Anticoagulants: mechanical valves: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Anticoagulants: mechanical valves

Sample item

A 40-year-old woman has just undergone mechanical mitral valve replacement. Which long-term anticoagulant is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Warfarin

In mechanical heart valves, warfarin is the established agent, and trials showed excess thrombosis and bleeding with dabigatran and with other direct oral anticoagulants. Hence DOACs are contraindicated here.

Option by option

  • A. Warfarin (correct)

    Correct. Warfarin remains the standard.

  • B. Dabigatran

    Dabigatran increased valve thrombosis in trials.

  • C. Apixaban

    Apixaban is not recommended for mechanical valves.

  • D. Rivaroxaban

    Rivaroxaban is not recommended for mechanical valves.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Warfarin. In mechanical heart valves, warfarin is the established agent, and trials showed excess thrombosis and bleeding with dabigatran and with other direct oral anticoagulants.

Why is "Dabigatran" not the answer?

Dabigatran increased valve thrombosis in trials.

Why is "Apixaban" not the answer?

Apixaban is not recommended for mechanical valves.

Why is "Rivaroxaban" not the answer?

Rivaroxaban is not recommended for mechanical valves.

What concept does this question test?

It tests Anticoagulants: mechanical valves in Pharmacology. Hence DOACs are contraindicated here.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anticoagulants: mechanical valves?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.