Bleeding Disorders

Question 1

A patient is prescribed tranexamic acid. What is its primary mechanism of action?
A. Anticoagulation
B. Platelet inhibition
C. Increased fibrinolysis
D. Reduced fibrinolysis

Answer 1

Correct answer: Reduced fibrinolysis. Explanation: Tranexamic acid works by inhibiting fibrinolysis, stabilising clots and reducing bleeding.

Question 2

In which situation is tranexamic acid most appropriately used?
A. Long-term prevention of thrombosis
B. Short-term management of bleeding risk
C. Treatment of atrial fibrillation
D. Chronic anticoagulation

Answer 2

Correct answer: Short-term management of bleeding risk. Explanation: Tranexamic acid is used short-term in patients with bleeding or high haemorrhage risk due to increased fibrinolysis.

Question 3

A woman presents with heavy menstrual bleeding. Which dosing regimen of tranexamic acid is appropriate?
A. Once daily for 7 days
B. Twice daily for 10 days
C. Three times daily for up to 4 days
D. Continuous daily use

Answer 3

Correct answer: Three times daily for up to 4 days. Explanation: Tranexamic acid is commonly used for menorrhagia at a dose taken three times daily for up to four days.

Question 4

Which condition is a common indication for tranexamic acid?
A. Dysmenorrhoea
B. Menorrhagia
C. Endometriosis
D. Polycystic ovarian syndrome

Answer 4

Correct answer: Menorrhagia. Explanation: Tranexamic acid is frequently prescribed for heavy menstrual bleeding.

Question 5

Which patient should NOT be prescribed tranexamic acid?
A. Patient with heavy menstrual bleeding
B. Patient with mild nausea
C. Patient with a history of thrombosis
D. Patient with iron deficiency anaemia

Answer 5

Correct answer: Patient with a history of thrombosis. Explanation: Tranexamic acid is contraindicated in patients with a history of thrombotic events due to increased clot risk.

Question 6

Which comorbidity is a contraindication to tranexamic acid use?
A. Asthma
B. Renal impairment
C. Hypertension
D. Diabetes

Answer 6

Correct answer: Renal impairment. Explanation: Tranexamic acid is contraindicated in renal impairment because it is renally excreted and may accumulate.

Question 7

Which neurological condition is a contraindication to tranexamic acid?
A. Migraine
B. Epilepsy with convulsions
C. Parkinson’s disease
D. Multiple sclerosis

Answer 7

Correct answer: Epilepsy with convulsions. Explanation: Tranexamic acid is contraindicated in patients with a history of convulsions.

Question 8

Which of the following is a common side effect of tranexamic acid?
A. Bradycardia
B. Constipation
C. Nausea and vomiting
D. Weight gain

Answer 8

Correct answer: Nausea and vomiting. Explanation: Gastrointestinal side effects such as nausea, vomiting and diarrhoea are common with tranexamic acid.

Question 9

A patient taking tranexamic acid reports diarrhoea. What is the most appropriate advice?
A. Stop immediately and seek emergency care
B. Continue and monitor
C. Increase the dose
D. Add an antidiarrhoeal routinely

Answer 9

Correct answer: Continue and monitor. Explanation: Diarrhoea is a known side effect and is usually mild and self-limiting.

Question 10

Tranexamic acid should be used with caution when combined with which medication?
A. Paracetamol
B. Ibuprofen
C. Oral contraceptives
D. Proton pump inhibitors

Answer 10

Correct answer: Oral contraceptives. Explanation: Combined use increases the risk of thrombosis.

Question 11

Why should tranexamic acid be used cautiously with anticoagulants?
A. Increased bleeding risk
B. Reduced efficacy of tranexamic acid
C. Increased risk of thrombosis
D. Reduced anticoagulant absorption

Answer 11

Correct answer: Increased risk of thrombosis. Explanation: Tranexamic acid promotes clot stability and may counteract anticoagulants, increasing thrombosis risk.

Question 12

Which statement about tranexamic acid is TRUE?
A. It is suitable for long-term daily use
B. It increases fibrinolysis
C. It is contraindicated in thrombotic history
D. It is first-line anticoagulation

Answer 12

Correct answer: It is contraindicated in thrombotic history. Explanation: A past thrombotic event is a key contraindication to tranexamic acid use.