Anticoagulants: warfarin initiation: 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: warfarin initiation

Sample item

Why is heparin commonly overlapped when warfarin is started for acute venous thromboembolism?

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

The answer and the reasoning

C. Warfarin initially lowers protein C before fully reducing procoagulant factors

Warfarin decreases short-half-life protein C early, creating a transient prothrombotic period before factors II, IX and X fall sufficiently. Therapeutic heparin supplies immediate anticoagulation during this interval.

Option by option

  • A. Warfarin has immediate direct thrombin inhibition

    Warfarin inhibits vitamin K epoxide reductase; it does not directly inhibit thrombin.

  • B. Warfarin initially causes platelet activation

    Warfarin affects vitamin K-dependent coagulation proteins, not platelets directly.

  • C. Warfarin initially lowers protein C before fully reducing procoagulant factors (correct)

    Correct. Early protein C depletion explains the need for bridging in acute thrombosis.

  • D. Heparin improves intestinal absorption of warfarin

    The purpose is pharmacodynamic bridging, not absorption.

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 C, Warfarin initially lowers protein C before fully reducing procoagulant factors. Warfarin decreases short-half-life protein C early, creating a transient prothrombotic period before factors II, IX and X fall sufficiently.

Why is "Warfarin has immediate direct thrombin inhibition" not the answer?

Warfarin inhibits vitamin K epoxide reductase; it does not directly inhibit thrombin.

Why is "Warfarin initially causes platelet activation" not the answer?

Warfarin affects vitamin K-dependent coagulation proteins, not platelets directly.

Why is "Heparin improves intestinal absorption of warfarin" not the answer?

The purpose is pharmacodynamic bridging, not absorption.

What concept does this question test?

It tests Anticoagulants: warfarin initiation in Pharmacology. Therapeutic heparin supplies immediate anticoagulation during this interval.

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: warfarin initiation?

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.