Coagulants MCQs With Answer

Coagulants MCQs With Answer

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Coagulants MCQs With Answer are essential for B.Pharm students to master pharmacology, formulation and clinical use of agents that promote haemostasis. This set covers coagulation cascade mechanisms, topical hemostats (fibrin sealants, gelatin sponges, oxidized cellulose, chitosan), systemic procoagulants (vitamin K, desmopressin, recombinant factors, PCC), and antifibrinolytics (tranexamic acid, aminocaproic acid). Questions emphasize mechanism of action, laboratory monitoring (PT/INR, aPTT, TT, TEG), indications, dosing considerations, safety, and reversal strategies. Designed for exam preparation and practical understanding, these MCQs reinforce critical concepts and decision-making in bleeding management. Answers include brief explanations to identify knowledge gaps and clinical application. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which molecule primarily initiates the extrinsic coagulation pathway?

  • Tissue factor (Factor III)
  • Factor XII (Hageman factor)
  • Thrombin (Factor IIa)
  • C4b binding protein

Correct Answer: Tissue factor (Factor III)

Q2. Prothrombin time (PT) and INR are most useful to monitor which aspect of coagulation?

  • Intrinsic pathway function
  • Extrinsic and common pathway function
  • Platelet aggregation
  • Fibrinolytic activity

Correct Answer: Extrinsic and common pathway function

Q3. Activated partial thromboplastin time (aPTT) primarily assesses which pathway?

  • Extrinsic pathway
  • Intrinsic pathway
  • Common pathway only
  • Platelet function

Correct Answer: Intrinsic pathway

Q4. Vitamin K is essential for gamma-carboxylation of which clotting factors?

  • Factors V, VIII, XIII
  • Factors II, VII, IX, X
  • Factors I and III only
  • Factors XI and XII

Correct Answer: Factors II, VII, IX, X

Q5. What is the specific antidote for unfractionated heparin overdose?

  • Vitamin K
  • Protamine sulfate
  • Fresh frozen plasma
  • Tranexamic acid

Correct Answer: Protamine sulfate

Q6. Warfarin exerts its anticoagulant effect by inhibiting which enzyme?

  • Thrombin
  • Gamma-glutamyl carboxylase
  • Vitamin K epoxide reductase
  • Factor Xa

Correct Answer: Vitamin K epoxide reductase

Q7. Tranexamic acid reduces bleeding by which mechanism?

  • Activating platelets directly
  • Inhibiting plasminogen activation and plasmin activity
  • Accelerating fibrin formation through thrombin activation
  • Blocking vitamin K recycling

Correct Answer: Inhibiting plasminogen activation and plasmin activity

Q8. Aminocaproic acid is best classified as:

  • A systemic procoagulant that increases thrombin generation
  • An antifibrinolytic agent
  • A vitamin K analogue
  • A recombinant clotting factor

Correct Answer: An antifibrinolytic agent

Q9. Recombinant activated factor VII (rFVIIa) is primarily used clinically to:

  • Reverse warfarin in all cases
  • Treat hemophilia patients with inhibitors to factor VIII or IX
  • Inhibit fibrinolysis
  • Replace fibrinogen deficiency

Correct Answer: Treat hemophilia patients with inhibitors to factor VIII or IX

Q10. Cryoprecipitate is rich in which of the following components?

  • Albumin and IgG
  • Fibrinogen, factor VIII, von Willebrand factor, factor XIII
  • Prothrombin complex factors only
  • Platelets and platelet factors

Correct Answer: Fibrinogen, factor VIII, von Willebrand factor, factor XIII

Q11. Prothrombin complex concentrate (PCC) commonly contains which combination of factors?

  • Factors II, VII, IX, X
  • Factors V and VIII only
  • Fibrinogen and thrombin
  • Platelets and vWF

Correct Answer: Factors II, VII, IX, X

Q12. Topical thrombin applied in surgery promotes hemostasis by:

  • Inhibiting plasminogen
  • Direct conversion of fibrinogen to fibrin at the wound site
  • Blocking platelet ADP receptors
  • Stimulating endothelial nitric oxide

Correct Answer: Direct conversion of fibrinogen to fibrin at the wound site

Q13. Oxidized regenerated cellulose (e.g., Surgicel) achieves hemostasis primarily through:

  • Systemic coagulation activation
  • Providing a mechanical matrix and local hemostatic environment
  • Chelating calcium and halting clotting
  • Acting as an antifibrinolytic agent

Correct Answer: Providing a mechanical matrix and local hemostatic environment

Q14. Absorbable gelatin sponge (Gelfoam) is best described as:

  • A nonabsorbable synthetic hemostat
  • An absorbable topical hemostatic matrix that promotes clot formation
  • A systemic procoagulant drug
  • An antifibrinolytic injectable

Correct Answer: An absorbable topical hemostatic matrix that promotes clot formation

Q15. Kaolin, used in some hemostatic dressings, contributes to clotting by:

  • Activating factor XII (contact activation)
  • Inhibiting antithrombin III
  • Directly cross-linking fibrin
  • Scavenging plasmin

Correct Answer: Activating factor XII (contact activation)

Q16. Chitosan-based hemostatic dressings mainly stop bleeding by:

  • Accelerating vitamin K–dependent factor synthesis
  • Providing mucoadhesive, platelet-independent physical aggregation of blood
  • Inhibiting thrombin formation
  • Neutralizing anticoagulant drugs

Correct Answer: Providing mucoadhesive, platelet-independent physical aggregation of blood

Q17. Desmopressin (DDAVP) is used to reduce bleeding by:

  • Directly converting fibrinogen to fibrin
  • Releasing von Willebrand factor and factor VIII from endothelium
  • Inhibiting plasmin activity
  • Blocking factor IX synthesis

Correct Answer: Releasing von Willebrand factor and factor VIII from endothelium

Q18. A markedly prolonged PT with near-normal aPTT suggests deficiency of which factor(s)?

  • Factor VIII deficiency
  • Factors II, V, X only
  • Factor VII or extrinsic pathway defect
  • Platelet dysfunction

Correct Answer: Factor VII or extrinsic pathway defect

Q19. Thromboelastography (TEG) provides information about:

  • Only plasma clotting factor levels
  • Whole blood clot formation dynamics including strength and lysis
  • Renal function effect on clotting
  • Specific factor VIII activity only

Correct Answer: Whole blood clot formation dynamics including strength and lysis

Q20. A prolonged thrombin time (TT) typically indicates which issue?

  • Platelet count reduction
  • Fibrinogen deficiency or presence of heparin
  • Factor VII excess
  • Increased von Willebrand factor

Correct Answer: Fibrinogen deficiency or presence of heparin

Q21. Unfractionated heparin anticoagulation is mediated primarily by potentiation of:

  • Protein C
  • Antithrombin III
  • Plasminogen
  • Factor V

Correct Answer: Antithrombin III

Q22. The preferred immediate reversal for major bleeding due to warfarin is:

  • Protamine sulfate alone
  • PCC (prothrombin complex concentrate) plus vitamin K
  • Tranexamic acid infusion alone
  • Desmopressin infusion

Correct Answer: PCC (prothrombin complex concentrate) plus vitamin K

Q23. Antifibrinolytic agents like tranexamic acid should be used with caution or avoided in patients with:

  • Active intravascular clotting such as DIC
  • Mild mucosal bleeding only
  • Vitamin K deficiency alone
  • Thrombocytopenia without active thrombosis

Correct Answer: Active intravascular clotting such as DIC

Q24. Hemophilia A results from deficiency of which clotting factor?

  • Factor IX
  • Factor VIII
  • Factor VII
  • Factor V

Correct Answer: Factor VIII

Q25. Hemophilia B is due to deficiency of which factor?

  • Factor IX
  • Factor VIII
  • Factor X
  • Factor XI

Correct Answer: Factor IX

Q26. Which of the following is NOT a vitamin K–dependent clotting factor?

  • Factor II
  • Factor VII
  • Factor VIII
  • Factor IX

Correct Answer: Factor VIII

Q27. For urgent major bleeding in a patient on warfarin, which provides the fastest correction of coagulopathy?

  • Oral vitamin K alone
  • Intravenous vitamin K with PCC
  • Fresh frozen plasma only
  • Desmopressin infusion

Correct Answer: Intravenous vitamin K with PCC

Q28. A fibrin sealant used in surgery is composed mainly of:

  • Collagen and kaolin
  • Thrombin and fibrinogen
  • Protamine and heparin
  • Albumin and immunoglobulin

Correct Answer: Thrombin and fibrinogen

Q29. Cryoprecipitate for transfusion is typically stored at which temperature?

  • Room temperature (20–25°C)
  • Refrigerated (2–6°C)
  • Frozen at ≤ -18°C
  • At -80°C only

Correct Answer: Frozen at ≤ -18°C

Q30. A recognized risk of topical bovine-derived thrombin use is:

  • Systemic hypertension due to endotoxin
  • Allergic reactions and development of antibodies causing coagulopathy
  • Immediate platelet activation leading to thrombocytopenia
  • Renal failure from direct nephrotoxicity

Correct Answer: Allergic reactions and development of antibodies causing coagulopathy

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