Thromboembolic Disease Flashcards
(19 cards)
How does PE typically present?
Sudden onset SOB with clear lungs on auscultation and a normal CXR
What are other common findings in DVT/PE?
Tachypnea, Tachycardia, cough, hemoptysis
U/L leg pain from DVT
Pleuritic chest pain from lung infarction
Fever
Hypotension
What are the best initial tests for DVT/PE?
CXR, EKG and ABG
After CXR, EKG and ABG for suspected DVT/PE what is the nest best step?
CT Angiogram
What is the most common CXR abnormality for PE?
Atelectasis
-others include
—Hampton Hump: wedge-shaped infarction pleural based lesion
–Westermark sign: oligemia of one lobs
What ABG findings combined with a normal CXR are highly suggestive of PE?
Hypoxia and Respiratory alkalosis (High pH and low pCO2)
How do you treat a PE?
DOAC or LMWH followed by warfarin
What DOACs are commonly used for PE?
Rivaroxaban
Apixaban
Dabigatran
What LMWH is commonly used for PE?
Enoxaparin
What is an alternative to Heparin that can be used for PE with Herapin-induced thrombocytopenia (HIT)?
Fondaparinux
What is Andexanet Alfa the reversal agent for?
Rivaroxaban
apixaban
Edoxaban
What is the reversal agent for Factor xa inhibtors?
Andexanet Alfa
What is Idarucizumab the reversal agent for?
Dabigatran
What is the reversal agent for Dabigatran?
Idarucizumab
What is PCC the reversal agent for?
Warfarin
What is the reversal agent for Warfarin?
PCC
When is an Inferior Vena Cava (IVC) filter indicated?
For a DVT + Contraindication to anticoagulant use
Recurrent emboli while on a DOAC or fully therapeutic Warfarin (INR 2-3)
When are Thrombolytics the right answer for a PE?
Hemodynamically unstable patients
Acute RV dysfunction such as enlarged RV on Echocardiogram
What is Catheter removal of the clot the answer in PE?
Hemodynamic instability and thrombolytics are contraindicated or ineffective
Severe Hypotension (SBP<90) with submassive clot requiring pressors
