MCQs-Drugs Affecting Blood and Blood Formation part 2 I Pharmacology KD Tripathi mcqs part 42

 

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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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