Brainscape's Knowledge GenomeTM

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


See full index

2. Cardiovascular System > 35.DVDT and Pulmonary Embolism (venous thromboembolism) > Flashcards

35.DVDT and Pulmonary Embolism (venous thromboembolism) Flashcards

1
Q

What is the prevalence rate of venous thromboembolism in a population?

A

1 in 1000 per year

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

What is the fatality/death rate in venous thromboembolism patients?

A

1-5%

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

When is the biggest risk of venous thromboembolism?

A
  • postoperative risk

- can be up to 6 week after discharge

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

Define thrombus.

A
  • blood clot formed in situ (stationary/in one place) within a vascular system of the body of impeding blood flow
  • causes vascular obstruction
  • remain attached to its place of origin (unlike embolism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define thromboembolism

A

movement of clot along a blood vessel to other body regions

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

Define embolism.

A
  • obstruction of an artery (can be clot, air bubble or any foreign material) that becomes stuck while travelling through the blood stream
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 2 things balance haemostasis?

A
  1. bleeding

2. thrombosis

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

What are 3 components of the Virchow’s Triad which contribute to thrombosis?

A
  1. stasis
  2. hypercoagulability
  3. vessel damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 2 factors which can affect blood stasis?

A
  1. bed rest (e.g. post op)

2. travel

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

What are 2 factors which can affect hypercoagulabiltiy?

A
  1. pregnancy

2. trauma/injury

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

What can affect vessel damage?

A

atherosclerosis

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

What are 2 main examples of venous thromboembolism?

A
  1. limb deep vein thrombosis

2. pulmonary embolism

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

What are conditions similar to venous thromboembolism? (3)

A
  1. visceral venous thrombosis
  2. intracranial thrombosis
  3. superficial thrombophlebitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is visceral venous thrombosis?

A

Thrombosis of splenic, hepatic, mesenteric, portal, renal, ovarian veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is intracranial thrombosis?

A

-thrombosis and obstruction in the cerebral veins

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

What is superficial thrombophlebitis?

A
  • vein inflammation which is due to a blood clot
  • thrombus develops in the vein which close to the surface of the skin
  • can occur anywhere but more likely in lower body regions
  • most superficial veins that develop thrombosis also develop phlebitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is venous thrombus mainly made up of? (2)

A
  1. fibrin
  2. red cells
    “red thrombus”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes a venous thrombus? (2)

A
  • results from back pressure

- due to stasis and hypercoagulability

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

Why is atherosclerosis not common in veins which is why vessel damage isn’t the main cause of venous thrombus?

A

Because arteries have blood at much higher pressure than veins which makes them more susceptible to vessel damage and plaque formation which results from high BP that causes endothelial damage (original insult to start cascade for plaque formation).
This is LESS common in veins

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

What is arterial thrombus mainly made up of? (2)

A
  1. fibrin
  2. platelets
    “white clot”
21
Q

What are arterial thrombi principally secondary to? (what causes them?)

A

atherosclerosis (due to vessel damage)

22
Q

What do arterial thrombi result in? (2)

A
  1. ischaemia

2. infarction

23
Q

Can DVT be clinically silent?

A

yes

24
Q

What are the common symptoms and signs of DVT? (7)

A
  1. unilateral limb swelling
  2. persisting discomfort
  3. calf tenderness
  4. warmth
  5. redness; erythema
  6. mild fever
  7. pitying oedema
25
Q

What are common symptoms and signs of pulmonary embolism? (5)

A
  1. pleuritic chest pain
  2. breathlessness; dyspnoea
  3. haemoptysis (blood in sputum)
  4. tachycardia
  5. pleural rub on auscultation
26
Q

What are common symptoms and signs of a massive pulmonary embolism? (6)

A
  1. severe dyspnoea of sudden onset
  2. blue lips and tongue (cyanosis)
  3. tachycardia
  4. low blood presure
  5. raised JVP
  6. altered heart sounds
    MAY CAUSE SUDDEN DEATH
27
Q

What is the biggest potential long-term consequence of DVT?

A

Post-phlebetic syndrome; due to venous inflammation and damage to venous valves

28
Q

What are signs of post-phlebetic syndrome? (4)

A
  • swelling and oedema
  • discomfort (itching/tingling)
  • pigmentation (reddish/brownish)
  • ulceration
29
Q

What is the biggest potential long term consequence of pulmonary embolism?

A

pulmonary hypertension

30
Q

What 2 component of the Virchow’s Triad are the biggest risk factors for venous thrombosis?

A
  1. Stasis

2. Hypercoagulability

31
Q

What are risk factors for venous thrombosis? (9)

A
  1. increasing age
  2. tissue trauma
  3. immobility
  4. obesity
  5. smoking
  6. some systemic disease e.g. cancer
  7. inheritance
  8. pregnancy
  9. exogenous oestrogen
32
Q

Define heritable thrombophilia.

A

An inherited predispostion to venous thrombosis

33
Q

What is the most common and prevalent hertiable thrombophillia?

A

Factor V Leiden

34
Q

What % of Caucasians suffer from Factor V Leiden? (heritable thrombophillia)

A

5%

35
Q

What does heritable thrombophilia condition like Factor V Leiden increase the risk of?

A

venous thromboembolism

36
Q

What increases risk of Factor V Leiden (clotting disorder) which leads to venous thromboembolism?

A

oral contraceptive

37
Q

Who does travel affect in terms of increasing risk of venous thromboembolism? (5)

A
  1. short
  2. tall
  3. overweight /obese
  4. women on the contraceptive pill
  5. window seats people
38
Q

What investigations need to be done to diagnose DVT? (5)

A
  • clinical assessment
  • Blood test: D dimer (measures substance that is released when clot broken down)
  • ultrasound (for propagating DVTs)
  • thrombophilia test (esp. if in family history or no predisposing factors)
  • check underlying malignancy
39
Q

What imaging techniques can be used as investigation for DVT? (1)

A

-compression ultrasound (to check for malignancies or for propagating DVTs)

40
Q

What features are on the clinical probability assessment used to establish if patient is at risk of a DVT?

A
  1. active cancer
  2. paralysis
  3. bed>3 days/ surgery within 4 weeks
  4. tender veins
  5. entire leg and calf swelling>3cm
  6. pitting oedema
  7. collateral veins
  8. alternative diagnosis likely (-2 points)
41
Q

What is a low probability score for clinical probability assessment for DVT?

A

0 or less (~3% risk)

42
Q

What is a moderate probability score for clinical probability assessment for DVT?

A

1 or 2 (~17% risk)

43
Q

What is a high probability score for clinical probability assessment for DVT?

A

3 or more (~75% risk)

44
Q

What investigations are done to diagnose pulmonary embolism? (7)

A
  1. clinical assessment
  2. D dimer (blood)
  3. CT pulmonary angiogram
  4. Isotope ventilation/perfusion scan
  5. chest x ray
  6. full blood count: Urea+electrolytes, arterial blood gases (ABG), baseline clotting
  7. ECG
45
Q

What preventive measure of venous thromboembolism can be undertaken in a hospital?

A
  1. early mobilisation
  2. anti-embolism stockings
  3. other physical methods
  4. daily injections of low molecular weight heparin (anticoagulant)
46
Q

How do antiembolism stockings help reduce risk of DVT?

A

Promote maximal femoral blood flow velocty of 139% baseline

47
Q

What pressures do antiembolism stockings in the 3 leg regions?

A
  1. 18mmHg at the ankle
    2;. 14mmHg at the mid-calf
  2. 8mmHg at the upper thigh
48
Q

When are graduated compression stockings used? (6)

A
  1. prevention of DVT
  2. chronic venous insufficiency
  3. varicose veins
  4. oedema
  5. lymphoedema
  6. prevention of post-phlebetic syndrome

2. Cardiovascular System (42 decks)

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