CJ is a 64-year-old female who is transferred to the catheterization laboratory for an emergent PCI following an ST elevation myocardial infarction (STEMI). Two drug-eluting stents are placed. Past medical history includes hypertension (HTN), hyperlipidemia, diabetes mellitus type 2, and gastroesophageal reflux disease. The patient’s current medications include lisinopril, simvastatin, metformin, glipizide, and pantoprazole. Which of the following antiplatelets would be best to start in combination with aspirin 324 mg in this patient for prevention of stent thrombosis?

1. Clopidogrel 300 mg loading dose, then 75 mg PO daily
   
2. Clopidogrel 600 mg loading dose, then 75 mg PO daily
   
3. Prasugrel 60 mg loading dose, then 10 mg PO daily
   
4. Ticagrelor 180 mg loading dose, then 90 mg PO twice daily

What is the proposed rationale behind avoiding concomitant use of ticagrelor with aspirin doses above 100 mg per day?

1. Concomitant use of ticagrelor and aspirin >100 mg daily may result in decreased efficacy of aspirin
   
2. Concomitant use of ticagrelor and aspirin >100 mg daily may result in decreased efficacy of ticagrelor
   
3. Concomitant use of ticagrelor and aspirin >100 mg daily may result in intolerable gastrointestinal adverse events that may lead to drug discontinuation
   
4. Concomitant use of ticagrelor and aspirin >100 mg daily may result in increased hypersensitivity to aspirin

JP is a 60-year-old female who presents to your outpatient clinic for a check-up. She has been on long-term warfarin therapy for secondary stroke prevention with a history significant for atrial fibrillation and ischemic stroke (2011). From reviewing her electronic profile, it is apparent that JP’s warfarin therapy has been difficult to maintain within therapeutic range. You would like to consider transitioning her to rivaroxaban as this is what her insurance company will cover. What is an appropriate method of transitioning JP from warfarin to rivaroxaban?

1. Discontinue warfarin; start rivaroxaban when international normalized ratio (INR) <2
   
2. Discontinue warfarin; start rivaroxaban when INR <3
   
3. Discontinue warfarin; start rivaroxaban after 3–5 days of discontinuation of warfarin
   
4. Start rivaroxaban 3–5 days before discontinuing warfarin

LT is a 48-year-old male presenting with a new STEMI who is transported from the medical intensive care unit to the catheterizatin laboratory for an emergent percutaneous coronary intervention (PCI). Labs from his current admission observe notable increases in blood urea nitrogen/serum creatinine and decreased urine output, suggesting signs of acute kidney injury. Which of the following intravenous antiplatelet inhibitors would be best to use if the patient is found to require emergency coronary artery bypass grafting surgery?

1. Abciximab
   
2. Eptifibatide
   
3. Tirofiban
   
4. Cangrelor

RG is a 46-year-old male who presents with swelling, erythema, and pain in his right lower extremity. Past medical history includes HTN, diabetes, and recent hospitalization for a total knee arthroplasty. The patient further admits to a 10-year smoking history. Ultrasound and D-dimer tests suggest that a deep venous thrombosis (DVT) is highly likely. For convenience, the patient indicates that he refuses parenteral agents and wishes to be started on solely an oral anticoagulant for DVT treatment. Which of the following is the best oral anticoagulant for RG?

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