A 55-year-old male presents with acute onset of shortness of breath. He has a computed tomography angiogram in the emergency room and is noted to have bilateral segmental and subsegmental pulmonary emboli (PEs). His past medical history is significant for non-small cell carcinoma of the lung, for which he is undergoing treatment. He reports nausea and vomiting. Which of the following would be the choice of anticoagulation?

1. Warfarin
   
2. Low molecular weight heparin (LMWH)
   
3. Dabigatran
   
4. Edoxaban

In a patient with deep venous thrombosis (DVT) of the leg, not cancer associated, what would not be the choice of anticoagulation for the first 3 months?

1. Dabigatran
   
2. Rivaroxaban
   
3. Apixaban
   
4. Edoxaban
   
5. Warfarin

Initial parentral anticoagulation is a must with what agents, when used to treat non-cancer-associated DVT or PEs?

1. Rivaroxaban and apixaban
   
2. Dabigatran and edoxaban
   
3. Rivaroxaban and edoxaban
   
4. Dabigatran and apixaban

A patient is on dabigatran 150 mg BID for paroxysmal atrial fibrillation. He is then prescribed dronedarone for rhythm control. What is the recommendation for dabigatran dosing?

1. Continue at 150 mg BID
   
2. Reduce dosage to 75 mg BID
   
3. Stop using dabigatran
   
4. Reduce dosage to 75 mg once daily

A 65-year-old male is on ketoconazole therapy. He has paroxysmal atrial fibrillation and his CHA₂DS₂–VASc score is 4. His physician decides on starting a novel anticoagulant, dabigatran. What is the recommendation regarding dabigatran dosing in this patient?

1. Start on 150 mg BID
   
2. Do not use dabigatran
   
3. Start on 75 mg BID
   
4. Start on 75 mg once daily

Which of the novel anticoagulants is mostly excreted through the kidneys?

1. Dabigatran
   
2. Rivaroxaban
   
3. Apixaban
   
4. Edoxaban

Which of the following novel anticoagulants is a direct thrombin inhibitor?

1. Rivaroxaban
   
2. Apixaban
   
3. Dabigatran
   
4. Edoxaban

Which of the following drugs has been approved by the US Food and Drug Administration for use to reverse the effect of dabigatran?

1. Idarucizumab
   
2. Andexanet alfa
   
3. Aripazine
   
4. Protamine

Which of the following drugs is being studied to reverse the effect of apixaban and rivaroxaban?

1. Idarucizumab
   
2. Andexanet alfa
   
3. Aripazine
   
4. Protamine

Which of the following drugs is being evaluated as a universal anticoagulant reversal agent (anti-direct thrombin inhibitors, anti-Xa inhibitors, unfractionated heparin, LMWH, and fondaparinux)?

1. Idarucizumab
   
2. Andexanet alfa
   
3. Aripazine
   
4. Protamine

For patients undergoing major orthopedic surgery, including total hip arthroplasty, total knee arthroplasty, and hip fracture surgery, what is the current recommendation for thromboprophylaxis from the day of surgery?

1. Thromboprophylaxis in the outpatient period for up to 35 days
   
2. Thromboprophylaxis for 10 days
   
3. No need for thromboprophylaxis
   
4. Thromboprophylaxis for 14 days

In patients undergoing total hip arthroplasty or total knee arthroplasty, irrespective of the concomitant use of an intermittent pneumatic compression device or length of treatment, what is the recommended choice for thrombopro- phylaxis?

1. Aspirin alone
   
2. Unfractionated heparin
   
3. LMWH
   
4. Vitamin K antagonist

For patients undergoing total hip arthroplasty, total knee arthroplasty, and hip fracture surgery, what is the recommended time period to start thromboprophylaxis with LMWH?

1. 4 h preoperatively
   
2. 4 h postoperatively
   
3. 12 h or more preoperatively or postoperatively
   
4. 24 h postoperatively

For acutely sick hospitalized medical patients who are at increased risk for thrombosis, what is the current recommendation for thromboprophylaxis?

1. LMWH
   
2. LDUH BID
   
3. LDUH TID
   
4. Fondaparinux
   
5. All of the above
   
6. None of the above

Based on the RE-LY trial, which of the following statements is false?

1. Dabigatran 110 mg was noninferior to warfarin in preventing stroke or embolism
   
2. Dabigatran 150 mg was superior to warfarin in preventing stroke/embolism
   
3. Dabigatran was associated with more gastrointestinal bleeds
   
4. Dabigatran was associated with more intracranial bleeds

Which of the following is not true regarding novel anticoagulants in nonvalvular atrial fibrillation?

1. Rivaroxaban was noninferior to warfarin in preventing stroke
   
2. Edoxaban was noninferior to warfarin in preventing stroke
   
3. Apixaban was superior to warfarin in preventing stroke
   
4. Apixaban was noninferior to warfarin in preventing stroke

In a patient with acute isolated distal DVT, what is the current recommendation regarding management?

1. Serial imaging of the deep veins in 2 weeks when there are no severe symptoms or risk for extension
   
2. Serial imaging in 4 weeks
   
3. No need to image further
   
4. Start anticoagulation

In a patient diagnosed with a distal DVT managed with serial imaging, which of the following statements is not true?

1. Anticoagulation if the thrombus has not extended
   
2. Anticoagulation is recommended if the thrombus has extended but remains confined to distal veins
   
3. Anticoagulation is recommended if the thrombus extends into the proximal veins

Which of the following is not true?

1. In patients with acute DVT of the leg, use of compression stockings is not recommended
   
2. In patients with subsegmental PE (not involving proximal pulmonary arteries) without proximal DVT of legs and a low risk for venous thromboembolism (VTE), clinical surveillance is recommended
   
3. In patients with subsegmental PE (not involving proximal pulmonary arteries) without proximal DVT of legs and a high risk for VTE, clinical surveillance is recommended
   
4. In patients with low-risk pulmonary embolism, treatment at home or early discharge is recommended (before 5 days of treatment)

Which of the following statements are true?

1. In patients with acute PE being managed by thrombolysis, systemic thrombolytic therapy is recommended over catheter-delivered thrombolysis
   
2. In patients with acute PE associated with hypotension, catheter-assisted thrombus removal is recommended when they are at high risk for bleeding, failed systemic thrombolysis, or in shock
   
3. In patients with upper extremity DVT involving axillary or more proximal veins, anticoagulation therapy is recommended over thrombolysis
   
4. In patients with recurrent DVT on therapeutic doses of warfarin or other NOACS, switching to LMWH for at least 1 month is recommended
   
5. Increasing the dose of LMWH by one-quarter to one-third is recommended if recurrent DVT occurs while on therapeutic dose of long-term LMWH therapy
   
6. All of the above
   
7. None of the above