Intro to VTE and Thromboembolic Disease Introduction

Question 1

Thrombosis

Answer 1

Formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system.

Question 2

Virchows triad.

Answer 2

Three major factors responsible for the development of venous thrombosis.

1. Blood stasis (reduced blood flow)
2. Vascular injury (collagen is exposed and can activate the coagulation cascade)
3. Hypercoagulable state (imbalance between procoagulant and anticoagulant proteins in the blood)

Question 3

VTE

Answer 3

Venous thromboembolism.

Disease resulting from excessive clot formation as a consequence of disturbed coagulation equilibrium.

Question 4

VTE refers to ____ and ___

Answer 4

DVT and PE

Question 5

Proximal DVT refers to thrombosis of the deep beings of the leg at the level of the ____ vein or above

Answer 5

Popliteal vein

Question 6

Distal DVT refers to thrombosis of the deep veins blow the level of the knee. Sometimes blood clots can be superficial, called ___ ____ and aren’t as serious

Answer 6

Superficial thrombophlebitis.

Question 7

Causes of “stasis”

Answer 7

Immobility, venous obstruction, increased venous pressure, increased viscosity

Question 8

Hypercoagulable state can be due to deficiencies of natural anticoagulants such as:

Answer 8

Antithrombin protein C, protein S.

Question 9

Hypercoagulable state can be due to upregulatin of production of coagulant proteins, or decreased sensitivity to action of natural anticoagulants, like ____

Answer 9

Factor 4 Leiden.

Hypercoagulbility can be due to genetic causes of acquired causes like APLA, malignancy, trauma, burns, drugs.

Question 10

Name some week, Mild, moderate and strong ACQUIRED risks to VTE

Answer 10

Weak; smoking and diabetes

Mild: pregnancy, ocp, Hart, obesity, long haul travel, MI, heart failure

Moderate; APLA, non major surgery, malignancy

Strong: major surgery, poly trauma, central venous catheters

Someone with APLA requires life long anticoagulant therapy

Question 11

Genetic risks to VTE

Answer 11

VTE= thrombosis issues like DVT and PE. Defieiciencies in things that cause clot breakdown would increase the likelihood of VTE

• protein S deficiency
• protein C deficiency
• factor 5 Leiden.
• antithrombin def
• non-O blood gro9up
• prothrombin mutaiton

Question 12

Why does the presence of factor 5 Leiden predispose someone to VTE issues

Answer 12

Leiden makes factor 5 more resistant to protein C inactivation

Question 13

When should you screen for thrombophilias

Answer 13

1. Individuals with first VTE before 40-45
2. VTE at any age with a strong family history of thrombotic disease
3. VTE in an unusual site (hepatic, mesenteric, portal,cerebral vein)

Question 14

When is the best time to test for thrombophilias

Answer 14

1 month after completion of anticoagulant therapy