State true or false: Warfarin is an antagonist of Vitamin K. A. True B. False - ✔✔A Regarding Vitamin K and its role, which of the following statements are correct? A. Vitamin K epoxide reducatase complex subunit 1 converts oxidized form of vitamin K to reduced form. B. Vitamin K is essential for the maturation of certain coagulation factors C. Vitamin K is a cofactor for the enzyme g-glutamyl carboxylase D. Warfarin inhibits VKORC1 E. All of the above - ✔✔E Vitamin K is important for the maturation of which of the following coagulation factors? A. Factor II B. Factor VII C. Factor IX D. Factor IX E. All of the above - ✔✔E State true or false. ADP can cause platelet aggregation whereas Adenosine diphosphatase can prevent platelet aggregation by degrading ADP. A. True B. False - ✔✔A List hereditary reasons for the development of VTE - ✔✔Mutations in factor II and Factor V Deficiency in protein C and deficiency in anti-thrombin High levels of factor VIII What is the co-factor for gamma glutamyl carboxylase enzyme? A. Vitamin A B. Vitamin D C. Vitamin K D. Vitamin E - ✔✔C Which of the following CYPs are involved in the metabolism of Warfarin? A. CYP2C9 B. CYP1A C. CYP3A4 D. All of the above - ✔✔D Black box warning in prescription drugs is_______ A. It is a type of alert notification that appears on the package insert for certain prescription drugs which notifies patients on the risk associated with taking the drugs due to gene polymorphisms. B. Alert notification to take the drug after the food in the morning and night C. Alert notification to indicate that it is only to be given people who are above 20 years old. D. Alert notification to indicate that it is used in treating animal diseases. - ✔✔A Clinically relevant CYP enzyme involved in the metabolism of warfarin is________ A. CYP2D6 B. CYP2C9 C. CYP2C19 D. All of the above - ✔✔B S-Warfarin is metabolized by _____ A. CYP1A B. CYP3A4 C. CYP2C9 D. All of the above - ✔✔C Define: Extensive metabolizer Intermediate metabolizer Poor metabolizer Ultra-metabolizer phenotypes - ✔✔Extensive metabolizers: two good copies of the gene (normal) Intermediate metabolizers: one good copy and one defective copy of the gene Poor metabolizers: Two defective copy of the gene Ultra-rapid metabolizers: three or more good copy of the gene Select the best answer. What is the main ADR associated with warfarin in individuals who have CYP2C9*1? A. Stroke B. Heart attack C. Bleeding D. All of the above - ✔✔C C1173T and G1639A alleles for VKORC1 are more common in which of the following populations? A. Caucasians B. Asians C. African Americans D. All of the above - ✔✔B Which of the following amino acids in the coagulation factors are carboxylated by gammaglutaby carboxylase catalyzed reaction? A. Alanine B. Serine C. Glutamic acid D. threonine - ✔✔C State true or false: Polymorphisms in CYP2C9 effects warfarin response, but polymorphism in VKORC1 does not. A. True B. False - ✔✔B CYP2C9*2 allele is more commonly present in which of the following population? A. Caucasians B. Ethiopeans C. Japanese D. East Indians - ✔✔A State true or false. CYP2C9*2 allele is absent or rarely present in Asian population. A. True B. False - ✔✔A