NBME 22 Answers ↦
nbme22/Block 3/Question#12
An 82-year-old woman has been bedridden since ...
Carboxylation of precursor proteins🔍
An 82-year-old woman has been bedridden since ...
Carboxylation of precursor proteins🔍
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warfarin inhibits the synthesis of factors II, VII, IX, X, C, and S by blocking reduction of oxidized vitamin K. The enzyme Epoxide Reductase is inhibited by warfarin. The reduced (active) form of vit. K is a cofactor for gamma-glutamyl carboxylase.
Warfarin inhibits Vit K dependent synthesis of factors & proteins.
Vit K is necessary for the maturation of clotting factors II, VII, IX, X and protein C & S
So a drug that can inhibit the carboxylation of precursor proteins or in other words inhibit the maturation of the clotting factors will decrease the risk of thrombosis in this patient.
Why not PGI2 by way of ASA? Especially given other answer choices of proteins C + S: doesn't warfarin also suppress these?
imnotarobotbut
Protein C and S are ANTI-thrombotic, so although Warfarin does decrease them, they wouldn't decrease the patient's risk for thrombosis
+1
epr94
the question ask "suppression" of which one will decrease risk of thrombosis
if you suppress C and S which and anti-thrombotic you get thrombotic
+1
submitted by humble_station(53), 2019-09-26T23:38:26Z
Warfarin inhibits Vit K dependent synthesis of factors & proteins.
Vit K is necessary for the maturation of clotting factors II, VII, IX, X and protein C & S
So a drug that can inhibit the carboxylation of precursor proteins or in other words inhibit the maturation of the clotting factors will decrease the risk of thrombosis in this patient.