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Pharmacology of drugs in hemostatic disorder

1. Which one of following is true about Heparin


A. It has thrombolytic activity
B. It has most prolonged activity when given orally
C. It acts by binding to AT III
D. It inhibits the aggregation of platelets caused by TXA2
E. It acts by blocking hepatic vitamin K regeneration
ANSWER: C
2. Warfarin :
A. Acts rapidly when given orally
B. Is potentiated by barbiturates
C. Is antagonized by protamine sulfate
D. Affects the activity of clotting factors
E. Is potentiated by platelet factor IV
ANSWER : D
3. The risk of bleeding in patients receiving heparin is increased by aspirin, because aspirin:
A. Inhibits heparin anticoagulant activity
B. Inhibits platelet function
C. Displaces heparin from plasma protein-binding sites
D. Inhibits prothrombin formation
E. Causes thrombocytopenia
ANSWER : B
4. Aspirin can :
A. Prevent the formation of TXA2
B. Prolong the whole blood clotting time
C. Shorten the bleeding time
D. Inhibit fibrinolysis
E. Inhibit the effects of warfarin
ANSWER : A
5. Which of the following may cause increased bleeding as a serious unwanted side effect?
A. Warfarin
ANSWER: E
B. Heparin
C. Aspirin
D. Tissue plasminogen activator
E. All of the above
6. Specific antidote of Heparin is
A. Aspirin
B. Vitamin K
C. Protamine
D. Coumarin derivative
E. Warfarin

ANSWER : C

7. Over dose of Heparin can be handled by giving


A. Protamin sulphate
B. Streptokinase
C. Aspirin
D. Dipiridamol
E. Urokinase
ANSWER: A
8. Specific antidote of Streptokinase
A. Aspirin
B. Coumarin
C. Aminocaproic acid
D. Ferritin
E. Warfarin
ANSWER : B
9. The inducer of platelet aggregation is
A. Adenosine monophosphate
B. Adenosine diphosphate
C. Adenosine triphosphate
D. Trigliseride
E. Fatty acid
ANSWER : B
10. Following are factors influenced by vitamin K, EXCEPT
A. Antithrombin
B. Christmas factor
C. Factor II
D. Stuart factor
E. Proconvertin
ANSWER : A
11. Following are true about Naftoquinone derivative, EXCEPT
A. Stimulates prothrombin production
B. Inhibits proconvertin production
C. Vitamin K is its synonym
D. Its synthetic preparation is Menadion
E. As floral intestine
ANSWER : B
12. The following drugs inhibit warfarin biotransformation, EXCEPT
A. Cimetidine
B. Barbiturates
C. Disulfiram
D. Large amount of alcohol at one time
E. Amiodarone
ANSWER : B

13. Aspirin is used in the treatment of


A. Arterial thrombotic
B. Venous thrombotic
C. Thromboxane synthesis
D. Lipoxigenase synthesis
E. Cyclooxigenase synthesis
ANSWER : A
14. Following are the inhibitor of platelet activity, EXCEPT
A. Aspirin
B. Carbazochrome
C. Dipiridamol
D. Sulfinpirazone
E. Dextran
ANSWER : B
15. Warfarin is not used in the treatment of
1. Unstable angina after myocardial infarction
2. Embolism after hip surgery
3. Arterial rethrombosis after thrombolysis
*4. Pulmonary embolism in pregnancy
ANSWER : D
16. Streptokinase causes bleeding by attacking
*1. Fibrinogen
*2. Factor V
*3. Factor VIII
4. Factor X
ANSWER : A
17. The action of antithrombotics
*1. Platelet aggregation inhibitors
*2. Supress platelet function
*3. Prevent platelet aggregation
4. Increase TXA2 synthesis
ANSWER :A
18. Daily intake of aspirin is for
*1. Its anti-clotting effect
*2. The inhibition of thromboxane synthesis
*3. Reducing the risk of myocardial infarction
*4. Its blockade of platelet cyclooxigenase
ANSWER: E

19. The anti clotting effect of aspirin is long lived BECAUSE platelet lack of nucleus and
do not make new enzyme
ANSWER : True ----- True and has a relationship
20. Endogenous heparin can not be detected in the blood BECAUSE heparin is released
from mast cells
ANSWER : True ----- True , but has not relationship
21. Anticoagulant action both in vitro & in vivo is seen with
A. EDTA
B. Heparin
C. Coumarin
D. Phenondione
22. Phenylbutazone enhances the anticoagulant effect of dicoumarol by
A. Preventing hepatic transport of vit. K
B. Preventing vit. K synthesis
C. Preventing vit. K absorption
D. Displacing dicoumarol from protein binding
23. Which of the following drugs may produce neutropenia leading to agranulocytosis?
A. Corticosteroids
B. Penylbutazone
C. Vincristin
D. Halothane
24. Action of heparin is potentiated by
A. Narcotics
B. NSAID
C. Analgesic
D. Warfarin
25. Methaemoglobinemia can be caused by all EXCEPT
A. Sulfonamides
B. Phenytoin
C. Phenactin
D. Salicylates
26. In dicumarol poisoning which vit K is used
A. Menadione
B. Menaquonone
C. Phytonadione
D. None of the above
27. Warfarin is not used in the treatment of
A. Unstable angina after myocardial infarction
B. Embolism after hip surgery
C. Arterial rethrombosis after thrombolysis
*D. Pulmonary embolism in pregnancy

28. The anti clotting effect of aspirin is long lived BECAUSE platelet lack of nucleus and
do not make new enzyme
ANSWER : True ----- True and has a relationship
29. Endogenous heparin can not be detected in the blood BECAUSE heparin is released
from mast cells
ANSWER : True ----- True , but has not relationship

Pharmacological aspect of anemia


1. Before beginning folate therapy for megaloblastic anemia, one should consider which of
the following to prevent neurological disease?
A. Vitamin B12 deficiency
B. Zinc deficiency
C. Iron deficiency
D. Vitamin B6 deficiency
E. Vitamin K deficiency
ANSWER : A
2.

Iron can be absorbed as


A. Ferri ion
B. Ferritin
C. Apoferritin
D. Ferro ion
E. Protoporfirin
ANSWER : D

3. The absorption of orally Cyanocobalamine needs


A. Intrinsic factor of Castle
B. Extrinsic factor of Castle
C. Folic acid
D. RNA
E. DNA
ANSWER : A
4. Antagonist of Folic acid in neoplasmata is
A. Cyanocobalamine
B. Vitamin B12
C Aminopterin
D. Iron
E. Aspirin
ANSWER : C
5. Antidotum of iron toxicity is
A. Hemosiderin
B. Ferrosulphate
C. Ferritin
D. Deferoxamine
E. Folic acid
ANSWER : D
6. Which of the following vitamins needs intrinsic factor for its absorption
A. Vitamin C
B. Vitamin B12
C. Vitamin D

D. Vitamin A
E. Vitamin K
ANSWER : B
7. Parenteral iron formulation for iron deficiency that may only be given intramuscularly
A. Iron sulphate
B. Iron fumarate
C. Iron gluconate
D. Iron dextran
E. Iron sorbitol
ANSWER : E
8. The most common cause of failure to respond to oral iron therapy is:
A. Failure of bone marrow to produce adequate reticulocytes
B. Failure to take an adequate dose
C. Excessive amount transferrin
D. Small intestine malabsorption
E. Allergic reactions
ANSWER : B
9. Increased folate requirements occur in all of the following conditions except
A. Pregnancy
B. Sickle cell anemia
C. Chronic alcoholism
D. Anemia of chronic disease
E. Chronic hemolysis
ANSWER : D
10. The major side effect of oral iron therapy is :
A. Hypokalemia
B. Hypertension
C. Digestive tract irritation
D. Headache
E. Hypercalcemia
ANSWER: C
11. Which of following is true for folic acid
A. High dose can mask a vitamin B12 deficiency
B. Folic acid is the active form of the vitamin
C. Folic acid is not to be reduced to tetrahydrofolate
D. Folate reductase cant be bound by Methotrexate
E. Its synonym is cyanocobalamine
ANSWER : A
12. Fanconis anemia is caused by

A.
B.
C.
D.

Chloramphenicol
Cyclosporin
Old & degraded tetracycline
Decreased pseudocholineesterase

13. All of the following can cause macrocytic anemia, EXCEPT


A. Methotrexate
B. Pyrimethamine
C. Trimethoprim
D. Pentamidine
14. Vitamin B12 deficiency can be caused by all of the following except
A. Zollinger Ellison syndrome
B. Fish tapeworm
C. Blind loop syndrome
D. Liver disease
E. Intestinal malabsorption

ANSWER : D

15. Parenteral iron formulation for iron deficiency that may only be given intramuscularly
A. Iron sulphate
ANSWER : E
B. Iron fumarate
C. Iron gluconate
D. Iron dextran
E. Iron sorbitol
16. Following drugs can cause haemolytic anemia in association with G6PD, EXCEPT
A. Mepacrine
B. Quinine
C. Antipyrine
D. L-DOPA
17. Following information are true about Hematinics EXCEPT
A. Improve the quality of the blood
B. Increase the hemoglobin level
C. Increase the number of erythrocytes
D. Reduce bone marrow erythroid cells
18. All of the following are factors that may increase erythropoietin production EXCEPT
A. Thyroxine
B. Oxygen free radicals
C. 2 Adrenergic receptor agonist
D. Estrogen
19. Which of the following agents used for the treatment of anemia may cause life
threatening toxicity
A. Vitamin B12
B. Folate
C. Pyridoxine
D. Ferrous sulfate
20. Deferoxamine used in the following, EXCEPT
A. Patients with iron overload

B. Removing iron from hemosiderin


C. Removing iron from ferritin
D. Removing iron from hemoglobin
21. Increased folate requirements occur in all of the following conditions except
A. Pregnancy
B. Sickle cell anemia
ANSWER : D
C. Chronic alcoholism
D. Anemia of chronic disease
E. Chronic hemolysis
22. The major side effect of oral iron therapy is :
A. Hypokalemia
B. Hypertension
C. Digestive tract irritation
D. Headache
E. Hypercalcemia
23. Vitamin B12 deficiency can be caused by all of the following except
A. Zollinger Ellison syndrome
B. Fish tapeworm
C. Blind loop syndrome
D. Liver disease
E. Intestinal malabsorption

ANSWER: C

ANSWER : D

24. Which of the following vitamins needs intrinsic factor for its absorption
A. Vitamin C
ANSWER : B
B. Vitamin B12
C. Vitamin D
D. Vitamin A
E. Vitamin K
25. Parenteral iron formulation for iron deficiency that may only be given intramuscularly
A. Iron sulphate
ANSWER : E
B. Iron fumarate
C. Iron gluconate
D. Iron dextran
E. Iron sorbitol
26. Following drugs can cause haemolytic anemia in association with G6PD, EXCEPT
A. Mepacrine
ANSWER : D
B. Quinine
C. Antipyrine
D. L-DOPA
E. Dimercaprol

Petunjuk: Pilih satu jawaban yang paling tepat


1. Besi diabsorbsi dalam bentuk:
A. Feri

*D. Fero

B. Feritin

E. Protoporfirin

C. Apoferitin
2. Dosis Besi yang diberikan secara bertahap kepada penderita anaemia yang tidak
mempunyai simpanan Fe serta hanya mempunyai Hb 10 g %
A. 500 mg

D. 1250 mg

B. 750 mg

*E. 1500 mg

C. 1000 mg
3. Absorbsi Sianokobalamin yang diberikan per oral memerlukan
A. Intrinsic factor of Castle *
B. Extrinsic factor of Castle
C. Asam Folat
D. RNA
E. DNA
4. Antagonis asam folat pada neoplasmata ialah
A. Sianokobalamin
B. Vitamin B12
C. Aminopterin *
D. Besi

5. Derivat Naftoquinone mempunyai sifat sifat sebagai berikut, KECUALI


A. Menstimulasi produksi Protrombin
B. Menghambat produksi Prokonvertin
C. Sinonimnya ialah Vitamin K
D. Terdapat dalam flora usus
E. Preparat sintetisnya ialah Menadion

6. Antidotum spesifik Heparin ialah


A. Aspirin
B. Vitamin K
C. Protamine

D. Derivat Kumarin
E. Warfarin
7. Pernyataan ini benar tentang Heparin
A. Mempunyai aktivitas trombolitik
B. Terjadi perpanjangan aktivitas bila diberikan secara oral
C. Mekanisme kerjanya ialah dengan cara berikatan dengan AT III *
D. Menghambat agregasi platelet yang disebabkan oleh TXA2
E. Bekerja dengan caar memblok regenerasi vitamin K hepatik
8. Risiko perdarahan pada penderita yang mendapat pengobatan heparin akan meningkat
oleh aspirin, karena aspirin
A. menghambat aktivitas antikoagulan heparin
B. Menghambat fungsi platelet *
C. Melepaskan heparin dari ikatannya dengan protein plasma
D. Menghambat pembentukan protrombin
E. Menimbulkan trombositopenia
9. Sifat Aspirin :
A. Mecegah pembentukan TXA2 *
B. Memperpanjang whole blood clotting time
C. Memperpendek waktu perdarahan
D. Menghambat fibrinolisis
E. Menghambat efek warfarin
10. Substansi di bawah ini meningkatkan risiko perdarahan yang serius
A. Warfarin
B. Heparin
C. Aspirin
D. Tissue plasminogen activator
E. Semuanya benar *

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