent(s) selectively activate(s)
fibrin bound plasminogen rather than circulating plasminogen:
A. Urokinase
B. Streptokinase
C. Alteplase
D. Both ‘A’ and ‘C’
42.25 The most important complication of streptokinase therapy is:
A. Hypotension
B. Bleeding
C. Fever
D. Anaphylaxis
42.26 Thrombolytic therapy is indicated in the following conditions except:
A. Acute myocardial infarction
B. Stroke due to cerebral thrombosis
C. Deep vein thrombosis
D. Large pulmonary embolism
42.27 A patient of acute myocardial infarction has been
brought to the ICU. What is the time lapse since
symptom onset beyond which you will not consider
instituting thrombolytic therapy:
A. 3 hours
B. 6 hours
C. 16 hours
D. 24 hours
42.28 Thrombolytic therapy instituted within 3-6 hours of
onset of acute myocardial infarction affords the following benefit(s):
A. Reduces mortality
B. Reduces area of myocardial necrosis
C. Preserves ventricular function
D. All of the above
42.29 The preferred route of administration of streptokinase
in acute myocardial infarction is:
A. Intravenous
B. Subcutaneous
C. Intracoronary
D. Intracardiac
42.30 Streptokinase therapy of myocardial infarction is
contraindicated in the presence of the following except:
A. Peptic ulcer
B. Ventricular extrasystoles
C. History of recent trauma
D. Severe hypertension
42.31 A patient has an episode of hematemesis following
streptokinase infused for the treatment of deep vein
thrombosis. Which of the following drugs would be
most effective in controlling the bleeding episode:
A. Vitamin K
B. Noradrenaline
C. Epsilon aminocaproic acid
D. Rutin
42.32 Tranexaemic acid is a specific antidote of:
A. Fibrinolytic drugs
B. Organophosphates
C. Barbiturates
D. Heparin
42.33 Aspirin prolongs bleeding time by inhibiting the synthesis of:
A. Clotting factors in liver
B. Prostacyclin in vascular endothelium
C. Cyclic AMP in platelets
D. Thromboxane A2 in platelets
42.34 Inhibition of thromboxane synthesis by aspirin in
platelets lasts for 5-7 days because:
A. Aspirin persists in the body for 5-7 days
B. Aspirin induced depletion of arachidonic acid lasts 5-7 days
C. Regeneration of aspirin inhibited cyclooxygenase takes 5-7 days
D. Platelets cannot generate fresh thromboxane
synthetase and their turnover time is 5-7 days
42.35 The following drug increases cyclic-AMP in platelets
and inhibits their aggregation without altering levels of
thromboxane A2 or prostacyclin:
A. Aspirin
B. Sulfinpyrazone
C. Dipyridamole
D. Abciximab
42.36 Choose the correct statement about ticlopidine:
A. It blocks GPIIb/IIIa receptors on platelet membrane
B. It prevents ADP mediated platelet adenylylcyclase inhibition
C. It inhibits thromboxane A2 synthesis in platelets
D. It does not prolong bleeding time
42.37 Choose the drug which alters surface receptors on
platelet membrane to inhibit aggregation, release
reaction and to improve platelet survival in extracorporeal
circulation:
A. Dipyridamole
B. Ticlopidine
C. Aspirin
D. Heparin
42.38 Ticlopidine is recommended for the following except:
A. To reduce neurological sequelae of stroke
B. Transient ischaemic attacks
C. To prevent occlusion of coronary artery bypass graft
D. Intermittent claudication
42.39 The following is true of clopidogrel except:
A. It is a GPIIb/IIIa receptor antagonist
B. It inhibits fibrinogen induced platelet aggregation
C. It is indicated for prevention of stroke in patients with transient ischaemic attacks
D. It is a prodrug
42.40 The following is true of abciximab except:
A. It is a monoclonal antibody against GPIIb/IIIa
B. It inhibits platelet aggregation induced by a variety of platelet agonists
C. It is antigenic
D. It is used to reduce the risk of restenosis in patients undergoing PTCA
42.41 Combined therapy with dipyridamole and warfarin is
recommended in subjects with the following:
A. Risk factors for coronary artery disease
B. Prosthetic heart valves
C. Cerebral thrombosis
D. Buerger's disease
42.42 Indications for the use of antiplatelet drugs include the following except:
A. Secondary prophylaxis of myocardial infarction
B. Unstable angina pectoris
C. Disseminated intravascular coagulation
D. Stroke prevention in patients with transient ischaemic attacks
Ans:
42.1 C 42.2D 42.3D 42.4 A 42.5 B 42.6 A 42.7 B 42.8 C 42.9 C 42.10D 42.11 A 42.12 A 42.13 B 42.14 C 42.15 A 42.16 A 42.17D 42.18D 42.19 B 42.20 A 42.21 C 42.22 B 42.23 A 42.24 C 42.25 B 42.26 B 42.27 C 42.28D 42.29 A 42.30 B 42.31 C 42.32 A 42.33D 42.34D 42.35 C 42.36 B 42.37 B 42.38 A 42.39 A 42.40 C 42.41 B 42.42 C
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