1. Which of the following statements about the history of aspirin (ASA) as a therapeutic is NOT correct?

a. It was first described in ancient Chinese herbal medicine texts. 
b. Hippocrates referred to the use of salicylic tea to reduce fevers.
c. The gastrotoxic effects of salicylate were recognized very early on.
d. Early uses of salicylate treatment included malaria and rheumatism.

 

You answered A. Your answer was correct! 

EXPLANATION: The first therapeutic use of willow bark, from which ASA was originally derived, came from ancient Egypt, not ancient China.

1. Which of the following statements about the history of aspirin (ASA) as a therapeutic is NOT correct?

a. It was first described in ancient Chinese herbal medicine texts. 
b. Hippocrates referred to the use of salicylic tea to reduce fevers.
c. The gastrotoxic effects of salicylate were recognized very early on.
d. Early uses of salicylate treatment included malaria and rheumatism.

 

You answered B. Your answer was incorrect. A is the correct answer.

EXPLANATION: The first therapeutic use of willow bark, from which ASA was originally derived, came from ancient Egypt, not ancient China.

1. Which of the following statements about the history of aspirin (ASA) as a therapeutic is NOT correct?

a. It was first described in ancient Chinese herbal medicine texts. 
b. Hippocrates referred to the use of salicylic tea to reduce fevers.
c. The gastrotoxic effects of salicylate were recognized very early on.
d. Early uses of salicylate treatment included malaria and rheumatism.

 

You answered C. Your answer was incorrect. A is the correct answer.

EXPLANATION: The first therapeutic use of willow bark, from which ASA was originally derived, came from ancient Egypt, not ancient China.

1. Which of the following statements about the history of aspirin (ASA) as a therapeutic is NOT correct?

a. It was first described in ancient Chinese herbal medicine texts. 
b. Hippocrates referred to the use of salicylic tea to reduce fevers.
c. The gastrotoxic effects of salicylate were recognized very early on.
d. Early uses of salicylate treatment included malaria and rheumatism.

 

You answered D. Your answer was incorrect. A is the correct answer.

EXPLANATION: The first therapeutic use of willow bark, from which ASA was originally derived, came from ancient Egypt, not ancient China.

2. Concentration peaks of regular and enteric-coated ASA are reached when, respectively?

a. 1 hr and 6 hr.
b. 15-20 min and 8 hr.
c. 15-20 min and 3-4 hr.
d. 5 min and 5 hr.

 

You answered A. Your answer was incorrect. C is the correct answer.

EXPLANATION: Regular AA is rapidly absorbed, even more so when chewed (though patients report the taste is awful!).  Enteric-coated ASA is not appropriate in acute use because its absorption is quite a bit slower.

2. Concentration peaks of regular and enteric-coated ASA are reached when, respectively?

a. 1 hr and 6 hr.
b. 15-20 min and 8 hr.
c. 15-20 min and 3-4 hr.
d. 5 min and 5 hr.

 

You answered B. Your answer was incorrect. C is the correct answer.

EXPLANATION: Regular AA is rapidly absorbed, even more so when chewed (though patients report the taste is awful!).  Enteric-coated ASA is not appropriate in acute use because its absorption is quite a bit slower.

2. Concentration peaks of regular and enteric-coated ASA are reached when, respectively?

a. 1 hr and 6 hr.
b. 15-20 min and 8 hr.
c. 15-20 min and 3-4 hr.
d. 5 min and 5 hr.

 

You answered C. Your answer was correct!

EXPLANATION: Regular AA is rapidly absorbed, even more so when chewed (though patients report the taste is awful!).  Enteric-coated ASA is not appropriate in acute use because its absorption is quite a bit slower.

3. Which of the following is a potential source of “pseudoresistance” to ASA?

a. Noncompliance
b. Decreased platelet turnover
c. The decreased thrombogenicity of reticulated platelets
d. Accelerated absorption of enteric-coated formulations

 

You answered A. Your answer was correct!

EXPLANATION: Choices (b), (c), and (d) are sources of true resistance to ASA; only noncompliance is associated with “pseudo” or apparent resistance without a biologic mechanism.

3. Which of the following is a potential source of “pseudoresistance” to ASA?

a. Noncompliance
b. Decreased platelet turnover
c. The decreased thrombogenicity of reticulated platelets
d. Accelerated absorption of enteric-coated formulations

 

You answered B. Your answer was incorrect. A is the correct answer.

EXPLANATION: Choices (b), (c), and (d) are sources of true resistance to ASA; only noncompliance is associated with “pseudo” or apparent resistance without a biologic mechanism.

3. Which of the following is a potential source of “pseudoresistance” to ASA?

a. Noncompliance
b. Decreased platelet turnover
c. The decreased thrombogenicity of reticulated platelets
d. Accelerated absorption of enteric-coated formulations

 

You answered C. Your answer was incorrect. A is the correct answer.

EXPLANATION: Choices (b), (c), and (d) are sources of true resistance to ASA; only noncompliance is associated with “pseudo” or apparent resistance without a biologic mechanism.

3. Which of the following is a potential source of “pseudoresistance” to ASA?

a. Noncompliance
b. Decreased platelet turnover
c. The decreased thrombogenicity of reticulated platelets
d. Accelerated absorption of enteric-coated formulations

 

You answered D. Your answer was incorrect. A is the correct answer.

EXPLANATION: Choices (b), (c), and (d) are sources of true resistance to ASA; only noncompliance is associated with “pseudo” or apparent resistance without a biologic mechanism.

4. In what settings is the role of ASA in cardiovascular disease management still essentially unquestioned?

a. At presentation with ACS
b. Primary prevention in diabetic patients
c. Secondary prevention for at least the first 3 months after PCI in patients at high ischemic risk
d. a and c

 

You answered A. Your answer was incorrect. D is the correct answer.

EXPLANATION: Only in some primary prevention settings has the data truly moved beyond ASA.

4. In what settings is the role of ASA in cardiovascular disease management still essentially unquestioned?

a. At presentation with ACS
b. Primary prevention in diabetic patients
c. Secondary prevention for at least the first 3 months after PCI in patients at high ischemic risk
d. a and c

 

You answered B. Your answer was incorrect. D is the correct answer.

EXPLANATION: Only in some primary prevention settings has the data truly moved beyond ASA.

4. In what settings is the role of ASA in cardiovascular disease management still essentially unquestioned?

a. At presentation with ACS
b. Primary prevention in diabetic patients
c. Secondary prevention for at least the first 3 months after PCI in patients at high ischemic risk
d. a and c

 

You answered C. Your answer was incorrect. D is the correct answer.

EXPLANATION: Only in some primary prevention settings has the data truly moved beyond ASA.

4. In what settings is the role of ASA in cardiovascular disease management still essentially unquestioned?

a. At presentation with ACS
b. Primary prevention in diabetic patients
c. Secondary prevention for at least the first 3 months after PCI in patients at high ischemic risk
d. a and c

 

You answered D. Your answer was correct!

EXPLANATION: Only in some primary prevention settings has the data truly moved beyond ASA.

5. Which of the following therapeutic approaches DOES NOT offer an offset to the ischemic benefit in primary prevention ascribed to ASA in the past?

a. Tighter blood pressure control in patients with hypertension
b. Tighter glycemic control in patients with diabetes
c. Unfavorable lifestyle modifications
d. Broad use of lipid-lowering agents

 

You answered A. Your answer was incorrect. C is the correct answer. 

EXPLANATION: Choice (c) actually moves risk in the wrong direction. The other choices likely have a greater impact on risk that ASA in the absence of known cardiovascular disease.

5. Which of the following therapeutic approaches DOES NOT offer an offset to the ischemic benefit in primary prevention ascribed to ASA in the past?

a. Tighter blood pressure control in patients with hypertension
b. Tighter glycemic control in patients with diabetes
c. Unfavorable lifestyle modifications
d. Broad use of lipid-lowering agents

 

You answered B. Your answer was incorrect. C is the correct answer. 

EXPLANATION: Choice (c) actually moves risk in the wrong direction. The other choices likely have a greater impact on risk that ASA in the absence of known cardiovascular disease.

5. Which of the following therapeutic approaches DOES NOT offer an offset to the ischemic benefit in primary prevention ascribed to ASA in the past?

a. Tighter blood pressure control in patients with hypertension
b. Tighter glycemic control in patients with diabetes
c. Unfavorable lifestyle modifications
d. Broad use of lipid-lowering agents

 

You answered C. Your answer was correct!

EXPLANATION: Choice (c) actually moves risk in the wrong direction. The other choices likely have a greater impact on risk that ASA in the absence of known cardiovascular disease.

5. Which of the following therapeutic approaches DOES NOT offer an offset to the ischemic benefit in primary prevention ascribed to ASA in the past?

a. Tighter blood pressure control in patients with hypertension
b. Tighter glycemic control in patients with diabetes
c. Unfavorable lifestyle modifications
d. Broad use of lipid-lowering agents

 

You answered D. Your answer was incorrect. C is the correct answer. 

EXPLANATION: Choice (c) actually moves risk in the wrong direction. The other choices likely have a greater impact on risk that ASA in the absence of known cardiovascular disease.

6. Which of the following groups of patients does NOT have an increased risk of major bleeding on ASA therapy?

a. Younger patients
b. Patients on long-term ASA therapy
c. Patients on dual antiplatelet therapy
d. Patients on ASA and oral anticoagulant

 

You answered A. Your answer was correct! 

EXPLANATION: The patient groups in (b), (c), and (d) all do have an increased bleeding risk attributable to SA therapy; only younger patients do not.

6. Which of the following groups of patients does NOT have an increased risk of major bleeding on ASA therapy?

a. Younger patients
b. Patients on long-term ASA therapy
c. Patients on dual antiplatelet therapy
d. Patients on ASA and oral anticoagulant

 

You answered B. Your answer was incorrect. A is the correct answer. 

EXPLANATION: The patient groups in (b), (c), and (d) all do have an increased bleeding risk attributable to SA therapy; only younger patients do not.

6. Which of the following groups of patients does NOT have an increased risk of major bleeding on ASA therapy?

a. Younger patients
b. Patients on long-term ASA therapy
c. Patients on dual antiplatelet therapy
d. Patients on ASA and oral anticoagulant

 

You answered C. Your answer was incorrect. A is the correct answer. 

EXPLANATION: The patient groups in (b), (c), and (d) all do have an increased bleeding risk attributable to SA therapy; only younger patients do not.

6. Which of the following groups of patients does NOT have an increased risk of major bleeding on ASA therapy?

a. Younger patients
b. Patients on long-term ASA therapy
c. Patients on dual antiplatelet therapy
d. Patients on ASA and oral anticoagulant

 

You answered D. Your answer was incorrect. A is the correct answer. 

EXPLANATION: The patient groups in (b), (c), and (d) all do have an increased bleeding risk attributable to SA therapy; only younger patients do not.

7. True or False: The most dramatic reduction in ischemic events after a stroke that is attributable to ASA occurs in the first few weeks after the index event.

a. True
b. False

 

You answered A. Your answer was correct! 

EXPLANATION: Multiple studies have shown the benefit of ASA in the first 30 days-few months after ischemic stroke outweighs excess bleeding risk. That changes as the weeks go by, and bleeding risk from longer-term ASA therapy increases while potential ischemic benefit flattens out.

7. True or False: The most dramatic reduction in ischemic events after a stroke that is attributable to ASA occurs in the first few weeks after the index event.

a. True
b. False

 

You answered B. Your answer was incorrect. A is the correct answer.

EXPLANATION: Multiple studies have shown the benefit of ASA in the first 30 days-few months after ischemic stroke outweighs excess bleeding risk. That changes as the weeks go by, and bleeding risk from longer-term ASA therapy increases while potential ischemic benefit flattens out.

8. What type of surgery is likely the only procedural type that warrants serious consideration of perioperative cessation when a patient is on ASA for secondary prevention?

a. Vascular access procedures
b. Neurosurgical or spine surgery
c. Bowel resection
d. Major orthopedic surgery

 

You answered A. Your answer was incorrect. B is the correct answer.

EXPLANATION: The risk of catastrophic bleeding complications, while rare on ASA, is too worrisome in patients undergoing brain or spine surgery. ASA’s benefits in secondary prevention (when properly administered) outweigh ASA-induced bleeding risk in the other types of surgery listed.

8. What type of surgery is likely the only procedural type that warrants serious consideration of perioperative cessation when a patient is on ASA for secondary prevention?

a. Vascular access procedures
b. Neurosurgical or spine surgery
c. Bowel resection
d. Major orthopedic surgery

 

You answered B. Your answer was correct!

EXPLANATION: The risk of catastrophic bleeding complications, while rare on ASA, is too worrisome in patients undergoing brain or spine surgery. ASA’s benefits in secondary prevention (when properly administered) outweigh ASA-induced bleeding risk in the other types of surgery listed.

8. What type of surgery is likely the only procedural type that warrants serious consideration of perioperative cessation when a patient is on ASA for secondary prevention?

a. Vascular access procedures
b. Neurosurgical or spine surgery
c. Bowel resection
d. Major orthopedic surgery

 

You answered C. Your answer was incorrect. B is the correct answer.

EXPLANATION: The risk of catastrophic bleeding complications, while rare on ASA, is too worrisome in patients undergoing brain or spine surgery. ASA’s benefits in secondary prevention (when properly administered) outweigh ASA-induced bleeding risk in the other types of surgery listed.

8. What type of surgery is likely the only procedural type that warrants serious consideration of perioperative cessation when a patient is on ASA for secondary prevention?

a. Vascular access procedures
b. Neurosurgical or spine surgery
c. Bowel resection
d. Major orthopedic surgery

 

You answered D. Your answer was incorrect. B is the correct answer.

EXPLANATION: The risk of catastrophic bleeding complications, while rare on ASA, is too worrisome in patients undergoing brain or spine surgery. ASA’s benefits in secondary prevention (when properly administered) outweigh ASA-induced bleeding risk in the other types of surgery listed.

9. Which of the following statements about ASA therapy in primary prevention is NOT correct?

a. Enteric-coated oral formulations of low-dose aspirin (e.g., 75 to 100 mg) are most commonly used for primary prevention.  
b. Low-dose aspirin regimens exceed the minimum dose required for complete COX-1 blockade.
c. The risk of bleeding complications from low-dose ASA is unchanged by the concomitant use of non-selective nonsteroidal anti-inflammatory drugs.
d. Twice-daily low-dose ASA administration provides more effective platelet inhibition in patients with diabetes mellitus.

 

You answered A. Your answer was incorrect. C is the correct answer.

EXPLANATION: The risk of bleeding complications from ASA is increased when other NSAIDs are also used, and those NSAIDs actually reduce whatever primary prevention benefit might accrue to ASA.

9. Which of the following statements about ASA therapy in primary prevention is NOT correct?

a. Enteric-coated oral formulations of low-dose aspirin (e.g., 75 to 100 mg) are most commonly used for primary prevention.  
b. Low-dose aspirin regimens exceed the minimum dose required for complete COX-1 blockade.
c. The risk of bleeding complications from low-dose ASA is unchanged by the concomitant use of non-selective nonsteroidal anti-inflammatory drugs.
d. Twice-daily low-dose ASA administration provides more effective platelet inhibition in patients with diabetes mellitus.

 

You answered B. Your answer was incorrect. C is the correct answer.

EXPLANATION: The risk of bleeding complications from ASA is increased when other NSAIDs are also used, and those NSAIDs actually reduce whatever primary prevention benefit might accrue to ASA.

9. Which of the following statements about ASA therapy in primary prevention is NOT correct?

a. Enteric-coated oral formulations of low-dose aspirin (e.g., 75 to 100 mg) are most commonly used for primary prevention.  
b. Low-dose aspirin regimens exceed the minimum dose required for complete COX-1 blockade.
c. The risk of bleeding complications from low-dose ASA is unchanged by the concomitant use of non-selective nonsteroidal anti-inflammatory drugs.
d. Twice-daily low-dose ASA administration provides more effective platelet inhibition in patients with diabetes mellitus.

 

You answered C. Your answer was correct!

EXPLANATION: The risk of bleeding complications from ASA is increased when other NSAIDs are also used, and those NSAIDs actually reduce whatever primary prevention benefit might accrue to ASA.

9. Which of the following statements about ASA therapy in primary prevention is NOT correct?

a. Enteric-coated oral formulations of low-dose aspirin (e.g., 75 to 100 mg) are most commonly used for primary prevention.  
b. Low-dose aspirin regimens exceed the minimum dose required for complete COX-1 blockade.
c. The risk of bleeding complications from low-dose ASA is unchanged by the concomitant use of non-selective nonsteroidal anti-inflammatory drugs.
d. Twice-daily low-dose ASA administration provides more effective platelet inhibition in patients with diabetes mellitus.

 

You answered D. Your answer was incorrect. C is the correct answer.

EXPLANATION: The risk of bleeding complications from ASA is increased when other NSAIDs are also used, and those NSAIDs actually reduce whatever primary prevention benefit might accrue to ASA.

10. Which of the following statements about historical trials of primary prevention with ASA is NOT true?

a. Heterogeneity in the dosing regimen and populations studied contribute to difficulties generalizing these data.
b. Reductions in the rate of serious vascular events attributable to primary prevention with ASA were mostly driven by a reduction in MI.
c. Reduction in ischemic benefit events from primary prevention with ASA was largely counterbalanced by an increase in major bleeding and hemorrhagic stroke.
d. All-cause mortality was consistently reduced with primary prevention with ASA in these early studies.

 

You answered A. Your answer was incorrect. D is the correct answer.

EXPLANATION: Statements (a), (b), and (c) are true of the early primary prevention studies of ASA. There was never a demonstration in those studies of a significant decrease in all-cause mortality.

10. Which of the following statements about historical trials of primary prevention with ASA is NOT true?

a. Heterogeneity in the dosing regimen and populations studied contribute to difficulties generalizing these data.
b. Reductions in the rate of serious vascular events attributable to primary prevention with ASA were mostly driven by a reduction in MI.
c. Reduction in ischemic benefit events from primary prevention with ASA was largely counterbalanced by an increase in major bleeding and hemorrhagic stroke.
d. All-cause mortality was consistently reduced with primary prevention with ASA in these early studies.

 

You answered B. Your answer was incorrect. D is the correct answer.

EXPLANATION: Statements (a), (b), and (c) are true of the early primary prevention studies of ASA. There was never a demonstration in those studies of a significant decrease in all-cause mortality.

10. Which of the following statements about historical trials of primary prevention with ASA is NOT true?

a. Heterogeneity in the dosing regimen and populations studied contribute to difficulties generalizing these data.
b. Reductions in the rate of serious vascular events attributable to primary prevention with ASA were mostly driven by a reduction in MI.
c. Reduction in ischemic benefit events from primary prevention with ASA was largely counterbalanced by an increase in major bleeding and hemorrhagic stroke.
d. All-cause mortality was consistently reduced with primary prevention with ASA in these early studies.

 

You answered C. Your answer was incorrect. D is the correct answer.

EXPLANATION: Statements (a), (b), and (c) are true of the early primary prevention studies of ASA. There was never a demonstration in those studies of a significant decrease in all-cause mortality.

10. Which of the following statements about historical trials of primary prevention with ASA is NOT true?

a. Heterogeneity in the dosing regimen and populations studied contribute to difficulties generalizing these data.
b. Reductions in the rate of serious vascular events attributable to primary prevention with ASA were mostly driven by a reduction in MI.
c. Reduction in ischemic benefit events from primary prevention with ASA was largely counterbalanced by an increase in major bleeding and hemorrhagic stroke.
d. All-cause mortality was consistently reduced with primary prevention with ASA in these early studies.

 

You answered D. Your answer was correct!

EXPLANATION: Statements (a), (b), and (c) are true of the early primary prevention studies of ASA. There was never a demonstration in those studies of a significant decrease in all-cause mortality.

11. Three signal studies were published in 2018 that shed new light on the net clinical benefit of ASA in primary prevention of CV events. These were:

a. ACUITY, ABOARD, ABSORB
b. ARRIVE, ASCEND, ASPREE
c. ASPREE, ACCORD, ACTIVATE
d. ASCEND, ACTION, APEX

 

You answered A. Your answer was incorrect. B is the correct answer.

EXPLANATION: Only choice (b) is correct. ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events; ASCEND = A Study of Cardiovascular Events in Diabetes; ASPREE = Aspirin in Reducing Events in the Elderly.

11. Three signal studies were published in 2018 that shed new light on the net clinical benefit of ASA in primary prevention of CV events. These were:

a. ACUITY, ABOARD, ABSORB
b. ARRIVE, ASCEND, ASPREE
c. ASPREE, ACCORD, ACTIVATE
d. ASCEND, ACTION, APEX

 

You answered B. Your answer was correct!

EXPLANATION: Only choice (b) is correct. ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events; ASCEND = A Study of Cardiovascular Events in Diabetes; ASPREE = Aspirin in Reducing Events in the Elderly.

11. Three signal studies were published in 2018 that shed new light on the net clinical benefit of ASA in primary prevention of CV events. These were:

a. ACUITY, ABOARD, ABSORB
b. ARRIVE, ASCEND, ASPREE
c. ASPREE, ACCORD, ACTIVATE
d. ASCEND, ACTION, APEX

 

You answered C. Your answer was incorrect. B is the correct answer.

EXPLANATION: Only choice (b) is correct. ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events; ASCEND = A Study of Cardiovascular Events in Diabetes; ASPREE = Aspirin in Reducing Events in the Elderly.

11. Three signal studies were published in 2018 that shed new light on the net clinical benefit of ASA in primary prevention of CV events. These were:

a. ACUITY, ABOARD, ABSORB
b. ARRIVE, ASCEND, ASPREE
c. ASPREE, ACCORD, ACTIVATE
d. ASCEND, ACTION, APEX

 

You answered D. Your answer was incorrect. B is the correct answer.

EXPLANATION: Only choice (b) is correct. ARRIVE = Aspirin to Reduce Risk of Initial Vascular Events; ASCEND = A Study of Cardiovascular Events in Diabetes; ASPREE = Aspirin in Reducing Events in the Elderly.

12. What pathophysiologic feature of diabetes mellitus is thought to result in relative resistance among diabetic patients to primary prevention with ASA?

a. High platelet turnover rates
b. Depression of megakaryocyte activity in the bone marrow
c. Elevated blood glucose levels
d. Higher baseline thrombin levels

 

You answered A. Your answer was correct!

EXPLANATION: Only choice (a) contributes to ASA “resistance.” ASA binds noncompetitively to platelets but in diabetics, new “crops” of platelets are released more often, reducing the ability of ASA to inhibit all of them.

12. What pathophysiologic feature of diabetes mellitus is thought to result in relative resistance among diabetic patients to primary prevention with ASA?

a. High platelet turnover rates
b. Depression of megakaryocyte activity in the bone marrow
c. Elevated blood glucose levels
d. Higher baseline thrombin levels

 

You answered B. Your answer was incorrect. A is the correct answer.

EXPLANATION: Only choice (a) contributes to ASA “resistance.” ASA binds noncompetitively to platelets but in diabetics, new “crops” of platelets are released more often, reducing the ability of ASA to inhibit all of them.

12. What pathophysiologic feature of diabetes mellitus is thought to result in relative resistance among diabetic patients to primary prevention with ASA?

a. High platelet turnover rates
b. Depression of megakaryocyte activity in the bone marrow
c. Elevated blood glucose levels
d. Higher baseline thrombin levels

 

You answered C. Your answer was incorrect. A is the correct answer.

EXPLANATION: Only choice (a) contributes to ASA “resistance.” ASA binds noncompetitively to platelets but in diabetics, new “crops” of platelets are released more often, reducing the ability of ASA to inhibit all of them.

12. What pathophysiologic feature of diabetes mellitus is thought to result in relative resistance among diabetic patients to primary prevention with ASA?

a. High platelet turnover rates
b. Depression of megakaryocyte activity in the bone marrow
c. Elevated blood glucose levels
d. Higher baseline thrombin levels

 

You answered D. Your answer was incorrect. A is the correct answer.

EXPLANATION: Only choice (a) contributes to ASA “resistance.” ASA binds noncompetitively to platelets but in diabetics, new “crops” of platelets are released more often, reducing the ability of ASA to inhibit all of them.

13. Which of the following issues might have limited the ability of the three large trials released in 2018 to detect a net clinical benefit for ASA in primary prevention?

a. Suboptimal identification of baseline risk
b. Length of follow-up perhaps too short
c. Qualifying age perhaps too young
d. a & b

You answered A. Your answer was incorrect. D is the correct answer. 

EXPLANATION: In general in those three trials, there was evidence-supported risk stratification, and the follow-up interval was sufficiently long to identify an effect.

13. Which of the following issues might have limited the ability of the three large trials released in 2018 to detect a net clinical benefit for ASA in primary prevention?

a. Suboptimal identification of baseline risk
b. Length of follow-up perhaps too short
c. Qualifying age perhaps too young
d. a & b

You answered B. Your answer was incorrect. D is the correct answer. 

EXPLANATION: In general in those three trials, there was evidence-supported risk stratification, and the follow-up interval was sufficiently long to identify an effect.

13. Which of the following issues might have limited the ability of the three large trials released in 2018 to detect a net clinical benefit for ASA in primary prevention?

a. Suboptimal identification of baseline risk
b. Length of follow-up perhaps too short
c. Qualifying age perhaps too young
d. a & b

You answered C. Your answer was incorrect. D is the correct answer. 

EXPLANATION: In general in those three trials, there was evidence-supported risk stratification, and the follow-up interval was sufficiently long to identify an effect.

13. Which of the following issues might have limited the ability of the three large trials released in 2018 to detect a net clinical benefit for ASA in primary prevention?

a. Suboptimal identification of baseline risk
b. Length of follow-up perhaps too short
c. Qualifying age perhaps too young
d. a & b

You answered D. Your answer was correct!

EXPLANATION: In general in those three trials, there was evidence-supported risk stratification, and the follow-up interval was sufficiently long to identify an effect.

14. Which of the following statements about the reasoning behind de-escalation of DAPT in secondary prevention is NOT correct?

a. With contemporary stents, the process of coronary artery re-endothelialization requires about a year in typical patients.
b. Stent platforms have improved, making drug-eluting stents (DES) safer to deliver.
c. Implanting techniques have been improved with intracoronary imaging modalities.
d. Extended DAPT exposes patients to an increased risk of bleeding.

 

You answered A. Your answer was correct!

EXPLANATION: Contemporary stents re-endotheliaze much more quickly than earlier generations of stent.

14. Which of the following statements about the reasoning behind de-escalation of DAPT in secondary prevention is NOT correct?

a. With contemporary stents, the process of coronary artery re-endothelialization requires about a year in typical patients.
b. Stent platforms have improved, making drug-eluting stents (DES) safer to deliver.
c. Implanting techniques have been improved with intracoronary imaging modalities.
d. Extended DAPT exposes patients to an increased risk of bleeding.

 

You answered B. Your answer was incorrect. A is the correct answer. 

EXPLANATION: Contemporary stents re-endotheliaze much more quickly than earlier generations of stent.

14. Which of the following statements about the reasoning behind de-escalation of DAPT in secondary prevention is NOT correct?

a. With contemporary stents, the process of coronary artery re-endothelialization requires about a year in typical patients.
b. Stent platforms have improved, making drug-eluting stents (DES) safer to deliver.
c. Implanting techniques have been improved with intracoronary imaging modalities.
d. Extended DAPT exposes patients to an increased risk of bleeding.

 

You answered C. Your answer was incorrect. A is the correct answer. 

EXPLANATION: Contemporary stents re-endotheliaze much more quickly than earlier generations of stent.

14. Which of the following statements about the reasoning behind de-escalation of DAPT in secondary prevention is NOT correct?

a. With contemporary stents, the process of coronary artery re-endothelialization requires about a year in typical patients.
b. Stent platforms have improved, making drug-eluting stents (DES) safer to deliver.
c. Implanting techniques have been improved with intracoronary imaging modalities.
d. Extended DAPT exposes patients to an increased risk of bleeding.

 

You answered D. Your answer was incorrect. A is the correct answer. 

EXPLANATION: Contemporary stents re-endotheliaze much more quickly than earlier generations of stent.

15. Which of the following options for de-escalation of DAPT in secondary prevention has not yet been studied in a completed trial?

a. Switching from the ticagrelor or prasugrel to either a lower dose or to clopidogrel, while maintaining ASA.
b. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping the P2Y12 inhibitor.
c. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping ASA.
d. Discontinuing ASA at discharge from the index hospitalization.

 

You answered A. Your answer was incorrect! D is the correct answer. 

EXPLANATION: The value of DAPT for the first few months after an intervention remains largely unquestioned. A study of no ASA after index hospital discharge is not yet seriously contemplated.

15. Which of the following options for de-escalation of DAPT in secondary prevention has not yet been studied in a completed trial?

a. Switching from the ticagrelor or prasugrel to either a lower dose or to clopidogrel, while maintaining ASA.
b. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping the P2Y12 inhibitor.
c. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping ASA.
d. Discontinuing ASA at discharge from the index hospitalization.

 

You answered B. Your answer was incorrect! D is the correct answer. 

EXPLANATION: The value of DAPT for the first few months after an intervention remains largely unquestioned. A study of no ASA after index hospital discharge is not yet seriously contemplated.

15. Which of the following options for de-escalation of DAPT in secondary prevention has not yet been studied in a completed trial?

a. Switching from the ticagrelor or prasugrel to either a lower dose or to clopidogrel, while maintaining ASA.
b. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping the P2Y12 inhibitor.
c. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping ASA.
d. Discontinuing ASA at discharge from the index hospitalization.

 

You answered C. Your answer was incorrect! D is the correct answer. 

EXPLANATION: The value of DAPT for the first few months after an intervention remains largely unquestioned. A study of no ASA after index hospital discharge is not yet seriously contemplated.

15. Which of the following options for de-escalation of DAPT in secondary prevention has not yet been studied in a completed trial?

a. Switching from the ticagrelor or prasugrel to either a lower dose or to clopidogrel, while maintaining ASA.
b. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping the P2Y12 inhibitor.
c. Changing DAPT to a single antiplatelet earlier than 6-12 months after the PCI procedure, by stopping ASA.
d. Discontinuing ASA at discharge from the index hospitalization.

 

You answered D. Your answer was correct!

EXPLANATION: The value of DAPT for the first few months after an intervention remains largely unquestioned. A study of no ASA after index hospital discharge is not yet seriously contemplated.

16. Laboratory testing-guided de-escalation of DAPT in secondary prevention has been studied using:

a. Platelet function testing
b. CYP2C19 genotype
c. P-selectin, hsC-reactive protein, and peak troponin during index hospitalization
d. a and b

 

You answered A. Your answer was incorrect. D is the correct answer. 

EXPLANATION: The markers listed in (c) have not been studied as, and are not currently considered as, markers that might signal the safety of DAPT de-escalation.

16. Laboratory testing-guided de-escalation of DAPT in secondary prevention has been studied using:

a. Platelet function testing
b. CYP2C19 genotype
c. P-selectin, hsC-reactive protein, and peak troponin during index hospitalization
d. a and b

 

You answered B. Your answer was incorrect. D is the correct answer. 

EXPLANATION: The markers listed in (c) have not been studied as, and are not currently considered as, markers that might signal the safety of DAPT de-escalation.

16. Laboratory testing-guided de-escalation of DAPT in secondary prevention has been studied using:

a. Platelet function testing
b. CYP2C19 genotype
c. P-selectin, hsC-reactive protein, and peak troponin during index hospitalization
d. a and b

 

You answered C. Your answer was incorrect. D is the correct answer. 

EXPLANATION: The markers listed in (c) have not been studied as, and are not currently considered as, markers that might signal the safety of DAPT de-escalation.

16. Laboratory testing-guided de-escalation of DAPT in secondary prevention has been studied using:

a. Platelet function testing
b. CYP2C19 genotype
c. P-selectin, hsC-reactive protein, and peak troponin during index hospitalization
d. a and b

 

You answered D. Your answer was correct!

EXPLANATION: The markers listed in (c) have not been studied as, and are not currently considered as, markers that might signal the safety of DAPT de-escalation.

17. Which of the following has NOT been one of the typical endpoints in de-escalation trials?

a. BARC bleeding scale
b. Cardiovascular or all-cause mortality
c. Health-related quality of life
d. Stent thrombosis

 

You answered A. Your answer was incorrect. C was the correct answer.

EXPLANATION: We are still at the “hard endpoint” stage of evaluating approaches to de-escalation of DAPT. Those endpoints in (a), (b), and (d) have all been studied.

17. Which of the following has NOT been one of the typical endpoints in de-escalation trials?

a. BARC bleeding scale
b. Cardiovascular or all-cause mortality
c. Health-related quality of life
d. Stent thrombosis

 

You answered B. Your answer was incorrect. C was the correct answer.

EXPLANATION: We are still at the “hard endpoint” stage of evaluating approaches to de-escalation of DAPT. Those endpoints in (a), (b), and (d) have all been studied.

17. Which of the following has NOT been one of the typical endpoints in de-escalation trials?

a. BARC bleeding scale
b. Cardiovascular or all-cause mortality
c. Health-related quality of life
d. Stent thrombosis

 

You answered C. Your answer was correct!

EXPLANATION: We are still at the “hard endpoint” stage of evaluating approaches to de-escalation of DAPT. Those endpoints in (a), (b), and (d) have all been studied.

17. Which of the following has NOT been one of the typical endpoints in de-escalation trials?

a. BARC bleeding scale
b. Cardiovascular or all-cause mortality
c. Health-related quality of life
d. Stent thrombosis

 

You answered D. Your answer was incorrect. The correct answer is C.

EXPLANATION: We are still at the “hard endpoint” stage of evaluating approaches to de-escalation of DAPT. Those endpoints in (a), (b), and (d) have all been studied.

18. Which of the following characteristics has NOT been validated as a guide to timing of de-escalation of DAPT in secondary prevention?

a. Whether or not the stent was placed for ACS
b. Complexity of PCI
c. Patient’s fall risk
d. Relative evaluation of bleeding vs ischemic risk

You answered A. Your answer was incorrect. C was the correct answer.

EXPLANATION: While fall risk is typically considered a concern for bleeding risk in anticoagulation studies (particularly in elderly patients with atrial fibrillation), it is inexact and has not been proposed as a reason to de-escalate DAPT.

18. Which of the following characteristics has NOT been validated as a guide to timing of de-escalation of DAPT in secondary prevention?

a. Whether or not the stent was placed for ACS
b. Complexity of PCI
c. Patient’s fall risk
d. Relative evaluation of bleeding vs ischemic risk

You answered B. Your answer was incorrect. C was the correct answer.

EXPLANATION: While fall risk is typically considered a concern for bleeding risk in anticoagulation studies (particularly in elderly patients with atrial fibrillation), it is inexact and has not been proposed as a reason to de-escalate DAPT.

18. Which of the following characteristics has NOT been validated as a guide to timing of de-escalation of DAPT in secondary prevention?

a. Whether or not the stent was placed for ACS
b. Complexity of PCI
c. Patient’s fall risk
d. Relative evaluation of bleeding vs ischemic risk

You answered C. Your answer was the correct answer.

EXPLANATION: While fall risk is typically considered a concern for bleeding risk in anticoagulation studies (particularly in elderly patients with atrial fibrillation), it is inexact and has not been proposed as a reason to de-escalate DAPT.

18. Which of the following characteristics has NOT been validated as a guide to timing of de-escalation of DAPT in secondary prevention?

a. Whether or not the stent was placed for ACS
b. Complexity of PCI
c. Patient’s fall risk
d. Relative evaluation of bleeding vs ischemic risk

You answered D. Your answer was incorrect. C was the correct answer.

EXPLANATION: While fall risk is typically considered a concern for bleeding risk in anticoagulation studies (particularly in elderly patients with atrial fibrillation), it is inexact and has not been proposed as a reason to de-escalate DAPT.

19. Which approach to safe and effective stroke prevention is atrial fibrillation is supported by the most robust data?

a. NOACs (non-vitamin K-antagonist oral anticoagulants)

b. Warfarin

c. Clopidogrel

d. Clopidogrel + aspirin

 

You answered A. Your answer was the correct answer. 

EXPLANATION: NOACs (also called DOACs—direct-acting oral anticoagulants) are considered a pharmacologic advance over warfarin, and many studies over the years have shown superiority of anticoagulation over antiplatelets for stroke prevention in atrial fibrillation.

19. Which approach to safe and effective stroke prevention is atrial fibrillation is supported by the most robust data?

a. NOACs (non-vitamin K-antagonist oral anticoagulants)

b. Warfarin

c. Clopidogrel

d. Clopidogrel + aspirin

 

You answered B. Your answer was the incorrect answer. The correct answer is A.

EXPLANATION: NOACs (also called DOACs—direct-acting oral anticoagulants) are considered a pharmacologic advance over warfarin, and many studies over the years have shown superiority of anticoagulation over antiplatelets for stroke prevention in atrial fibrillation.

19. Which approach to safe and effective stroke prevention is atrial fibrillation is supported by the most robust data?

a. NOACs (non-vitamin K-antagonist oral anticoagulants)

b. Warfarin

c. Clopidogrel

d. Clopidogrel + aspirin

 

You answered C. Your answer was the incorrect answer. The correct answer is A.

EXPLANATION: NOACs (also called DOACs—direct-acting oral anticoagulants) are considered a pharmacologic advance over warfarin, and many studies over the years have shown superiority of anticoagulation over antiplatelets for stroke prevention in atrial fibrillation.

19. Which approach to safe and effective stroke prevention is atrial fibrillation is supported by the most robust data?

a. NOACs (non-vitamin K-antagonist oral anticoagulants)

b. Warfarin

c. Clopidogrel

d. Clopidogrel + aspirin

 

You answered D. Your answer was the incorrect answer. The correct answer is A.

EXPLANATION: NOACs (also called DOACs—direct-acting oral anticoagulants) are considered a pharmacologic advance over warfarin, and many studies over the years have shown superiority of anticoagulation over antiplatelets for stroke prevention in atrial fibrillation.

20. Which of the following trials of de-escalation of triple oral antithrombotic therapy to dual therapy in patients with atrial fibrillation undergoing PCI showed triple therapy to be safer?
a. WOEST
b. PIONEER AF-PCI
c. AUGUSTUS
d. None of the above

 

You answered A. Your answer was incorrect. The correct answer is D.

EXPLANATION: In evaluating safety of so-called “triple oral antithrombotic therapy” (TOAT) in patients with AFib + PCI, triple therapy has never been found to be superior to double therapy.

20. Which of the following trials of de-escalation of triple oral antithrombotic therapy to dual therapy in patients with atrial fibrillation undergoing PCI showed triple therapy to be safer?
a. WOEST
b. PIONEER AF-PCI
c. AUGUSTUS
d. None of the above

 

You answered B. Your answer was incorrect. The correct answer is D.

EXPLANATION: In evaluating safety of so-called “triple oral antithrombotic therapy” (TOAT) in patients with AFib + PCI, triple therapy has never been found to be superior to double therapy.

20. Which of the following trials of de-escalation of triple oral antithrombotic therapy to dual therapy in patients with atrial fibrillation undergoing PCI showed triple therapy to be safer?
a. WOEST
b. PIONEER AF-PCI
c. AUGUSTUS
d. None of the above

 

You answered C. Your answer was incorrect. The correct answer is D.

EXPLANATION: In evaluating safety of so-called “triple oral antithrombotic therapy” (TOAT) in patients with AFib + PCI, triple therapy has never been found to be superior to double therapy.

20. Which of the following trials of de-escalation of triple oral antithrombotic therapy to dual therapy in patients with atrial fibrillation undergoing PCI showed triple therapy to be safer?
a. WOEST
b. PIONEER AF-PCI
c. AUGUSTUS
d. None of the above

 

You answered D. Your answer was correct.

 

EXPLANATION: In evaluating safety of so-called “triple oral antithrombotic therapy” (TOAT) in patients with AFib + PCI, triple therapy has never been found to be superior to double therapy.

21. Which of the following statements is NOT TRUE regarding the AUGUSTUS trial?

a. AUGUSTUS compared regimens with both VKA and apixaban in a 2x2 factorial design to either apixaban or VKA, and then to either a P2Y 12 inhibitor with ASA or placebo
b. For ASA vs placebo, the risk of bleeding only started after 30 days
c. The primary endpoint of ISTH major bleeding and clinically relevant non-major bleeding was reduced with apixaban compared to VKA.
d. AUGUSTUS was a study of AFib patients who underwent PCI or had ACS.

You answered A. Your answer was incorrect. The correct answer is B.

EXPLANATION: The risk of bleeding in AUGUSTUS attributable to ASA over placebo was evident very early after
randomization; remember this was not, however, ASA monotherapy.

21. Which of the following statements is NOT TRUE regarding the AUGUSTUS trial?

a. AUGUSTUS compared regimens with both VKA and apixaban in a 2x2 factorial design to either apixaban or VKA, and then to either a P2Y 12 inhibitor with ASA or placebo
b. For ASA vs placebo, the risk of bleeding only started after 30 days
c. The primary endpoint of ISTH major bleeding and clinically relevant non-major bleeding was reduced with apixaban compared to VKA.
d. AUGUSTUS was a study of AFib patients who underwent PCI or had ACS.

You answered B. Your answer was correct.

EXPLANATION: The risk of bleeding in AUGUSTUS attributable to ASA over placebo was evident very early after randomization; remember this was not, however, ASA monotherapy.

21. Which of the following statements is NOT TRUE regarding the AUGUSTUS trial?

a. AUGUSTUS compared regimens with both VKA and apixaban in a 2x2 factorial design to either apixaban or VKA, and then to either a P2Y 12 inhibitor with ASA or placebo
b. For ASA vs placebo, the risk of bleeding only started after 30 days
c. The primary endpoint of ISTH major bleeding and clinically relevant non-major bleeding was reduced with apixaban compared to VKA.
d. AUGUSTUS was a study of AFib patients who underwent PCI or had ACS.

You answered C. Your answer was incorrect. The correct answer is B.

EXPLANATION: The risk of bleeding in AUGUSTUS attributable to ASA over placebo was evident very early after randomization; remember this was not, however, ASA monotherapy.

21. Which of the following statements is NOT TRUE regarding the AUGUSTUS trial?

a. AUGUSTUS compared regimens with both VKA and apixaban in a 2x2 factorial design to either apixaban or VKA, and then to either a P2Y 12 inhibitor with ASA or placebo
b. For ASA vs placebo, the risk of bleeding only started after 30 days
c. The primary endpoint of ISTH major bleeding and clinically relevant non-major bleeding was reduced with apixaban compared to VKA.
d. AUGUSTUS was a study of AFib patients who underwent PCI or had ACS.

You answered D. Your answer was incorrect. The correct answer is B.

EXPLANATION: The risk of bleeding in AUGUSTUS attributable to ASA over placebo was evident very early after randomization; remember this was not, however, ASA monotherapy.

22. The one large trial that did NOT show a statistically significant lower rate of bleeding with de-escalation in antithrombotic therapy for patients with AF plus PCI was
a. ENTRUST AF-PCI
b. PIONEER AF-PCI
c. AUGUSTUS
d. RE-DUAL PCI

 You answered A. That is the correct answer.

EXPLANATION: The ENTRUST-AF PCI trial showed that edoxaban/clopidogrel was noninferior to warfarin-based triple therapy for bleeding, with similar ischemic outcomes. The results were the same among those with either acute or chronic coronary disease. This is the only trial with a novel oral anticoagulant that did not
show superiority for bleeding compared with a vitamin K antagonist-based strategy.

22. The one large trial that did NOT show a statistically significant lower rate of bleeding with de-escalation in antithrombotic therapy for patients with AF plus PCI was
a. ENTRUST AF-PCI
b. PIONEER AF-PCI
c. AUGUSTUS
d. RE-DUAL PCI

 You answered b. That is the incorrect answer. A is the correct answer.

EXPLANATION: The ENTRUST-AF PCI trial showed that edoxaban/clopidogrel was noninferior to warfarin-based triple therapy for bleeding, with similar ischemic outcomes. The results were the same among those with either acute or chronic coronary disease. This is the only trial with a novel oral anticoagulant that did not
show superiority for bleeding compared with a vitamin K antagonist-based strategy.

22. The one large trial that did NOT show a statistically significant lower rate of bleeding with de-escalation in antithrombotic therapy for patients with AF plus PCI was
a. ENTRUST AF-PCI
b. PIONEER AF-PCI
c. AUGUSTUS
d. RE-DUAL PCI

 You answered C. That is the incorrect answer. A is the correct answer.

EXPLANATION: The ENTRUST-AF PCI trial showed that edoxaban/clopidogrel was noninferior to warfarin-based triple therapy for bleeding, with similar ischemic outcomes. The results were the same among those with either acute or chronic coronary disease. This is the only trial with a novel oral anticoagulant that did not
show superiority for bleeding compared with a vitamin K antagonist-based strategy.

22. The one large trial that did NOT show a statistically significant lower rate of bleeding with de-escalation in antithrombotic therapy for patients with AF plus PCI was
a. ENTRUST AF-PCI
b. PIONEER AF-PCI
c. AUGUSTUS
d. RE-DUAL PCI

 You answered D. That is the incorrect answer. A is the correct answer.

EXPLANATION: The ENTRUST-AF PCI trial showed that edoxaban/clopidogrel was noninferior to warfarin-based triple therapy for bleeding, with similar ischemic outcomes. The results were the same among those with either acute or chronic coronary disease. This is the only trial with a novel oral anticoagulant that did not
show superiority for bleeding compared with a vitamin K antagonist-based strategy.

23. The primary endpoint of clinically significant bleeding in PIONEER AF-PCI was highest in which cohort?

a. Rivaroxaban 15 mg plus P2Y12 inhibitor
b. Rivaroxaban 2.5 mg two times per day plus P2Y 12 inhibitor and ASA
c. Vitamin K antagonist plus a P2Y 12 inhibitor and ASA
d. The three cohorts were indistinguishable with regards to bleeding risk

You answered A. That is the incorrect answer. C is the correct answer.

EXPLANATION: Triple antithrombotic therapy with warfarin + ASA + a P2Y 12 carried the highest risk of clinically significant bleeding in PIONEER AF-PCI.

23. The primary endpoint of clinically significant bleeding in PIONEER AF-PCI was highest in which cohort?

a. Rivaroxaban 15 mg plus P2Y12 inhibitor
b. Rivaroxaban 2.5 mg two times per day plus P2Y 12 inhibitor and ASA
c. Vitamin K antagonist plus a P2Y 12 inhibitor and ASA
d. The three cohorts were indistinguishable with regards to bleeding risk

You answered B. That is the incorrect answer. C is the correct answer.

EXPLANATION: Triple antithrombotic therapy with warfarin + ASA + a P2Y 12 carried the highest risk of clinically significant bleeding in PIONEER AF-PCI.

23. The primary endpoint of clinically significant bleeding in PIONEER AF-PCI was highest in which cohort?

a. Rivaroxaban 15 mg plus P2Y12 inhibitor
b. Rivaroxaban 2.5 mg two times per day plus P2Y 12 inhibitor and ASA
c. Vitamin K antagonist plus a P2Y 12 inhibitor and ASA
d. The three cohorts were indistinguishable with regards to bleeding risk

You answered C. That is the correct answer.

EXPLANATION: Triple antithrombotic therapy with warfarin + ASA + a P2Y 12 carried the highest risk of clinically significant bleeding in PIONEER AF-PCI.

23. The primary endpoint of clinically significant bleeding in PIONEER AF-PCI was highest in which cohort?

a. Rivaroxaban 15 mg plus P2Y12 inhibitor
b. Rivaroxaban 2.5 mg two times per day plus P2Y 12 inhibitor and ASA
c. Vitamin K antagonist plus a P2Y 12 inhibitor and ASA
d. The three cohorts were indistinguishable with regards to bleeding risk

You answered D. That is the incorrect answer. C is the correct answer.

EXPLANATION: Triple antithrombotic therapy with warfarin + ASA + a P2Y 12 carried the highest risk of clinically significant bleeding in PIONEER AF-PCI.

24. The most common major bleeding complication from aspirin is

a. Intracranial
b. Genitourinary
c. Gastrointestinal
d. Intraocular

You answered A. This answer is incorrect. C is the correct answer.

EXPLANATION: While intracranial bleeding is the most-feared complication of ASA therapy, it is fortunately
much less common than GI bleeding.

24. The most common major bleeding complication from aspirin is

a. Intracranial
b. Genitourinary
c. Gastrointestinal
d. Intraocular

You answered B. This answer is incorrect. C is the correct answer.

EXPLANATION: While intracranial bleeding is the most-feared complication of ASA therapy, it is fortunately
much less common than GI bleeding.

24. The most common major bleeding complication from aspirin is

a. Intracranial
b. Genitourinary
c. Gastrointestinal
d. Intraocular

You answered C. This answer is correct.

EXPLANATION: While intracranial bleeding is the most-feared complication of ASA therapy, it is fortunately
much less common than GI bleeding.

24. The most common major bleeding complication from aspirin is

a. Intracranial
b. Genitourinary
c. Gastrointestinal
d. Intraocular

You answered D. This answer is correct.

EXPLANATION: While intracranial bleeding is the most-feared complication of ASA therapy, it is fortunately
much less common than GI bleeding.

25. All of the following are potential approaches tested or being studied to reduce the gastrotoxicity of ASA EXCEPT:
a. Encasing oral ASA in a lipid envelope
b. Coadministration of a proton pump inhibitor
c. Administration of ASA by inhalation
d. Administration of ASA by subcutaneous injection

You answered a, that is incorrect. The correct answer is D.

EXPLANATION: Choices (a), (b), and (c) have all shown some benefit in reducing gastrotoxicity. Alternative administration routes for ASA—including inhalational--are being evaluated, but SQ ASA has not yet been adequately studied.

25. All of the following are potential approaches tested or being studied to reduce the gastrotoxicity of ASA EXCEPT:
a. Encasing oral ASA in a lipid envelope
b. Coadministration of a proton pump inhibitor
c. Administration of ASA by inhalation
d. Administration of ASA by subcutaneous injection

You answered B, that is incorrect. The correct answer is D.

EXPLANATION: Choices (a), (b), and (c) have all shown some benefit in reducing gastrotoxicity. Alternative administration routes for ASA—including inhalational--are being evaluated, but SQ ASA has not yet been adequately studied.

25. All of the following are potential approaches tested or being studied to reduce the gastrotoxicity of ASA EXCEPT:
a. Encasing oral ASA in a lipid envelope
b. Coadministration of a proton pump inhibitor
c. Administration of ASA by inhalation
d. Administration of ASA by subcutaneous injection

You answered C, that is incorrect. The correct answer is D.

EXPLANATION: Choices (a), (b), and (c) have all shown some benefit in reducing gastrotoxicity. Alternative administration routes for ASA—including inhalational--are being evaluated, but SQ ASA has not yet been adequately studied.

25. All of the following are potential approaches tested or being studied to reduce the gastrotoxicity of ASA EXCEPT:
a. Encasing oral ASA in a lipid envelope
b. Coadministration of a proton pump inhibitor
c. Administration of ASA by inhalation
d. Administration of ASA by subcutaneous injection

You answered D, that is correct.

EXPLANATION: Choices (a), (b), and (c) have all shown some benefit in reducing gastrotoxicity. Alternative administration routes for ASA—including inhalational--are being evaluated, but SQ ASA has not yet been adequately studied.

26. Hospitalization for gastrointestinal bleeding was significantly lower with clopidogrel monotherapy than with ASA monotherapy in CAPRIE. What daily ASA dose was used in CAPRIE?
a. 75/81 mg
b. 150/162 mg
c. 325 mg
d. 75/81 mg twice daily

You answered A. That is incorrect. The correct answer is C.

EXPLANATION: The does of ASA in CAPRIE was 325mg, a rather high dose by today’s standards, and one certainly associated with increased bleeding risks over today’s lower doses.

26. Hospitalization for gastrointestinal bleeding was significantly lower with clopidogrel monotherapy than with ASA monotherapy in CAPRIE. What daily ASA dose was used in CAPRIE?
a. 75/81 mg
b. 150/162 mg
c. 325 mg
d. 75/81 mg twice daily

You answered B. That is incorrect. The correct answer is C.

EXPLANATION: The does of ASA in CAPRIE was 325mg, a rather high dose by today’s standards, and one certainly associated with increased bleeding risks over today’s lower doses.

26. Hospitalization for gastrointestinal bleeding was significantly lower with clopidogrel monotherapy than with ASA monotherapy in CAPRIE. What daily ASA dose was used in CAPRIE?
a. 75/81 mg
b. 150/162 mg
c. 325 mg
d. 75/81 mg twice daily

You answered C. That is correct. The correct answer is C.

EXPLANATION: The does of ASA in CAPRIE was 325mg, a rather high dose by today’s standards, and one certainly associated with increased bleeding risks over today’s lower doses.

26. Hospitalization for gastrointestinal bleeding was significantly lower with clopidogrel monotherapy than with ASA monotherapy in CAPRIE. What daily ASA dose was used in CAPRIE?
a. 75/81 mg
b. 150/162 mg
c. 325 mg
d. 75/81 mg twice daily

You answered D. That is incorrect. The correct answer is C.

EXPLANATION: The does of ASA in CAPRIE was 325mg, a rather high dose by today’s standards, and one certainly associated with increased bleeding risks over today’s lower doses.