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VenousClass > Week 6 > Flashcards

Week 6 Flashcards

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1
Q

What does “Anticoagulation” mean?

A

anti (against) coagulation (to clot)

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2
Q

What do anticoagulants do?

A

prevent clotting of the blood by thinning the blood and changing the clotting factors in the blood

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3
Q

To whom and why are anticoagulants given?

A

patients at high risk for DVT (orthopedic surgery, long hospital stays); they are given prophylactically

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4
Q

What does prophylactically mean?

A

preventatively

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5
Q

Spell the word that means preventatively ;-)

A

PROPHYLACTICALLY

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6
Q

What are the 2 most common blood thinners used to treat DVT?

A

Heparin and Coumadin

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7
Q

How is Heparin given?

A

Intravenously

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8
Q

TRUE/FALSE. Heparin is an outpatient treatment that dissolves blood clots.

A

FALSE. Heparin is given in the hospital and does NOT dissolve clots.

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9
Q

What does Heparin prevent?

A

Extension and embolization of a thrombus

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10
Q

Which is more concerning, proximal or distal extension?

A

Proximal extension

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11
Q

What are some negatives to Heparin?

A

Effects wear off quickly, Uncomfortable for patient, requires an injection, Burns when administered, can leave bruises on skin

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12
Q

What does HIT stand for?

A

Heparin Induced Thrombocytopenia

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13
Q

What is HIT?

A

A paradoxical reaction where Heparin causes a drop in platelet count resulting in hypercoagulability

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14
Q

What is another name for low molecular weight heparin?

A

Lovenox

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15
Q

How is Lovenox administered?

A

Subcutaneously

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16
Q

What are some benefits of Lovenox?

A

Outpatient treatment, effects last longer than Heparin, lower incidents of HIT

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17
Q

What are some negatives of Lovenox?

A

Possible HIT, Uncomfortable for patient, injection, bruising

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18
Q

What is the most common oral anticoagulant?

A

Coumadin

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19
Q

What is another name for Coumadin?

A

Warfarin

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20
Q

How is Coumadin administered?

A

Orally, Outpatient

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21
Q

What is Coumadin used for?

A

Long term anticoagulation

  1. Treatment of DVT and PE
  2. Arterial thrombosis
  3. arterial bypass grafts
  4. AFIB patients
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22
Q

TRUE/FALSE. Coumadin is a reliable clot dissolver.

A

FALSE. Coumadin does not dissolve clots; prevents formation or extension of thrombus

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23
Q

What are some negatives for Coumadin?

A

Slow onset, Slow offset, Vitamin K contraindication, Many food interactions, frequent blood monitoring needed

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24
Q

How long does Coumadin take to become active in the body?

A

36 hours

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25
How long does Coumadin take to wear off and leave the body?
2 days
26
What are some examples of foods high in Vitamin K?
Kale, Collard greens, Spinach
27
What are the 2 reasons why frequent blood monitoring is required while a patient is on Coumadin?
1. To be sure the anticoagulation is effective and working | 2. To ensure the blood is not getting too thin
28
What are 2 lab values that need to be monitored while a patient is on Coumadin?
INR and PTT
29
What does INR and PTT stand for?
International normalization ratio, Partial Prothrombin Time
30
What does INR measure?
how fast the blood is clotting
31
What does PTT detect?
Clotting abnormalities
32
What is it called when you develop a new clot while on anticoagulants?
Failed Anticoagulation
33
Name 3 new oral anticoagulant drugs
Xarelto, Pradaxa, Eliquis
34
What is a huge advantage of the new anticoagulant drugs?
They do not require the extensive monitoring of Coumadin
35
What happens during a Transcatheter Thrombolysis procedure?
Catheter inserted into the leg, Medication delivered directly into the clot, clot is rapidly dissolved
36
What is the most common thrombolytic?
TPA
37
What does TPA stand for?
tissue plasminogen activator
38
Where and when is the transcatheter thrombolysis procedure commonly used?
large veins of iliofemoral level, occlusive DVT, younger patients
39
What is a venous thrombectomy?
a surgical removal of a thrombus
40
What is the risk of venous thrombectomy?
Endothelial injury (hypercoagulability)
41
When is venous thrombectomy used more often?
Trauma cases
42
What is an IVC filter?
inferior vena cava filter; metal umbrella-like structure surgically placed in the IVC to catch an emboli coming from the legs
43
What does an IVC filter prevent?
Fatal PE
44
When are IVC filters used?
Patients who cannot be anticoagulated, patients at high risk for DVT, surgical patients (esp. spinal surgeries)
45
What are some complications of IVC filters?
struts can break and metal pieces embolize, entire filter can migrate, punctures of vessel walls
46
Name 4 venous diseases
Phlegmasia Alba Dolens Phlegmasia Cerulea Dolens Venous Gangrene Postphlebitic Syndrome (Venous insufficiency)
47
What is the most common of the 4 venous diseases?
Postphlebitic Syndrome (Venous insufficiency)
48
What is May-Thurner syndrome?
Occurs when the left common iliac vein is compressed against the L5 vertebrae by the right common iliac artery
49
What is the result of May-Thurner syndrome?
Extrinsic compression
50
What are the risk factors for May-Thurner syndrome?
Middle aged, postpartum, Female
51
What are symptoms of May-Thurner syndrome?
Unilateral left leg swelling, DVT in the left leg
52
What is the treatment for May-Thurner syndrome?
Anticoagulation, Balloon angioplasty and stunting of left common iliac vein, IVC filter, Surgery (bypass from IVC to left common iliac
53
What is Phlegmasia Alba Dolens?
WHITE, decreased venous drainage from acute ililfemoral DVT, edema obscures capillary circulation, Hypercoagulability, Extensive venous thrombosis
54
What are the physical characteristics of Phlegmasia Alba Dolens?
Swollen, pale "white" discoloration of the leg, cool to the touch, arterial pulselessness
55
What is the treatment for Phlegmasia Alba Dolens?
Anticoagulation, compression stockings, Thrombolytics, Thrombectomy, Amputation
56
What is Phlegmasia Cerulea Dolens?
BLUE, Massive decrease in venous return due to extensive DVT at multiple levels (Iliofemoral, calf, and collaterals) Massive Occlusion
57
What are the causes of Phlegmasia Cerulea Dolens?
Hypercoagulability, Trauma, Cancer
58
What are the physical characteristics of Phlegmasia Cerulea Dolens?
Blue discoloration to the leg, cool to the touch, swollen, absent arterial pulses
59
What is the treatment for Phlegmasia Cerulea Dolens?
Thrombectomy, Amputation, Thombolytics, Aggressive anticoagulation, Extensive leg elevatioin
60
What is Venous Gangrene?
Necrosis of the tissue due to massive venous outflow and arterial inflow obstructions
61
What is happening to blood flow during Venous Gangrene?
No venous return, No arterial circulation getting to tissue
62
Postphlebitic Syndrome is also know as what?
Venous insufficiency
63
What causes venous insufficiency?
non-functioning valves resulting in the inability for the blood to travel proximally to the heart
64
What is the term meaning "non-functioning valves"?
Valvular incompetence
65
What is ambulatory venous pressure?
the pressure with the veins when standing
66
What is it called when there is an increased pressure inside the vein?
venous hypertension
67
When venous pressure increases, the pressure in the microvasculature _____________.
increases
68
What is the result of increased microvasculature pressure?
edema
69
What occurs when there is edema?
RBCs are released into the tissue, RBCs break down causing hyperpigmentation, O2 absorption is diminished leading to ulceration
70
Where does hyper pigmentation normally occur?
Gaiter area
71
What are the risk factors for venous insufficiency?
DVT (80% will get CVI), Long sessions of standing or sitting, female, Family Hx, Age, pregnancy
72
What is the treatment for venous insufficiency?
Compression stockings, leg elevation, skin care for ulcers, sclerotherapy, Vein stripping, RFA
73
What is vein stripping?
removal of superficial veins
74
What is RFA?
radio frequency ablation
75
What are Primary Varicose Veins?
Hereditary, superficial, varicose veins
76
What are secondary varicose veins?
Related to another problem, Deep vein issue (insufficiency) , Deep pressure higher than superficial, Venous blood gathers in superficial system, RECURRENT

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