Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CDVD > Thromboembolism > Flashcards

Thromboembolism Flashcards

1
Q

Venous thromboembolism

What is VTE?

A

Blood clot in vein which obstructs blood flow.

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

What is DVT?

A

-Deep vein thrombosis
-In legs or pelvis
-Unilateral localised pain +/or swelling

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

What is PE?

A

-Pulmonary embolism
-In lungs
-chest pain or SoB

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

Risk factors for thromboembolism?

A
  • Surgery
  • trauma
  • significant immobility
  • malignancy
  • obesity
  • pregnancy
  • -hormonal therapy (COC/HRT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which diagnositic test is done to test for VTE?

A

D-Dimer test

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

what are the two methods of prophylaxis for VTE?

A

Mechanical
Pharmacological

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

What is mechanical prophylaxis for VTE?

A

-graduated compression stockings wear till mobile

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

When do you start pharmacological prophylaxis for VTE?

A

-within 14hr of admission
-only use if risk factor for VTE outweighs risk of bleeding

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

How long is mechanical surgical prophylaxis for VTE used for?

A

all pt should continue until sufficiently mobile or discharged from hospital

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

Examples of pharmacologiccal surgical prophylaxis for VTE

A

-low molecular weight heparin (LMWH)
-unfractionated heparin (UH)
-fondaparinux sodium

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

when is LMWH suitable in prophylatic surgery

A

suitable in all types of general, orthopaedic and pregnancy surgeries

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

when is unfractionated heparin preferred in prophylatic surgery

A

in renal impairment as it has a low half life so if need to stop fluidity of blood quickly

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

when is fondaparinux sodium preferred in prophylatic surgery

A

lower limb immobilisation or pelvis fragility fractures

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

how long is pharmacological prophylaxis used for in surgery

A
  • at least 7 days post surgery or until suf mobility
  • 28DY after major cancer surgery in abdomen
  • 30DY in spinal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tx for elective hip replacement?

A

1) LMWH 10DY * 75mg aspirin 28DY
2) LMWH 28DY + stockings until discharge
3) rivaroxaban = common

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

tx for elective knee replacement?

A

1) 75mg aspirin 14DY
2)LMWH 14DY+ stockings until discharge
3)rivaroxaban

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

if pt has as high risk of VTE what should you give for prophylaxis and how long for?

A

-Mechanical until mobile
-Pharmacological for 7DY at least

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

what is the VTE prophylaxis in pregn?

A

1) LMWH during hosp admission
- prophylaxis until no risk of VTE or till discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is VTE prophylaxis in pt who have given birth, miscarried or termination within 6 weeks

A

start LMWH 4-8hr after event and continue for min 7 days

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

tx of VTE in pregnancy

A
  • LMWH
  • Unfractionated heparin if high risk of haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how long is additional mechanical prophylaxis if immobilised

A

until mobile or discharged

22
Q

1st line tx if confirmed proximal DVT or PE

A

apixaban
rivaroxaban

23
Q

2nd line tx if confirmed proximal DVT or PE

A

LMWH for 5DY then dabigatran or edoxaban

24
Q

3rd line tx if confirmed proximal DVT or PE

A

LMWH + warfarin for 5DY till INR 2.0 for 2x readings then warfarin alone

25
Q

What is the duration of distal DVT (calf) tx?

A

6 weeks

26
Q

what is duration of proximal DVT/PE

A

3MT (3-6MT in active cancer)

27
Q

what is duration of provoked DVT/PE

A

stop at 3MT if factors stopped

28
Q

what is duration of unprovoked DVT/PE

A

3MT+

29
Q

what is duration of recurrent DVT/PE

A

long term

30
Q

When do you need to maintain and INR of 2.5 (+/-0.5)?

A
  • VTEs
  • AF
  • cardioversion
  • MI
  • cardiomyopathy
31
Q

When do you need to maintain and INR of 3.5

A

recurrent VTE or mechanical heart valves

32
Q

What do you do in a major bleed?

A

stop warfarin + give IV vit K (phytomenadione) + dried prothrombin

33
Q

What do you give if INR >8 and is minor bleed?

A

stop warfarin and give IV vit K

34
Q

What do you give if INR >8 and no bleed?

A

stop warfarin and give oral vit K

35
Q

What do you give if INR 5-8 and is minor bleed?

A

stop warfarin and give IV vit K

36
Q

What do you give if INR 5-8 and no bleed?

A

withhold 1-2 doses of warfarin and restart when INR is <5

37
Q

MHRA s/e warning of warfarin

A

skin necrosis and calciphylaxis (pale skin rash)

38
Q

s/e of warfarin

A
  • haemorrhage; prolonged bleed give vit K antidote
  • pregn = avoid in 1st + 3rd trimester (use contraception
39
Q

Interactions of warfarin

A

-vit k rich foods (reduce efficacy)
-pomegranate + cranberry juice (inc INR)
-miconazole (inc INR)
-CYP450 inhibitors/inducers (inc/dec conc of warfarin)

40
Q

if it is minor procedure with low risk of bleeding what do you do (warfarin surgery)

A

only perform if INR less than 2.5 - restart warfarin within 24 hr of surgery

41
Q

What do you do in (warfarin) procedures where there is severe risk of bleeding?

A

1) stop warfarin 3-5DYs before
2) vit K if INR is > or = to 1.5 the day before surgery
3) pt = high risk of thromb stop LMWH 24hr before + restart 48hr after

42
Q

if it a emergency surgery do you do in regards with warfarin

A

if it can be delayed by 6-12hr give IV vit K if not then give IV vit k + dried prothrombin complex

43
Q

What are the doses for apixaban?

A

10mg BD 7DY then 5mg BD

44
Q

which DOACs are given after 5DYs of heparin?

A

edoxaban and dabigatran

45
Q

What do all heparins do?

A
  • avoid in heparin induced thrombocytopenia
  • can cause hyperkalaemia
  • haemorrhage tx protamine sulphate (unfractionated)
46
Q

what do unfractionated heparins do?

A
  • quick initation + elimiation ideal for high bleeding risk (monitor APTT)
  • high risk of heparin induced thrombocytopenia
47
Q

dose for rivaroxaban

A

15mg BD 3WK then 20mg OD

48
Q

dose for dabigatran when 18-74yr

A

150mg BD

49
Q

dose for dabigatran when 75-79yr

A

110-115mg BD

50
Q

dose for dabigatran when 80yr+

A

110mg BD

51
Q

dose for edoxaban

A
  • 60mg OD
  • if under 6kg then 30mg

CDVD (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions