Medicine MCQ session
Cardiology - GI/hepatology
Dr Hannah Gogarty
22.10.2021
,Question 1
A 45 year old man undergoes a metallic aortic valve replacement for aortic
stenosis due to a congenital bicuspid valve. He has a past medical history
hypertension. He is a smoker and drinks 25 units of alcohol per week. Surg
is uncomplicated. Which of the following is the most appropriate choice of
anticoagulant for his long-term management?
A. Dabigatran
B. Aspirin
C. Warfarin
D. Enoxaparin
E. Rivaroxaban
, Explanation
• Answer: C - Warfarin
• Rationale:
– Warfarin is the only anticoagulant licenced for long term anticoagulation for mechan
valve replacement.
– Aspirin is not an anticoagulant
– DOACs (Dabigatran/rivaroxaban) are not licenced for this indication due to safety
concerns (bleeding/thrombus).
– Enoxaparin can be used, but is not typically first choice for long term anticoagulatio
• Source:
– RCSI Handbook of Clinical Medicine 3rd Edition Volume 1 page 44
Cardiology - GI/hepatology
Dr Hannah Gogarty
22.10.2021
,Question 1
A 45 year old man undergoes a metallic aortic valve replacement for aortic
stenosis due to a congenital bicuspid valve. He has a past medical history
hypertension. He is a smoker and drinks 25 units of alcohol per week. Surg
is uncomplicated. Which of the following is the most appropriate choice of
anticoagulant for his long-term management?
A. Dabigatran
B. Aspirin
C. Warfarin
D. Enoxaparin
E. Rivaroxaban
, Explanation
• Answer: C - Warfarin
• Rationale:
– Warfarin is the only anticoagulant licenced for long term anticoagulation for mechan
valve replacement.
– Aspirin is not an anticoagulant
– DOACs (Dabigatran/rivaroxaban) are not licenced for this indication due to safety
concerns (bleeding/thrombus).
– Enoxaparin can be used, but is not typically first choice for long term anticoagulatio
• Source:
– RCSI Handbook of Clinical Medicine 3rd Edition Volume 1 page 44
