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Flashcards in 3 Anticoagulation - Consultant Deck (23):
1

Symoptoms of DVT

Pain
Leg swelling
Redness

2

if patient has eGFR

UFH

3

High risk surgeries include

Orthopadedic, hip and knee replacement, gynacological

4

After surgery continue thromboprophylaxis until

mobile or discharge

5

commonest way to diagnose a DVT?

colour duplex scan

6

how to diagnose PE?

Perfusion scan (cannot see on xray)

7

Wells score tells us (DVT)

Which patients to scan and not
Likelyhood that pt is having a DVT
>2 is high
1-2 moderate

8

Wells score catagories (DVT):

LEARN

+1 for:
Active cancer
Paralysis/ recent plaster
Bedridden/surgery
Tenderness along deep veins system
Entire leg swollen
Calf swelling

9

D dimer levels indicate

....clotting is occurring
D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis

10

What does the D-dimer test tell us?

Negative - rules out DVT
High - further testing required

11

Which first: D-dimer or wells score?

Well's score

12

When to use D-dimer test?

When the risk is low to EXCLUDE DVT

13

Well's score (PE) catagories:

LEARN

+3:
Symptoms of PE
Alternative diagnosis less likely
+1.5:
Heart rate >100
Immobilisation in past 4 weeks
Previous PE/DVT
+1:
Haemoptysis
Cancer

High >6 **** Moderate 2-6 **** Low

14

Learn coagulation cascade slide

.

15

two types of heparin

Large UFH
and
LMWH

16

Route of admin of
UFH
LMWH

UFH - IV/SC
LMWH - SC only

17

Which heparins require monitoring

UFH - yes - vital
LMWH - no usually

18

Cost of heparins

UFH - low
LMWH - high

19

Which heparin has greater
anti-Xa action
antithrombin action

LMWH - antiXa
UFH - antithrombin

20

What do you monitor in UFH?

-APTT

-Heprain (antifactorXa) assay is used in specialsed cercumstances (preg,paeds,renal fail)

21

How often to meaure APTT

every 4h to start then every 6.

22

Why do we try to avoid UFH?

monitoring is intensive

23

Why are clotting tests different for UFH and LMWH?

UFH is a bigger molecule which wraps around trapping thrombin