venous thromboembolism Flashcards Preview

Undeleted > venous thromboembolism > Flashcards

Flashcards in venous thromboembolism Deck (32):
1

virchow's triad for why blood clots when it shouldn't

1. activation of coag
2. venous stasis
3. injury to vessel wall

2

2 main types of VTEs

1. PE
2. DVT
- same disease, different course

3

most common location of DVT

legs>>>>arms

4

3 classes of DVT

1. proximal - pop>iliac>IVC - 90% of PEs
2. distal/calf - below knee - rarely PE
3. superficial - not a DVT, never PE

5

what is key component leading to PE

proximal DVT

6

what is epi of VTE

- age dep.
- most common preventable cause of death in hosp.

7

**9 acute risk factors for VTE

1. major surg.
2. trauma
3. CA
4. CA treatments
5. immobilization
6. acute medical illness
7. acute infection
8. inflammation
9. E, preg, post-partum

8

5 other risk factors for VTE

1. previous VTE
2. fam Hx
3. inherited
4. age
5. obesity

9

where are most VTE aquired

hospital

10

3 major risk surgeries

1. spinal cord
2. trauma
3. ortho

11

how long is VTE risk for

up to 12 weeks out of hospital

12

what is role of immobilozation

alone not a factor, but in combination with other factors

13

what is relation to CA

25x in CA
- often first manifestation of CA

14

3 E related risks for VTE

1. OCP - 4x
2. HRT - 4X
3. preg

15

why does a VTE develop

generally multifactorial with a number of factors

16

S and Sx of DVT (4)

1. leg swelling
2. leg pain
3. warmth
4. purple-blue colot
many have no Sx

17

S and Sx of PE

1. SOB
2. chest pain
3. desaturation
4. tachycard
5. unexplained fever
6. blood in sputum
7. feeling faint

18

investigations for VTE

D-dimer - not a very good test
DVT - doppler US
PE - CXR

19

what is d-dimer

formed by plasmin effect on fibrin
- increased in VTE

20

what is seen on doppler

can't collapse the vein

21

3 tests for PE

1. CT pulm angio
2. look for DVTs
3. V/Q scan - rules out PE if perfusion normal

22

4 possible treatments

1. IV heparin
2. LMWH
3. oral warfarin
4. directo oral anticoags

23

MOA, adv. and dis of IV hep

MOA:
- inhibs factors 2, 10, 9, 11, 12
adv:
- good control of coag cascade
- rapidly reversed
dis:
- IV -in patient
- frequent PTT tests
- possible HIT

24

MOA, adv. and dis of LMWH

MOA:
- inhibs factor 10 and 2
adv:
- sub-cut
- predictable
- can vary dose
dis:
- needle phobia
- renal accum
- costly

25

MOA, adv. and dis of IV warfarin

MOA:
- inhib vit K factors: 10, 9, 7, 2
adv:
- 60 years
- not renal
- labmonitoring
- cheap
dis
- lab monitoriing
- unpredictable
- 50 fold varitation in dose

26

MOA, adv. and dis of direct oral anti-coag

MOA
- 10a or 2a inhibs
adv
- fixed dose
- few interaction
- no labs
dis
- uncertain doses
- renal accum
- cost

27

3 basic VTE treatment options

1. LMWH q1d for 5-7 days, + warfarin
2. LMWH q1d for fll time
3. direct oral anti-coag

28

2 clot reduction therapies for massive PE

1. cath. endo therapy
2. tPA

29

therapy for massive DVT

tPA

30

how long for anti-coag

3 months + continue if at risk of recurrence (unprovoked, active factors)

31

what is natural VTE history

slowly go away

32

3 outcomes

1. recur in 30%
2. post-thrombotic syndrome - 20-50%
3. chronic pulm hypertension - 2-5%

Decks in Undeleted Class (589):