Antiplatlet Use In Medical Events

Question 1

Acute ischemic stroke

Answer 1

If within 3-4.5 hours give thrombolytic
Decrease risk of ascvd give asa+p2y12 (chronic)

Question 2

Cerebral venous sinus thrombosis

Answer 2

Initially heparin (UFH VS LMWH)
(Direct 10a inhibitors or Thrombin inhibitor) or warfarin

Question 3

Cerebral venous sinus thrombosis

Answer 3

Initially heparin (UFH VS LMWH)
Direct oral anticoagulants or warfarin

Question 4

Acute coronary syndrome (unstable angina, STEMI, nonSTEMI)

Answer 4

1. Antiplatlets -asa/p2y12 receptor inhibitors
2. If plans for PCI and at high risk (Gp3a2b receptor inhibitors)
3. If PCI - start heparin
4. After PCI start aspirin+p2y12 receptor inhibitor (12 months)
5. Asa or p2y12 (chronic)

Question 5

Acute coronary syndrome (unstable angina, STEMI, nonSTEMI)

Answer 5

1. Antiplatlets -asa/p2y12 receptor inhibitors
2. If plans for PCI and at high risk (gp2b3a receptor inhibitors)
3. If PCI - start heparin
4. After PCI start aspirin+p2y12 receptor inhibitor (12 months)
5. Asa or p2y12 (chronic)

Question 6

Atrial fibrillation

Answer 6

1. Heparin
2. Transition to warfarin for vascular atrial fib (mitral stenosis)
   Nonvalvular - doac or warfarin

Question 7

Left ventricular thrombosis

Answer 7

Heparin
Transition to DOAC or warfarin unless mechanical valve then warfarin + aspirin

Question 8

Left ventricular thrombosis

Answer 8

Heparin
Transition to DOAC or warfarin unless mechanical valve then warfarin + aspirin

Question 9

Unstable Pulmonary embolism (hypotension, tachycardia, hypoxic)

Answer 9

Thrombolytics

Question 10

Unstable Pulmonary embolism (hypotension, tachycardia, hypoxic)

Answer 10

Thrombolytics

Question 11

Stable pulmonary embolism

Answer 11

Heparin ufh or (lmwh for cancer patients)
Transition to (10a inhibitors or thrombin inhibitors ) or warfarin

Question 12

Reduce risk of atherosclerosis cardiovascular disease (ascvd)

Answer 12

1st line aspirin and/or p2y12 receptor inhibitors
For severe symptoms of PAD ( peripheral arterial disease) -cilastazol

Question 13

Acute limb ischemia

Answer 13

Catheter directed TPA
Prior to intervention give heparin

Question 14

DVT

Answer 14

If high clot burden with significant complications(give TPA)
Otherwise give heparin then transition to DOAC (preferred) or warfin (3-6 months)

Question 15

Mesenteric venous thrombosis (Liver) leads to…..

Answer 15

Portal hypertension and ascites

Question 16

Mesenteric venous thrombosis

Answer 16

Heparin (UFH Or LMWH)
Or can use anticoagulants if using for alternative indication

Question 17

Risk factors for DVT

Answer 17

Immobility
Surgery
Malignancy

Question 18

Risk factors for DVT

Answer 18

Immobility
Surgery
Malignancy

Question 19

Venous thromboembolism prophylaxis

Answer 19

Low dose heparin (lmwh)
Anticoagulants for underlined disorders

Question 20

Prevention of circulatory clotting in ECMO or coronary pulmonary artery bypass

Answer 20

Heparin (UFH >LMWH)

Question 21

Central venous catheter clot

Answer 21

TPA