273 - Deep Venous Thromboembolism and Pulmonary Thromboembolism Flashcards Preview

Harrison's Principles of Internal Medicine 20 > 273 - Deep Venous Thromboembolism and Pulmonary Thromboembolism > Flashcards

Flashcards in 273 - Deep Venous Thromboembolism and Pulmonary Thromboembolism Deck (20)
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1
Q

What are the common complications of PE and DVT? (3)

A

Chronic pulmonary HTN
Exertional dyspnea
Venous insufficiency

2
Q

What does the Virchow triad include?

A
  1. Venous stasis
  2. Hypercoagulability
  3. Endothelial damage
3
Q

What are the two common autosomal dominant mutation leading to prothrombotic states?

A
  1. Factor V Leiden

2. Prothrombin mutations

4
Q

What is the deficiency in Factor V Leiden?

A

Resistance to the endogenic anticoagulant - Protein C

5
Q

What is the deficiency in prothrombin mutations

A

increases prothrombin concentration in the plasma

6
Q

What is the common cause for acquired thrombophilia?

A

APLA (Anti Phospholipid Antibodies)

7
Q

Name some of the common risk factors for thromboembolism (5)

A
  1. Malignancy
  2. Obesity
  3. Smoking
  4. HTN
  5. COPD
8
Q

D-Dimer is very ____, but not _____ at all

A

Sensitive

Specific

9
Q

What are the common changes in ECG caused by PE? 4

A

S1Q3T3
sinus tachycardia
RBBB
Right axis

10
Q

______ is the main imaging test for PE

A

CT with contrast

11
Q

______ is the second line of imaging for PE patients who are intolerable for contrast fluid

A

Lung scan

12
Q

What are the 3 strategies for anticoagulation treatment?

A
  1. Parenteral heparin/ LMWH/ fondaparinux
  2. Parenteral treatment for 5 days followed by NOAC (edoxaban, dabigatran=Pradaxa)
  3. Monotherapy with rivaroxaban (Xarelto) / apixaban (Eliquis)
13
Q

What is the antidote for heparin / LMWH?

A

Protamine sulfate

14
Q

What is the antidote for dabigatran (Pradaxa)?

A

Idarucizumab

15
Q

In provoked thromboembolism treatment will last for __ months

A

3

16
Q

Cancer patients will be treated with LMWH for ____ or ____

A

Their entire life

Until the cancer is resolved

17
Q

In unprovoked thromboembolism treatment will last for __

A

The patient’s entire life

18
Q

IVC filters is given when: (2)

A
  1. Active bleeding which prevents anticoagulation

2. Recurrent venous thrombosis under pharmaceutical treatment

19
Q

_____ is the preferred drug for fibrinolysis in massive PE

A

tPA

20
Q

tPA is C/I in (3):

A
  1. Intracranial disease
  2. Recent surgery
  3. Trauma

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