BCACP Anticoagulation Management

Question 1

What is the target INR range for a patient with nonvalvular atrial fibrillation on warfarin?

Accepted Answer

2.0–3.0

Answer

1.5–2.0

Answer

2.5–3.5

Answer

3.0–4.0

Question 2

Which of the following clotting factors is NOT inhibited by warfarin?

Accepted Answer

Factor VIII

Answer

Factor II (Thrombin)

Answer

Factor VII

Answer

Factor X

Question 3

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?

Accepted Answer

Hold warfarin, administer oral vitamin K 2.5 mg, and recheck INR in 24–48 hours

Answer

Continue warfarin at current dose and recheck INR in one week

Answer

Administer IV vitamin K 10 mg and fresh frozen plasma immediately

Answer

Discontinue warfarin permanently and switch to a DOAC

Question 4

Which drug is most likely to INCREASE warfarin's anticoagulant effect by inhibiting its primary metabolizing enzyme?

Accepted Answer

Fluconazole

Answer

Rifampin

Answer

Carbamazepine

Answer

St. John's Wort

Question 5

A patient with a bileaflet mechanical mitral valve requires long-term anticoagulation. Which agent is most appropriate?

Accepted Answer

Warfarin with target INR 2.5–3.5

Answer

Rivaroxaban 20 mg daily

Answer

Apixaban 5 mg twice daily

Answer

Dabigatran 150 mg twice daily

Question 6

What is the correct target INR range for a patient with a bileaflet mechanical aortic valve and no additional thromboembolic risk factors?

Accepted Answer

2.0–3.0

Answer

1.5–2.0

Answer

2.5–3.5

Answer

3.5–4.5

Question 7

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?

Accepted Answer

Rivaroxaban 15 mg twice daily for 21 days, then 20 mg daily

Answer

Warfarin 5 mg daily alone without heparin bridging

Answer

Aspirin 325 mg daily for 3 months

Answer

Unfractionated heparin alone without transition to an oral agent