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Flashcards in VTE Deck (26)
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1

Statin therapy

Decrease VTE risk

2

Low risk thromboprophylaxis

Low risk med, same day surgery and
Early aggressive ambulation only

3

Minor surgery in mobile pt

Mechanical ppx

4

Hi risk medical

Immobile, history of VTE, thrombophilia or cancer
Most surgical pts
uFH, lmwh, or Fonda if hit positive, or mech. Ppx if high bleeding risk

5

Ortho surgery

Lmwh or Fonda, rivaroxaban, or warfarin x 35 days plus mech ppx

6

Phlegmasia cerulea dolens

Stagnant blood leading to edema, cyanosis and pain

7

Simplified wells score for DVT

2-13
0, 1-2, >\=3

8

D dimer cut off

Less than 500

9

Simplified wells pretest probability for PE

2-14
0-1, more than 1

10

RV strain on ECG

RAD, p pulmonale, RBBB, S1Q3T3 and TWI V1-V4

11

Vq scan

High sensitivity, very low 10% specifity, sp improves with high probability VQ

12

Discordant CTPE and clinical suspicion

Consider additional imaging studies if high clinical suspicion and no alternative diagnosis

13

When to consider thrombophilia work up

Positive Fhx, age younger than 50, or on OCP/HRt, send panel 2 was after complete anticoagulation

14

Risk stratification for pts with PE

Hypotension, tachycardia, hypoxemia
rV to LV dimension >0.9
Elevated trop, BNP assoc with increased mortality
RV dysfunction

15

PE severity index
0-1, 2 and above

Age more than 80, history of cancer, history HF or lung disease, Hr >\= 110, sBp

16

Catheter associated DVT

Anticoagulant, no need to remove catheter if functional

17

UFH over LmWH

Renal failure crcl less than 25, extreme obesity, hemodynamically unstable, or bleeding risk

18

Lmwh and Fonda dose

Enox 1mg/kg bid, dalte 200iu/kg qd
Fonda 5-10mg qd

19

Riva dose

15 mg bid x 3 weeks, then 20 mg qd

20

Outpatient treatment

DVT and low risk PE

21

Indication for thrombolysis in PE

Hemodynamically instability or submassive PE with risk factors with low bleeding risk

22

Thrombectomy indication for PE

Large prox PE, and hemo compromise, and contra to lysis

23

Warfarin with heparin overlap duration

More than 5 days, and inr great than 2 for 24 hrs

24

Dabigatran in PE

Not FDA approved yet

25

VTE with cancer

Lmwh only till cancer cured at least 3-6 months

26

Duration of anticoagulation

Superficial: 4 weeks
1st unprovoked: at least 3 months, then reassess, if low bleeding risk, indefinitely
2nd VTE event: indefinite warfarin
1st prox DVT or PE from time limited risk factor or distal DVT: 3 month