thrombosis Flashcards

(42 cards)

1
Q

if you have a peripheral arterial thrombosis what is it called

A

gangrene

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2
Q

what is the biggest risk factor for a DVT

A

previous one

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3
Q

what type of clots are seen in the arterial system

A

platelet rich

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4
Q

what drugs are used in arterial clots

A

aspirin and anti-platelet

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5
Q

are platelets activated in venous clots ?

A

no as no endothelial damage

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6
Q

what type of clots seen in venou ssytem

A

fibrin rich

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7
Q

what causes venous clots

A

valve degeneration

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8
Q

treatment of venous clots

A

heparin, warfarin, DOAC

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9
Q

what is given in acute VTE

A

heparin - immediate action

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10
Q

what us the annual risk of a vte

A

1/1000
young 1/10,000
old 1/100

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11
Q

symptoms of VTE

A

pitting oedema, swelling , red ,tender

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12
Q

examples of hereditary thrombophilias

A
factor V Leiden 
prothrombin 20210 mutation 
anti-thrombin deficiency 
protein S deficiency 
protein C Deficiency
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13
Q

name an acquired thrombophilia

A

anti-phospholipid syndrome

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14
Q

what is more likely to casue clot inherited or acquired thrombophilia

A

acquired anti-phospholipid

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15
Q

what is prolonged in anti-phospholipid APTT or PTT

A

APTT

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16
Q

treatment of anti-phospholipid syndrome

A

aspirin and warfarin as both venous and arterial clots seen

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17
Q

what clot do heparin and warfarin target

A

fibrin clot - venous system

18
Q

indications for anti-coagulants

19
Q

action of heparin

A

potentiates anti-thrombin

20
Q

how is heparin delivered

21
Q

how does unfractionated heparin work

A

inactivating thrombin and activated factor X (factor Xa) through an antithrombin (AT)-dependent mechanism

22
Q

how does LMWH work

A

binds to anti-thrombin and creates a conformational change. This change accelerates its inhibition of activated factor X

23
Q

what should be used for monitoring heparin and LMWH respectively

A

heparin - APTT

LMWH - Factpr Xa assay - monitoring not rquired

24
Q

side effects of heparin

A

bleeding
induced thrombocytopenia
osteoporosis long term

25
how to reverse heparin
stop heparin | protamine sulphate
26
what class of anticoagulant is warfarin
coumarin anticoag
27
what must be given alongside warfarin at initiation
heparin
28
how is warfarin delivered
Oral
29
mechanism of action of warfarin
Vitamin K inhibitor
30
why does heparin need to be given alongside warfarin at intitiation
warfarin inhibitd vitamin K which carboxylases protein c and s so transient increase in clotting chance at beginning
31
when shoudl warfarin be taken
same time everyday 6pm recommended
32
what is used to monitor warfarin
PTT as factor 7 most sensitive
33
how is warfarin metabolised
by CYP450 in liver
34
side effects of warfarin
bleeding | lots of interactions
35
what do you do if INR too high on warfarin
vit k admin
36
what is dabigatran
oral direct thrombin inhibitor
37
how is dabigatrann excreted
renally
38
give examples of oral Xa inhibitors
apixaban , rivaroxiban , edoxaban
39
mechanism of action for aspirin
cox inhibtior - cox makes thromboxane A 2
40
side effects of aspirin
bleeding GI ulcer brnchospasm - not in asthma
41
mechanism of action for clopidergrel
ADP receptor antag - P2Y12 receptor
42
what receptors do platelets bind to in aggregation
GPIIb, IIa (abciximab - an inhibitor of this used prior to surgery)