EDAIC - European Diploma in Anesthesiology and Intensive Care Coagulation and Transfusion Medicine Questions and Answers

Question 1

A 78-year-old male on long-term apixaban for atrial fibrillation presents to the emergency department with a life-threatening gastrointestinal bleed.
He requires urgent endoscopy.
Which of the following is the most appropriate agent for the immediate reversal of apixaban's anticoagulant effect?

Accepted Answer

Andexanet alfa

Answer

Prothrombin Complex Concentrate (PCC)

Answer

Vitamin K

Answer

Fresh Frozen Plasma (FFP)

Question 2

A massively bleeding trauma patient has a critically low fibrinogen level of 0.7 g/L. Which blood product is the most concentrated source of fibrinogen and therefore the most appropriate choice to specifically correct this deficiency?

Accepted Answer

Cryoprecipitate

Answer

Fresh Frozen Plasma (FFP)

Answer

Platelet Concentrate

Answer

Packed Red Blood Cells (PRBCs)

Question 3

Within two hours of receiving a transfusion of packed red blood cells, a 65-year-old ICU patient develops acute respiratory distress, hypoxemia (SpO2 85% on 60% O2), and bilateral infiltrates on chest X-ray. Her blood pressure is 90/50 mmHg, and there are no signs of fluid overload such as jugular venous distension or peripheral edema. Which of the following is the most likely diagnosis?

Accepted Answer

Transfusion-Related Acute Lung Injury (TRALI)

Answer

Transfusion-Associated Circulatory Overload (TACO)

Answer

Anaphylactic Reaction

Answer

Acute Hemolytic Transfusion Reaction

Question 4

A bleeding patient's ROTEM analysis shows a normal EXTEM Clotting Time (CT), but the Maximum Clot Firmness (MCF) is severely reduced. The FIBTEM analysis also shows a severely reduced MCF. What is the most likely deficiency that needs to be addressed?

Accepted Answer

Fibrinogen deficiency

Answer

Platelet dysfunction

Answer

Coagulation factor deficiency

Answer

Hyperfibrinolysis

Question 5

A 52-year-old patient with end-stage liver disease is actively bleeding. Laboratory results show INR 3.0, platelets 50 x 10^9/L, and fibrinogen 0.8 g/L. To establish a functional clot, which of the following should be prioritized for replacement?

Accepted Answer

Cryoprecipitate or Fibrinogen Concentrate

Answer

Prothrombin Complex Concentrate (PCC)

Answer

Platelets

Answer

Fresh Frozen Plasma (FFP)

Question 6

Which of the following statements best describes the primary mechanism of action of tranexamic acid (TXA) in a trauma patient with massive hemorrhage?

Accepted Answer

It prevents the breakdown of existing clots by inhibiting plasminogen activation.

Answer

It directly activates platelets to enhance primary hemostasis.

Answer

It provides concentrated clotting factors to accelerate the coagulation cascade.

Answer

It inhibits the conversion of fibrinogen to fibrin.