High - Cardiovascular system > Blood clots > Flashcards

Blood clots Flashcards

(51 cards)

Study These Flashcards
1
Q

What are the types of venous thromboembolism?

A
  • Deep vein thrombosis - blood clot (thrombus) forms in deep vein in 1 leg + partially/totally blocks blood flow
  • Pulmonary embolism - life threatening - blood clot (embolus) travels to lungs + block blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of deep vein thrombosis?

A
  • Unilateral pain + swelling
  • Warm + red skin
  • Vein distention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of pulmonary embolism?

A
  • Dyspnoea
  • Chest pain
  • Coughing blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which Pts require thromboprophylaxis?

A
  • Immobility
  • Obesity BMI >30
  • 60+
  • Pregnancy, postpartum
  • Oestrogens: HRT, COC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the pharmacological treatment of VTE?

A

DOAC
Heparin
- Unfractionated in renal impairment
- Alt: fondaparinux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the duration of VTE pharmacological prophylaxis?

A
  • General surgery/medical patient: 7 days
  • Major cancer surgery in abdomen: 28 days
  • Spinal surgery: 30 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the mechanical treatment for VTE?

A

For excessive bleed risk:
Pneumatic compression
Anti-embolism stockings
- Don’t offer in acute stroke + leg condition (peripheral arterial disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the duration for VTE mechanical prophylaxis?

A
  • Until sufficiently mobile
  • Spinal injury, spinal/cranial surgery: 30 days
  • Acute stroke: 30 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is used for pharmacological thromboprophylaxis in hip and knee replacement?

A

FIRST LINE - Rivaroxaban
- Hip: 35 days, Knee: 14 days
LMWH + anti-embolism stockings
- Hip: 28 days, knee: 14 days
Hip: LMWH 10 days + low dose aspirin 28 days
Knee: low dose aspirin 14 days
Alt: apixaban, dabigatran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is used for mechanical thromboprophylaxis in hip and knee replacement?

A
  • Knee: pneumatic compression
  • Hip: anti-embolism stockings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for DVT + PE?

A

Apixaban OR rivaroxaban
- At least 3m (3-6m if active cancer) (Provoked VTE: surgery, COC, pregnancy, leg cast)
- Unprovoked 3m+ (6m+ if active cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the thromboprophylaxis + treatment for VTE used in pregnancy?

A
  • Thromboprophylaxis: LMWH + pneumatic compression (if immobilised)
  • VTE: LMWH (unfractionated if INC bleeding)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which anticoagulants are factor XA inhibitors?

A
  • Apixaban
  • Edoxaban
  • Rivaroxaban
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which anticoagulant is a thrombin inhibitor?

A

Dabigatran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of action of heparins?

A

Activates antithrombin which inhibits clotting factors Xa + IIa (thrombin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the indications for heparins?

A

LMWH: tinzaparin, enoxaparin, dalteparin

For pregnancy (RED risk of osteoporosis + heparin induced thrombocytopenia)

Unfractionated heparin - shorter HL
- For high risk of bleeding + renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the side effects of heparin?

A

Bleeding
- Antidote: protamine (reverse LMWH)

Hyperkalemia (heparins block aldosterone secretion in renin angiotensin system)
- Diabetics + CKD at higher risk
- Monitor: potassium

Heparin-induced thrombocytopenia → DISCONTINUE
- RED 30% platelet, skin allergy, thrombosis

Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the interactions of heparins?

A
  • Hyperkalaemia
  • Anticoagulants, anti-platelet, NSAIDs, SSRI → INC Bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the MOA of warfarin?

A

Vitamin K antagonist - reduce ability to form blood clots by blocking formation of vitamin K dependent clotting factors (48-72H)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the indication of warfarin?

A

VTE + stroke prevention in AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the rules for a missed warfarin dose?

Study These Flashcards
A

Missed dose: take ASAP but don’t take more than 1 dose in a day

22
Q

What are the pill colours for warfarin?

Study These Flashcards
A
  • 0.5mg - white
  • 1mg - brown
  • 3mg - blue
  • 5mg - pink
23
Q

How long do you take warfarin in provoked VTE + isolated calf DVT?

Study These Flashcards
A

Isolated calf DVT: 6w

Provoked VTE: 3m

  • Surgery, COC, pregnancy, leg cast
24
Q

Can you take warfarin during pregnancy?

25
How often is warfarin monitored?
INR every 12 weeks - More frequent: intercurrent illness
26
What are the target INR when taking warfarin?
Must be w/in 0.5 of target - 2.5: VTE, AF, MI, cardioversion, artifical valves - 3.5: recurrent VTE if on anticoagulant + INR >2
27
What are the MHRA warnings for warfarin?
- Reports of calciphylaxis: consider stopping if diagnosed. Risk factor: end stage renal disease. Report painful skin rash - MHRA: OTC oral miconazole gel CI. Report signs of serious bleeding - if prescribed, monitor INR
28
What happens if a patient has an INR of 5-8 with no bleed?
w/hold 1-2 doses
29
What happens if a patient has an INR of 5-8 with minor bleed?
IV phytomenadione + restart when INR <5
30
What happens if a patient has an INR of >8 with no bleed?
Oral phytomenadione + restart when INR <5
31
What happens if a patient has an INR of >8 with minor bleed?
IV phytomenadione + restart when INR <5
32
What happens if a patient is on warfarin with a major bleed?
ADD dried prothrombin complex or fresh frozen plasma + restart when INR <5
33
What are the food interactions of warfarin?
- Alcohol binge - Cranberry juice - Green, leafy veg
34
What are the OTC interactions of warfarin?
- Miconazole - NSAID - Vit E + K supplement
35
What happens when taking warfarin and undergoing surgery?
- Elective: stop 5 days before - VTE high risk: bridge w LMWH - Emergency: IV phytomenadione
36
What are the interactions of warfarin?
- NSAID, anticoagulant, SSRI → INC bleed - Enzyme inhibitors → INC anticoagulant effect - Enzyme inducers → DEC anticoagulant effect
37
What is the MOA of DOACs?
Directly inhibits clotting factor Xa or IIa (thrombin)
38
What are examples of DOACs?
- Apixaban - Dabigatran (special container, protect from moisture: 4m expiry) - Edoxoban - Rivaroxaban (MHRA: after food, licensed to be crushed)
39
What are the indication of DOACs?
VTE, prevent stroke in Non-valvular AF
40
What are the missed dose rules when taking DOACs?
Missed dose >6h - Take dose at normal time - Anticoagulant effect last 12-24h
41
What are the side effects of DOACs?
Bleeding (Monitor signs of bleeding + anaemia, Renal function test in RI) - MHRA
42
What are the reversal agents for DOACs?
- Idarucizumab - dabigatran - Andexanet alfa - apixaban, rivaroxaban
43
What are the CI of DOACs?
Prosethetic heart valve - MHRA: rivaroxaban not for thromboprophylaxis - Inc risk of mortality, thromboembolic + bleeding events Antiphospholipid syndrome - MHRA: INC risk of recurrent thrombotic events MHRA: CI w new oral anticoagulants
44
What are the interactions of DOACs?
- NSAID, anticoagulant, SSRI → INC bleed - Enzyme inhibitors → INC anticoagulant effect - Enzyme inducers→ DEC anticoagulant effect - Carbamazepine red exposure to apixaban
45
What are the types of strokes?
Ischaemic (includes TIA - mini strokes that temp interrupt blood supply to brain) - Atherosclerosis, thromboembolism in AF Haemorrhagic - High BP, aneurysm, arteriovenous malformation
45
What is the treatment for an ischaemic stroke?
Clopidogrel (first line) - Alt: aspirin - Co-prescribe PPI, prevent dyspepsia + GI bleed High intensity statin Anti-hypertensive if BP is high - Don’t offer Beta-blocker unless for co-existing condition Review anticoagulant in patients w AF
46
What is the treatment for a haemorrhagic stroke?
- Antihypertensive - AVOID: aspirin, anticoagulant, statin - high risk of bleed
47
What is used for secondary CVD prevention?
- Low dose Aspirin (75mg OD) - Clopidogrel - Dipyridamole
48
How is dipyridamole taken?
- 30-60min before food - MR - after food - MR caps ‘special container’ - discard in 30 days/6 weeks
49
What are examples of glycoprotein IIB/IIA inhibitor (antiplatelets)?
Prasugrel + ticagrelor
50
What is used for long term management of a TIA?
MR Dipyridamole and Aspirin
High - Cardiovascular system
flashcards
Decks in class (7)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions