ANTICOAGULATION AND BLOOD
DISORDER NAPLEX EXAM
Anticoagulants are primarily use for: (4) - CORRECT ANSWER-1. Treatment of
ACS
2. Prevention of cardioembolic stroke (i.e. in Afib)
3. Prevention of DVT/PE
4. Treatment of DVT/PE
anticoag of choice in HIT:
Alternative and when to use: - CO...
ANTICOAGULATION AND BLOOD
DISORDER NAPLEX EXAM
2023\2024
Anticoagulants are primarily use for: (4) - CORRECT ANSWER-1. Treatment of
ACS
2. Prevention of cardioembolic stroke (i.e. in Afib)
3. Prevention of DVT/PE
4. Treatment of DVT/PE
anticoag of choice in HIT:
Alternative and when to use: - CORRECT ANSWER-Argatroban
Alt: if urgent cardiac surgery or PCI required: bivalirudin
anticoag of choice for treatment of VTE in cancer patients - CORRECT
ANSWER-LMWH
___________ requires policies and protocols to properly initate and manage
anticoagulants - CORRECT ANSWER-Joint Commission's National Patient
Safety Goals
A drop in hemoglobin of ______ could suggest bleeding - CORRECT ANSWER-≥2
g/dL
UFH MOA - CORRECT ANSWER-Binds and activates antithrombin (AT3) which
leads to inactivation of Factor Xa and thrombin -->prevents conversion of
fibrinogen to fibrin
,LMWH MOA - CORRECT ANSWER-Binds and activates AT3 which leads to
more selective inactivation of factor Xa > thrombin
Fondaparinux MOA - CORRECT ANSWER-Binds to antithrombin III and
selectively enhances the inactivation of factor Xa
UFH dose for prophylaxis of VTE - CORRECT ANSWER-5,000 U SC Q8-12h
UFH dose for treatment of VTE - CORRECT ANSWER-80 U/kg IV bolus
followed by 18 U/kg/hr infusion
UFH dose for treatment of ACS/STEMI - CORRECT ANSWER-60 U/kg IV bolus
(Max 4,000 U); 12 U/kg/hr (max 1,000 U/hr) infusion
UFH side effects - CORRECT ANSWER-bleeding
thrombocytopenia
HIT
hyperkalemia
osteoporosis (with long term use)
UFH monitoring (what and how often) - CORRECT ANSWER-aPTT or anti-Xa @
baseline then q6h until therapeutic, then q24h or after dose change
Plt, H&H @ baseline and everyday
aPTT therapeutic range for UFH - CORRECT ANSWER-1.5-2.5x control
A drop in platelets _____ from baseline suggests possible HIT - CORRECT
ANSWER-50%
Enoxaparin dose for prevention of VTE - CORRECT ANSWER-30mg SC q12h
OR 40mg SC daily
CrCl <30: 30mg SC DAILY
Enoxaparin dose for treatment of VTE and UA/NSTEMI - CORRECT ANSWER-
1mg/kg SC q12h
CrCl <30: 1mg/kg SC daily
or 1.5 mg/kg daily if inpatient treatment of VTE)
, Enoxaparin dose for STEMI - CORRECT ANSWER-30mg IV bolus + 1mg/kg SC
dose -->1mg/kg SC q12h (max 100mg for first two SC doses)
CrCl <30:
30mg IV bolus + 1mg/kg SC dose -->1mg/kg SC DAILY
Age >75: omit bolus --> 0.75mg/kg SC q12h
Enoxaparin BBW - CORRECT ANSWER-spinal/epidural hematoma if punctured
-->paralysis
When to draw LMWH peak anti-Xa levels - CORRECT ANSWER-4 hours after
SC dose
Who should receive anti-Xa monitoring with LMWH? - CORRECT ANSWER-
Pregnant women
Enoxaparin administration clinical pearl - CORRECT ANSWER-Do NOT expel
air bubble from syringe before injection (may cause loss of drug)
HIT is an immune mediated Ig____ reaction - CORRECT ANSWER-IgG
HIT 4 T's - CORRECT ANSWER-Timing: 5-14 days from first administration
Thrombocytopenia: 50% drop in plts from baseline
Thrombosis
Test: lab confirmed Ab's or plt activation by heparin
Management of HIT - CORRECT ANSWER-- *Discontinue all heparin* products
(LMWH, UFH)
- Remove heparin-coated catheters
- *Discontinue warfarin*, reverse INR if needed w/ vit K
- Initiate alternative anticoagulant (argatroban)
Why should you discontinue warfarin with HIT? - CORRECT ANSWER-Because
use of warfarin in someone with low platelets has a high correlation with
limb gangrene and necrosis
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller jackwa. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $22.99. You're not tied to anything after your purchase.
