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Hem/Onc > Anticoagulation Disorders > Flashcards

Anticoagulation Disorders Flashcards

1
Q

What are the risk factors for VTE?

A
  1. Age > 50
  2. Family hx
  3. Venous stasis
  4. Vascular injury
  5. Hypercoagulable disorders
  6. Drugs
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2
Q

What are the 3 components of Virchow’s Triad?

A
  1. Venous stasis
  2. Vascular injury
  3. Hypercoagulability
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3
Q

What falls under venous stasis in Virchow’s Triad?

A
  1. immobility
  2. paralysis
  3. atrial fibrillation
  4. LV dysfunction
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4
Q

What falls under vascular injury in Virchow’s Triad?

A
  1. indwelling catheter
  2. trauma
  3. surgery
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5
Q

What falls under hypercoagulability in Virchow’s Triad?

A
  1. protein C & S deficiencies
  2. antithrombin deficiency
  3. malignancy
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6
Q

What are the hereditary hypercoagulable disorders?

A
  1. Activated Protein C resistance/Factor V leiden mutation
  2. Prothrombin gene mutation
  3. Protein C deficiency
  4. Protein S deficiency
  5. Antithrombin deficiency
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7
Q

What are the acquired hypercoagulable disorders?

A
  1. pregnancy
  2. antiphospholipid antibodies
  3. drug therapy
  4. malignancy
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8
Q

What are the implications of cancer-associated VTE?

A
  1. increased mortality
  2. increased risk of fatal PE
  3. increased risk of recurrent VTE
  4. increased risk of bleeding
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9
Q

What are the four categories of risk factors for cancer-associated VTE?

A
  1. cancer related
  2. treatment related
  3. patient related
  4. biomarkers
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10
Q

What are the cancer related risk factors?

A
  1. primary site
  2. cancer histology
  3. time after diagnosis
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11
Q

What are the treatment related risk factors?

A
  1. chemotherapy
  2. antiangiogenic agents
  3. hormonal therapy
  4. erythropoiesis agents
  5. transfusions
  6. indwelling ports
  7. radiation
  8. surgery > 60 min
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12
Q

What are the patient related risk factors?

A
  1. older age
  2. race
  3. medical comorbidities
  4. obesity
  5. Hx of VTE
  6. low performance status
  7. inherited mutations
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13
Q

What are the biomarker risk factors?

A
  1. platelet count ≥ 350,000
  2. WBC count > 11,000
  3. hemoglobin < 10
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14
Q

Which cancers have a high risk for VTE?

A

pancreas, liver, stomach, esophagus, brain, leukemia, and lymphoma

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15
Q

Which cancers have an intermediate risk for VTE?

A

multiple myeloma, myeloproliferative neoplasm, lung, kidney, bladder, and prostate

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16
Q

Which cancers have a low risk for VTE?

A

ovary, breast, myelodysplastic syndrome, colon, and rectal

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17
Q

What are the S/Sx of DVT?

A
  1. unilateral calf pain or thigh swelling
  2. leg pain/calf tenderness
  3. increased leg warmth
  4. edema
  5. erythema
  6. palpable thrombosed veins
  7. homans sign
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18
Q

What are the S/Sx of PE?

A
  1. dyspnea
  2. tachypnea
  3. tachycardia
  4. hemoptysis
  5. chest pain and/or tightness
  6. cough
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19
Q

What is d-dimer?

A

a by-product of thrombin

20
Q

What is the normal range of d-dimer?

A

0-250 ng/mL

21
Q

What is the non-invasive test for DVT?

A

duplex ultrasonography

22
Q

What is the downside to duplex ultrasonography?

A

It can’t reliably detect small blood clots in distal veins

23
Q

What is the invasive test for DVT?

A

contrast venography

24
Q

What are the downsides to contrast venography?

A

placement of catheter, iodinated contrast, and radiation exposure

25
Q

What are the contraindications for contrast venography?

A

renal dysfunction and dye allergy

26
Q

What are the non-invasive tests for PE?

A

Ventilation-perfusion scanning and contrast-enhanced spiral chest CT

27
Q

When is V/Q scanning preferred?

A

In patients with kidney disease or with allergies to contrast dye

28
Q

What is the invasive test for PE?

A

pulmonary angiography

29
Q

What are the contraindications for pulmonary angiography?

A

renal dysfunction and dye allergy

30
Q

What is the dosing for treatment of VTE with UFH?

A

80 U/Kg IV bolus + 18 U/kg/hr IV

31
Q

What is the goal of UFH?

A

aPTT 0.3-0.7 IU/mL

32
Q

What is the outpatient treatment regimen with enoxaparin?

A

1 mg/kg SC q12h

33
Q

What is the inpatient treatment regimen with enoxaparin?

A

1 mg/kg SC q12h or 1.5 mg/kg qd

34
Q

What is the dose adjustment of enoxaparin if CrCl < 30?

A

1 mg/kg SC q24h

35
Q

What is the treatment regimen with dalteparin?

A

200 IU/kg SC once daily for 1 month, then 150 IU/kg SC once daily for 5 months

36
Q

What is the target anti Xa level in patients with CrCl < 30?

A

0.5-1.5 IU/mL

37
Q

What is the treatment regimen with tinzaparin?

A

175 IU/kg SC once daily

38
Q

What is the treatment regimen for fondaparinux for weight < 50 kg?

A

5 mg SC daily

39
Q

What is the treatment regimen for fondaparinux for weight 50-100 kg?

A

7.5 mg SC daily

40
Q

What is the treatment regimen for fondaparinux for weight > 100 kg?

A

10 mg SC daily

41
Q

Which drug is contraindicated in CrCl < 30?

A

fondaparinux

42
Q

What is the goal range of anti-Xa for enoxaparin, dalteparin, and tinzaparin?

A

0.5-1.0 IU/mL

43
Q

What is the preferred agent for long-term anticoagulation therapy?

A

LMWH given for at least 6 months

44
Q

What are the disadvantages of warfarin in cancer?

A
  1. narrow therapeutic window
  2. frequent monitoring
  3. drug and food interactions
  4. interruptions due to procedures
  5. resistance
45
Q

What are the advantages of LMWH in cancer?

A
  1. body weight adjusted dose
  2. no labs
  3. predictable response
  4. rapid onset
  5. Less recurrence and bleeding (dalteparin)
46
Q

What is the only acceptable alternative for VTE management if a patient denies LMWH?

A

apixaban

Hem/Onc (4 decks)

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