A 70-Year-Old Man Comes to the Office Due to Palpitations

A 70-year-old man comes to the office due to palpitations.  He has felt an irregular and fast heartbeat on multiple occasions over the last month.  The patient has not had chest pain, dyspnea, dizziness, or weakness.  His medical history includes hypertension and type 2 diabetes mellitus.  Temperature is 36.7 C (98.1 F) , pulse is 102/min and irregular, blood pressure is 140/82 mm Hg, and respirations are 16/min.  Cardiopulmonary auscultation reveals clear lungs and no heart murmurs.  ECG shows an irregularly irregular rhythm with absent P waves.  The patient is started on metoprolol and apixaban.  Which of the following is likely to be directly affected as the result of this therapy?

A) Conversion of factor X to Xa
B) Conversion of fibrinogen to fibrin
C) Conversion of plasminogen to plasmin
D) Conversion of prothrombin to thrombin
E) Gamma-carboxylation of coagulation factors

Correct Answer:

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