Flashcards in 3 Coagulation Workshop Deck (20):
Venous thromboembolism results from....
Where as arterial results from ....
Venous: poor blood flow (immobility, dehydration)
Arterial: hyeprcoagulability, vascular injury
How are e structures of a venous and arterial thromboembolism different?
Venous has low platelet content (red thrombus)
Arterial has larger platelet content (white thrombus)
Three was to treat thrombus
Modify blood coagulation (i.e. fibrin formation)
Modify platelet function
Modify fibrin removal (i.e. fibrinolysis)
Anticoagulants or antiplatelets are used for the treatment of arterial thrombus
Antiplatelets for arterial – MI and Stroke
After major surgery the risk of PE increases
Infection increases PE risk .... fold and admission increases risk....fold
Venous thromboembolism results in ..... Where as arterial results in....
Venous: PE and DVT
Arterial: MI and stroke
Outline the clotting pathway
Extrinsic - VII to X
Intrinsic - XII to XI to IX to X to prothrombin to fibrinogen to clot
What is the mode of action of clopidogrel?
Inhibits platelet aggregation by inhibiting ADP binding
What is the mode of action of prasugrel and ticagrelor?
Inhibits platelet aggregation by inhibiting P2Y binding
What is the mode of action of aspirin
Inhibits Cox preventing the synth of PG and thromboxane.
Risk factors for venous thrombosis 7
Age over 60
Immobility after surgery
Comorbidities (Cancer, MI, IBS)
INR is a measure of the ...... pathway
When to use d dimer?
To exclude PE in a low Well's score
Diagnosis for PE is obtained by...
Well's score low exclude with d dimer
Well's score high use CTPA scan (or VQ scan if young).
When dosing fatties in the exam write
Seek specialist advice regarding her weight
How long to continue LMWH when starting warfarin
At least five days and until INR is over two for two consecutive for days
Anticoagulant of choice in preg
Anticoagulants for breast feeding
Heparin and warfarin