AF Anticoagulation in CKD — PSA MCQ
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Correct answer: C — Calculate Cockcroft-Gault clearance using actual weight, then apply drug-specific criteria
C is correct. SPS recommends Cockcroft-Gault creatinine clearance for DOAC dosing because eGFR can overestimate renal function, particularly in older or low-weight adults; agent-specific criteria must then be applied. A uses the wrong renal estimate. B ignores low muscle mass and body size. D confuses indication-specific regimens. E is an unsupported class-wide prohibition: several DOACs have licensed AF regimens in renal impairment.
Reference: NHS Specialist Pharmacy Service: DOAC monitoring: https://www.sps.nhs.uk/monitorings/doacs-direct-oral-anticoagulants-monitoring/ GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map