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Physiology · Blood: fibrinolysis
Sample itemA 28-year-old woman with heavy menstrual bleeding is given tranexamic acid. Through which mechanism does it reduce bleeding?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Blocks lysine-binding sites on plasminogen, preventing its binding to fibrin
Plasminogen binds fibrin through lysine-binding sites and is converted to plasmin by tissue plasminogen activator. Tranexamic acid is a lysine analogue that occupies these sites, so clots are protected from premature lysis. It is used in menorrhagia, postpartum haemorrhage and trauma.
Option by option
A. Enhances antithrombin activity
Antithrombin enhancement is the action of heparin, an anticoagulant.
B. Inhibits vitamin K epoxide reductase
Vitamin K epoxide reductase inhibition is the action of warfarin.
C. Blocks lysine-binding sites on plasminogen, preventing its binding to fibrin (correct)
Correct. It is an antifibrinolytic acting at plasminogen lysine-binding sites.
D. Inhibits factor Xa directly
Direct factor Xa inhibition is the action of rivaroxaban and apixaban, which prevent clotting.
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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