Anticoagulation Management Flashcards
7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Anticoagulation Management flashcards as text
What is the target INR range for a patient with nonvalvular atrial fibrillation on warfarin?
Answer: 2.0–3.0
The standard therapeutic INR range for nonvalvular atrial fibrillation is 2.0–3.0 to balance stroke prevention with bleeding risk.
Which of the following clotting factors is NOT inhibited by warfarin?
Answer: Factor VIII
Warfarin inhibits only vitamin K-dependent clotting factors (II, VII, IX, X); Factor VIII is not vitamin K-dependent and is therefore unaffected.
A patient on warfarin for atrial fibrillation presents with an INR of 8.5 and no signs of active bleeding. What is the most appropriate management?
Answer: Hold warfarin, administer oral vitamin K 2.5 mg, and recheck INR in 24–48 hours
CHEST guidelines recommend holding warfarin and administering low-dose oral vitamin K (2.5 mg) for INR above 5 without active bleeding to safely lower the INR.
Which drug is most likely to INCREASE warfarin's anticoagulant effect by inhibiting its primary metabolizing enzyme?
Answer: Fluconazole
Fluconazole is a strong CYP2C9 inhibitor, the primary enzyme responsible for warfarin (S-enantiomer) metabolism, leading to increased warfarin levels and elevated INR.
A patient with a bileaflet mechanical mitral valve requires long-term anticoagulation. Which agent is most appropriate?
Answer: Warfarin with target INR 2.5–3.5
Warfarin is the only anticoagulant approved for mechanical heart valves; all DOACs are contraindicated due to demonstrated increased risk of thromboembolic events in this population.
What is the correct target INR range for a patient with a bileaflet mechanical aortic valve and no additional thromboembolic risk factors?
Answer: 2.0–3.0
A bileaflet mechanical aortic valve without additional risk factors targets INR 2.0–3.0; higher-risk situations (mitral position, prior thromboembolism) require 2.5–3.5.
Which is a guideline-recommended first-line option for initial treatment of acute DVT in a patient with adequate renal function and no active cancer?
Answer: Rivaroxaban 15 mg twice daily for 21 days, then 20 mg daily
Rivaroxaban monotherapy using a dual-dose regimen (15 mg BID x21 days, then 20 mg daily) is guideline-recommended for acute DVT without requiring initial parenteral therapy.