Haematology (DVT) Flashcards

1
Q

What is a deep vein thrombosis?

A

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

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

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

A

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

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

What are the causes of deep vein thrombosis?

A

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

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

DD of deep vein thrombosis?

A

musculoskeletal injury, bakers cyst rupture, cellulitis

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

Complications of deep vein thrombosis?

A

pulmonary emobolism, post thrombotic syndrome

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

What investigations should be done in deep vein thrombosis?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the modified wells score do?

A

calculates deep vein thrombosis probability

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

When is a B mode venous compression US used?

A

in deep vein thrombosis above the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

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

A

it excludes deep vein thrombosis

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

What can cause an abnormal d dimer?

A

deep vein thrombosis, pregnancy, surgery, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment of deep vein thrombosis?

A
anticoagulation therapy with unfractional heparin e.g. telteparin
vit k antagonist e.g. warfarin
compression stockings
treat cause
hydration, early mobilisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What classification is used for bleeding risk in DVT?

A
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do LMWH and warfarin inhibit

A

L - inhibits Xa and IIa

W- inhibits vit K dependent factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be kept between for LMWH and warfarin?

A

2-3INR

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

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

A

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

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

What is PT?

A

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

17
Q

What does a d dimer detect?

A

small protein fragments released following the breakdown of a clot

18
Q

How does warfarin treat DVT and what is its risk?

A

inhibits vit k synthesis, but before of over coagulation

19
Q

SE of LMWH?

A

bleeding, osteoporosis, heparin induced thrombocytopenia

20
Q

When is LMWH contraindicated?

A

in bleeding disorders, low platelets and HTN

21
Q

When is warfarin contraindicated?

A

pregnancy and peptic ulcer

22
Q

examples of other anticoagulants?

A

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

23
Q

What does TPA do?

A

generates plasmin and degrades fibrin

24
Q

What is thrombolytic therapy?

A

streptokinase tissue plasminogen activator

25
Q

What causes venous thrombosis?

A

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

26
Q

What is the initial and after anticoagulant treatment for DVT?

A

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

27
Q

How does heparin treat DVT?

A

glycoaminoglycan, binds to antithrombin and increases its activity

28
Q

Does LMWH or warfarin have a longer half life?

A

warfarin