46: Hypercoagulable Disorders - Kanis Flashcards
1
Q
If someone has a red, warm, swollen and tender leg or a PE- what diagnostic testing do you do?
A
- duplex ultrasound
- d-dimer
- chest CT
- resistance ot activated prtn C clotting assay
- genetic test for prothrombin G20210A mutation
- functional assay of antithrombin, prnt C, prtn S
- clotting assay for lupus anticoagulant
- ELISA for anticardiolipin anitbodies
- fasting total plasma homocysteine
2
Q
Treatment PE or DVT?
A
acute - anticoagulant (heparin)
long term - warfarin (can be procoagulant initially and doesn’t work right away)
3
Q
Who should receive prophylaxis?
A
patients with immobility, infections, history of thrombus, malignancy and CHF
4
Q
What is appropriate prophylaxis?
A
NOT STRICT BED REST
use sequential compression devices, compression stockings (TED hose), ambulation, LMWH
5
Q
most frequent cause of inherited thrombophilia
A
factor V leiden mutation
