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PHASE 2 cardio conditions > venous thromboembolism > Flashcards

venous thromboembolism Flashcards

1
Q

what is deep vein thrombosis

A

a blood clot that develops within a deep vein in the body, usually in the leg.

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2
Q

3 categories of causes of venous thrombosis

A
  1. circumstanstial
  2. genetic
  3. acquired
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3
Q

3 circumstantial causes of venous thrombosis

A

Surgery
Immobilisation
Long haul flights

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4
Q

2 genetic causes of venous thrombosis

A

Factor V Leiden
Antithrombin deficiency

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5
Q

2 acquired causes of venous thrombosis

A

Anti-phospholipid syndrome
Lupus anticoagulant

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6
Q

are symptoms and signs of DVT specific

A

no they are non specifc

clinical diagnosis is unreliable

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7
Q

symptoms of DVT

A

pain, swelling

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8
Q

signs of DVT

A

tenderness, swelling, warmth, decolourisation

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9
Q

risk factors of DVT

A
  1. Surgery, immobility, leg fracture, POP
  2. OC pill, HRT, pregnancy
  3. Long haul flights
  4. Inherited thrombophilia – genetic predisposition (Caucasian)
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10
Q

investigations for DVT

A
  1. D-dimer
  2. Ultrasound compression test
  3. venogram
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11
Q

does positive D dimer confirm diagnosis

A

no
Positive does not confirm diagnosis – surgery/ pregnancy/ infection can provide positive D-dimer (useless for inpatients in hospital)

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12
Q

what does ultrasound compresssio test

A

proximal veins

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13
Q

mechanical prevention of DVT

A

hydration and early mobilisation, compression stockings,
foot pumps

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14
Q

chemical prevention of DVT

A

LMW heparin

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15
Q

DVT treatment

A

Oral warfarin
LMW (low molecular weight) heparin
DOAC (direct oral anticoagulant)
Compression stockings
Treat underlying cause – malignancy, thrombophilia

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16
Q

what is Thromboprophylaxis

A

the prevention of clots forming in the veins.

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17
Q

what is pulmonary embolism

A

A blockage in one of the pulmonary arteries in your lungs, often caused by blood clots that travel to the lungs from the legs (DVTs)

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18
Q

when is a large PE signifcant

A

haemodynamically significant

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19
Q

complications of PE

A

Hypotension, cyanosis, severe dyspnoea, right heart strain/ failure

20
Q

differential diagnosis of PE

A

chest pain and shortness of breath

21
Q

symptoms of PE

A

Breathlessness
Pleuritic chest pain
Cyanosis
May have signs/ symptoms of DVT

22
Q

signs of PE

A

Tachycardia
Tachypnoea
Pleural rub
No signs of alternative diagnosis

23
Q

initial investgations for PE

A

CXR (chest X-ray) usually normal

ECG – sinus tachy

Blood gases: type 1 respiratory failure, decreased O2 and CO2

24
Q

further INVESTIGATIONS for PE

A

D-dimer: normal excludes diagnosis

Ventilation/ perfusion scan: mismatch defects

25
Q

Treatment for PE

A

Similar to treatment for DVT

  • LMW heparin
  • DOAC
  • Treat the cause
  • If cannot anti-coagulate, consider IVC filter (inferior vena cava)
26
Q

prevention for PE

A

Similar to prevention for DVT

Early mobilisation and hydration

Mechanical mobilisation – foot pumps

Chemical – LMW heparin

27
Q

define thrombosis

A

The formation of a blood clot in a blood vessel (blood coagulation).

28
Q

what is a thromboembolism

A

when a blood clot breaks loose and travels through the bloodstream it’s a thromboembolism

29
Q

describe thrombosis in artieral circulation

A

higher pressure – platelet rich

30
Q

describe thrombosis in venous circulation

A

low pressure – fibrin rich

31
Q

what happens if If an arterial thrombosis occurs in the coronary circulation

A

can lead to a myocardial infarction

32
Q

what happens if If an arterial thrombosis occurs in the cerebral circulation

A

stroke

33
Q

what happens if If an arterial thrombosis occurs in the peripheral circulation

A

peripheral vascular disease and gangrene.

34
Q

risk factos for athersclerosis

A

Smoking
Hypertension
Diabetes
Hyperlipidaemia
Obesity/ sedentary lifestyle
Stress/ type A personality

35
Q

how to diagnose MI

A

History
ECG
Cardiac enzymes

36
Q

how to diagnose CVA (cerebrovascular accident):

A

History and examination
CT scan/ MRI

37
Q

how to diagnose Peripheral vascular disease:

A

History and examination
Ultrasound
Angiogram

38
Q

MI treatment

A

Aspirin – inhibits platelet function
LMW heparin
Thrombolytic therapy

39
Q

stroke treatment

A

Aspirin or clopidogrel, tiglacor; anti-platelet

TPA (tissue plasminogen activator) – generates plasmin, degrades fibrin

Treat risk factor

40
Q

describe drug : heparin

A
  • Glycosaminoglycan
  • Binds to antithrombin and increases its activity
  • Indirect thrombin inhibitor
  • Given by continuous infusion
41
Q

describe drug : low molecular weight heparin

A
  • Smaller molecule, less variation in dose and renally excreted
  • Once daily, weight-adjusted dose given subcutaneously
  • Used for treatment and prophylaxis
42
Q

describe drug: aspirin

A
  • Inhibits cyclo-oxygenase irreversibly
  • Acts for lifetime of a platelet, 7-10 days
  • Inhibits thromboxane formation and hence platelet aggregation
43
Q

describe drug: warfarin

A
  • Prevents synthesis of active factors II, VII, IX and X
  • Antagonist of vitamin K
  • Prolongs the prothrombin time
  • Long half life – 36 hours
44
Q

describe drug: direct oral anticoagulant drugs

A
  • Orally active – like aspirin and warfarin
  • Directly acting on factor II and X
  • No blood tests or monitoring
  • Used for extended thromboprophylaxis
  • Not used in pregnancy
45
Q
A

PHASE 2 cardio conditions (20 decks)

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