SPLE #SPLE

1. 1
ANTICOAGULANTS
1.What is the appropriate anticoagulant if CHAD score is 5 ?
Dabigatran
38. High Risk on renal patient ?
Dabigatran
5. Anticoagulant cause GIT upset and GIT bleeding ?
Dabigatran
81. anticoagulant cause bleeding?
Dabigartan
21. Which anticoagulant cause dyspepsia ?
Dabigatran
78. Anticoagulant induce Dyspnea?
Dabigatran etexilate
77. which of the following anticoagulant used in case mitral valve(mechanical )?
Dabigatran
(34) Which of the following is the recommended anti-coagulation strategy for atrial fibrillation patient with a CHA2DS2-VACS score of 5?
dabigatran
22. Antiplatelet that cause dyspnea ?
Ticagrelor , Rivaroxaban ,Ticagrelor , Clopidogrel
26-which of the following antiplatelet agents the highest risk of causing dyspnea ?
Ticagrelor
23. Which one of the p2y12 receptor inhibitors provides variable anti platelets effect
ticagrelor (non – thienopyridie) reversible inhibit of P2Y12 receptor
36. Drug of choice in case of heparin induce thrombocytopenia? (Rx in Heparin induce thrombocytopenia )?
Argatroban
74. 69 year patient with erectile dysfunction , hypertension and pulmonary embolism , what is the anticoagulant of choice ?
direct thrombin inhibitors such as Argatropan , dapigatran
6)Which of the following is an example of a parenteral direct thrombin inhibitor?
Argatroban
60.anti coagulant taken oral ?
Clopidogril
39. patient on clopidogrel is going to surgery procedure so discontinuation of clopidogrel before surgery ?
5 days
52. the best drug to be used as an anti-platelet drug ?
Clopidogrel
10. Clopidogrel with poor metabolizer?
Decrease effect
41- Which of the following medications produces antiplatelet effect by inhibiting Adenosine Diphosphate (ADP) receptors?
.clopidogrel
28. which DOAC need initiation of parenteral anticoagulant for 5-10 before start oral dose ?
Apixaban
(16) Which of the following is the mechanism of action of apixaban?
a direct inhibitor of factor Xa
35. Which antiplatelet is contraindicated in patient with history of TIA (Transient Ischemic Attack)?
Prasugrel
41. Anticoagulant given with dinner /meal?
Rivaroxaban
66. What is the oral anticoagulant?
Warfarin /dabigatran/rivaroxaban and apixaban
19. Patient has high INR with no bleeding ?
Give vitamin K
11. Which one increase in case of bleeding?
Reticulocytes
13. Which one is responsible for fibrin lysis
Plasmin
14. Which of the following drugs can be used to lyse fibrin clots?
Streptokinase
69. Which drugs that may increase and decrease INR level ? ---------
73. CHADVAD score used for ?
need for anticoagulant after stroke
31. INR management

2. 2
2. INR in mechanical valve?
2.5 - 3.5 and the target is 3
3. INR target for pulmonary embolism??............
32. INR 2.5-3.5 in which condition ?
mitral valve
7. Normal range of INR on warfarin therapy?
2---3
27. Dose ( initial ) of warfarin when INR 1.5 ?
2.5-5 mg OD
4. Herbal interact with warfarin increase INR?
Potentiate INR Inhibit INR
Cranberry
Chinese angelica
Ginger
Chamomile
Cannabis
Garlic
Grapefruit
Fenugreek
Saw palmetto
Soya
St John's wort
coenzyme Q10
Ginseng
Green tea
Echinacea
25. Man take warfarin should ?
Should not take green leaf
16. Which of the following(plant) reduce warfarin level?
Green salad / Green plant
48. drug decreases warfarin action?
Multivitamins
42. Patient has arterial fib and prosthetics valve what is the best anticoagulant ?
Warfarin
65. Which Medication that affects extraction ratio of the liver?
Warfarin
40. Which need monitoring
Warfarin
18. Mechanism of phenytoin that decease effect of warfarin ??
Strong enzyme inducer
15. Which one decrease warfarin effect?
Rifampicin
12. Which one is safe to take with warfarin?
Cyanocobalamin
17. Any one serious adverse effect?
Bleeding – warfarin
85. gensing with warfarine ?
Increase INR
86. sulfamethoxazole with warfarin?
Increase INR
47. Pregnant has DVT (Deep Vein Thrombosis) ?
Heparin
24. Case of knee replacement dose of heparin ?
40 mg once daily
26. Which one need Monitor?
Unrationed heparin (UFH) IV
63. What is the preferred Anticoagulant with hemodialysis patient?
Heparin (Unfractionated heparin(UFH)

3. 3
49. one of the followimg not related to heparin ?
prevent formation of factor VII
75- Which of the following statements describes unfractionated heparin?
mucopolysaccharide polymers
32-What is the antidote for heparin toxicity? .
Protamine sulfate
75. Case of heparin infusion 12000/h , INR = 1.1 and other not normal i didn’t remember. What should do?
Hold for 60 min then re start at 1000/h
Hold for 60 min then re start at 900/h
55. warfarin oral anticoagulant determined or calculated by ?!
INR: international normalized ratio
33. Warfarin monitor (measured by)?
INR
54. heparin injection anti coagulant determined by ?
APTT activated partial thromboplastin time
80. heparin measurement ?
APTT
34. Enoxaparin monitor
Aptt
46- Which of the following is a potential serious side effect that is common among all anticoagulant agents?
Major Bleeding
44. Major side effects of anticoagulant like heparin and warfarin ?
Hemorrhage
56. if aspirin taken with warfarin or heparin lead to ?
bleeding
46. Drug interaction of heparin ?
Aspirin
37. Warfarin with Aspirin
Bleeding
59. which drug increase the action of warfarin? ---------
51. Effect of aspirin decrease?
Prostaglandin
53. Early symptoms of aspirin poisoning are ?
ringing in the ears & blurred vision
8. Antiplatelet activity of aspirin is due to?
Acetyl group bind covalent to cox receptor- Acetyl group bind hydrogen bond to cox Receptor
64. What is the preferred Anticoagulant with pregnant women ?
Enoxaparin
9. Dose of enoxaparin in DVT?
1 mg/kg 12 hr or 1.5 mg/kg once daily
72. enoxaparin in treatments dose? and prophylaxis dose?
treatments dose 1 mg /kg Bid or 1.5/kg once daily
prophylaxis dose 40 mg
45. Route of administration of morphin and enoxaparin ??
Morphine IV ... Enoxparin SC injection
63- Which of the following is recommended regarding air bubble in the syringe for a patient starting on enoxaparin subcutaneous Injection?
inject the dose with the air bubble
2-Which of the following medications is an anticoagulant agent?
Warfain
73- Which of the following best represents the activity of dipyridamole?
It is a platelet aggregation inhibitor
(13)Which of the following parenteral anticoagulants require routine monitoring of coagulation lab parameters?
UFH intravenously
MOA
21. clopidogrel :inhibit ADP that cause platlet aggregation
13. Fingolimod
Is used for treatment of multiple sclerosis (MS) it’s an oral drug that alters lymphocyte migration resulting in fewer lymphocytes in theCNS
4. Minoxidil
Vasodilator , act by producing relaxation of vascular smooth muscle, primarily in arteries and arterioles
46. about minoxidil ? Vasodilator, dilate arteries only

4. 4
ANEMIA√
18.Megaloblastic anemia treated with ?
folic acid and cyanocoblamin.......i.e (vitb9+vitb12)
Pernicious anemia. (Deficiency of vit b12)treated with ?
vit b12 .Only
19.Iron deficiency anemia treated with ? Iron
5.Glucose 6 dehydrogenase deficiency (G6D ) cause ?Hemolytic Anemia
22.Anemia of chronic renal failure treated with ? Epoetin
23.but if there is iron deficiency it will be treated with ? Derbepoetin
2.Patient has sickle cell anemia and severe pain? hydroxyurea therapy
27.Drug of choice for hemolytic anemia? Cortisone
17.Anemic patient refuses to take injection so DOC ? Ferrous gluconate
9.Iron advice ?Empty stomach
13.the action of epiotin enhanced with ? Iron
14.erythropoiten(eprex) will not be useful in case of ? iron deficiency
12.erythropoiten (eprex) is used for anemia caused by ?
chronic kidney disease
11.the dose of folic acid in non pregnant women is ?
400 mcg/ day
600 mcg/day >> pregnant
500>> lactating
1.What is the dose of ferrous sulfate that treat anemia? 100 TID
24.daily dose of iron in iron defficency anemia is ? 100 mg 3 times daily
15.daily dose in case of iron deficiency anemia? 1200
16.Dose in iron defecieny anaemia is ? 325 mg bid
8.Dose of ferrous sulfate ? 325 mg BID
7.Which one is used in treatment of Methemoglobinemia ?
methylene blue ( The primary emergency treatment for MMGE at dose 1-2 mg/kg )
3.Toxicity of carbon monoxide due to? decrease oxygen carring capacity of hemoglobin
28.Which anesthetic drug that cause anemia? nitrous oxide
29.drug not used with G6PD deficiency ? Primaquine
10.Anti-malaria cause anemia? Primaquine
4.First line of sepsis ? Norepinephrine
66. LDL indicate ?
Arteriosclerosis
OLD
 . . Epinephrine used in: anaphylactic shock
 . Dopamine used in: hypodynamic shock
 .Shock : hypoperfusion
 . Pentoxifyllin (Trental) : for peripheral vasodilation
 .Enoxaparin: - for deep vein thrombosis - taken S/C not oral anticoagulant
 . Ticlopidine= antiplatelet