46 - Hypercoaguable Disorders Flashcards
1
Q
What is the most frequent cause of inherited thrombophilia?
A
Factor V Leiden mutation
2
Q
What are some prophylactic measures that can be utilized to decrease the risk of thrombosis?
A
- Sequential compression devices
- Compression stockings - TED hose
- Ambulation
- LMWH
- NOT strict bed rest
3
Q
What tests should you run if you have a patient with a red, warm, swollen and tender leg or pulmonary embolism?
A
Diagnostic tests
Initial tests
- Duplex ultrasound
- D-dimer
- Chest CT
Blood tests (can do initially)
- Resistance to activated protein C clotting assay
- Genetic testing for prothrombin G20210A mutation
- Functional Assay of antithrombin
- Functional Assay of protein C
- Functional Assay of protein S
- Clotting assay for lupus anticoagulant
- ELISA for anticardiolipin antibodies
- Fasting total plasma homocysteine
4
Q
How do you treat a thrombosis?
A
Treatment
- Acute: heparin
- Long-term: warfarin
We put patients on heparin first because warfarin is not effective right away, and also because you are going to decrease the protein C and S concentration when they are given warfarin initially so you will actually have some pro-coaguable tendencies
