Haematology (DVT) Flashcards Preview

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Flashcards in Haematology (DVT) Deck (28):
1

What is a deep vein thrombosis?

a clot that develops in a deep vein, usually the leg

2

What are the signs and symptoms of a deep vein thrombosis?

asymptomatic, pain, oedema, erythema, discolouration, increased temperature in leg, engorgement of the surface veins, tenderness

3

What are the causes of deep vein thrombosis?

hypercoagulability - from malignancy, surgery, trauma, oral contraceptive pill, clotting abnormalities
venous stasis - immobility, pregnancy, heart failure
trauma - inflammation, previous thrombosis

4

DD of deep vein thrombosis?

musculoskeletal injury, bakers cyst rupture, cellulitis

5

Complications of deep vein thrombosis?

pulmonary emobolism, post thrombotic syndrome

6

What investigations should be done in deep vein thrombosis?

D dimer, B mode venous compression US, modified wells score, PT, APPT, blood films show evidence or myeloproliferative disorders

7

What does the modified wells score do?

calculates deep vein thrombosis probability

8

When is a B mode venous compression US used?

in deep vein thrombosis above the knee

9

What does it rule out it a d dimer is normal?

it excludes deep vein thrombosis

10

What can cause an abnormal d dimer?

deep vein thrombosis, pregnancy, surgery, infection

11

What is the treatment of deep vein thrombosis?

anticoagulation therapy with unfractional heparin e.g. telteparin
vit k antagonist e.g. warfarin
compression stockings
treat cause
hydration, early mobilisation

12

What classification is used for bleeding risk in DVT?

HAS-BLED
hypertension 1
abnormal liver or renal function 1 or 2
stroke 1
bleeding 1
labile INR 1
elder >65 1
drugs or alcohols 1 or 2

13

what do LMWH and warfarin inhibit

L - inhibits Xa and IIa
W- inhibits vit K dependent factors

14

What should be kept between for LMWH and warfarin?

2-3INR

15

What clinical features are in the two level DVT Wells Score?

active cancer, paralysis, paresis, recent bedridden or major surgery, local tenderness in deep venous system, entire swollen leg, calf swelling, pitting oedema, colateral superficial veins, previously docuented DVT

16

What is PT?

a measure of how quickly the blood clots, standardized by the INR

17

What does a d dimer detect?

small protein fragments released following the breakdown of a clot

18

How does warfarin treat DVT and what is its risk?

inhibits vit k synthesis, but before of over coagulation

19

SE of LMWH?

bleeding, osteoporosis, heparin induced thrombocytopenia

20

When is LMWH contraindicated?

in bleeding disorders, low platelets and HTN

21

When is warfarin contraindicated?

pregnancy and peptic ulcer

22

examples of other anticoagulants?

apixaban, rivaroxaban (xa inhibitors), dabigatran (direct thrombin inhibitor)

23

What does TPA do?

generates plasmin and degrades fibrin

24

What is thrombolytic therapy?

streptokinase tissue plasminogen activator

25

What causes venous thrombosis?

antithrombin deficiency, protein c deficiency, protein s deficiency, PT20210A, Factor V Leiden, anti phospholipid syndrome, lupus anticoagulant, hyperhomocysteinaemia

26

What is the initial and after anticoagulant treatment for DVT?

LMW sc od initial and then oral warfarin 3-6 months after

27

How does heparin treat DVT?

glycoaminoglycan, binds to antithrombin and increases its activity

28

Does LMWH or warfarin have a longer half life?

warfarin