Haematology: reversal of dabigatran: practice question

A General Medicine 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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General Medicine · Haematology: reversal of dabigatran

Sample item

A patient on dabigatran develops life-threatening intracranial bleeding. Which agent specifically reverses its effect?

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

The answer and the reasoning

D. Idarucizumab

Idarucizumab is a monoclonal antibody fragment that binds dabigatran and neutralises it rapidly. Andexanet alfa reverses factor Xa inhibitors, protamine reverses heparin, and vitamin K with prothrombin complex concentrate reverses warfarin. Dabigatran is also dialysable.

Option by option

  • A. Protamine sulfate

    Protamine neutralises unfractionated heparin.

  • B. Vitamin K

    Vitamin K reverses vitamin K antagonists such as warfarin.

  • C. Andexanet alfa

    Andexanet reverses rivaroxaban and apixaban.

  • D. Idarucizumab (correct)

    Correct. Idarucizumab is the specific antidote for dabigatran.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Idarucizumab. Idarucizumab is a monoclonal antibody fragment that binds dabigatran and neutralises it rapidly.

Why is "Protamine sulfate" not the answer?

Protamine neutralises unfractionated heparin.

Why is "Vitamin K" not the answer?

Vitamin K reverses vitamin K antagonists such as warfarin.

Why is "Andexanet alfa" not the answer?

Andexanet reverses rivaroxaban and apixaban.

What concept does this question test?

It tests Haematology: reversal of dabigatran in General Medicine. Andexanet alfa reverses factor Xa inhibitors, protamine reverses heparin, and vitamin K with prothrombin complex concentrate reverses warfarin. Dabigatran is also dialysable.

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 Haematology: reversal of dabigatran?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.