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cp test 2 > B4-030 CBCL: Venous Thromboembolism > Flashcards

B4-030 CBCL: Venous Thromboembolism Flashcards

1
Q

treatment for superficial vein thrombosis

A
  • warm compress
  • anti-inflammatory
  • follow up visit
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2
Q

homozygosity for Factor V Leiden or APLS require

A

long term anticoagulation

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3
Q

in a young patient with DVT and no known predisposition, what further testing should be done?

A

hypercoagulable work up for both inherited and non inherited disorders

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4
Q

unusual sites of thrombosis require

A

more extensive testing

malignancies and other underlying states

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5
Q

APLS should be managed with long term anticoagulation with

A

vitamin K antagonists

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6
Q

for patients over 50, the d dimer cutoff should be

A

10x their age

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7
Q
  • arterial blood flow to the limb is acutely compromised from severe arterial occlusion
  • painful, pale leg
A

phlegmasia alba dolens

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8
Q
  • severe and extensive acute DVT resulting in limb threatening emergency
  • venous blood unable to return to heart causing severe edema
A

phlegmasia cerulea dolens

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9
Q

occurs months/years after acute DVT has resolved

A

post thrombotic syndrome

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10
Q

catheter directed thrombolytic therapy reduces

A

the incidence of post thrombotic syndrome in some patients

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11
Q

results most often from compression of left iliac vein from right iliac artery

A

may thurner syndrome

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12
Q

associated with pelvic inflammatory disease, pregancy, or pelvic fx/surgery

A

pelvic vein thrombosis

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13
Q

occurs following long bone fx requiring surgery

A

fat embolization

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14
Q

acute PE with severe tachycardia and hypotension, non pleuritic chest pain

think…

A

RV strain/RV infarction

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15
Q

PE with pleuritic pain, hemoptysis

think..

A

pulmonary infarction

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16
Q

if clinical probability of PE is very high, first step is

A

start heparin therapy, then testing

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17
Q

in a patient with renal failure, what test can be done to dx PE?

A

VQ scan

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18
Q

in a pregnant patient with suspected PE, what test should be done to diagnose PE?

A

duplex of lower extremity

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19
Q

a large, acute PE can result in

A

RV dilation and flattened interventricular septum

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20
Q

classify risk of PE

hemodynamically unstable
PESI >1
RV dysfunction
Elevated troponin

A

high

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21
Q

classify risk for PE

stable
PESI >1
RV dysfunction
elevated troponin

A

intermediate high

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22
Q

classify risk of PE

stable
PESI >1
RV dysfunction OR elevated troponin

A

intermediate low

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23
Q

classify risk of PE

stable
negative on all assessments

A

low

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24
Q

needed to decide if patient is at high risk of acute mortality

A

RV/LV ratio

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25
Q

if you do not have echocardiogram, you can get RV/LV ratio from

A

CT scan

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26
Q

intervention that does not require thrombolytics and can remove large amounts of thrombus quickly

A

catheter directed mechanical pulmonary thrombectomy

27
Q

recent bleeds and active malignancy are contraindications for

A

thrombolytic therapy

28
Q

pose the highest risk of DVT

A

orthopedic surgery

29
Q

a palpable cord is likely to be from

A

thrombosis of superficial vein

30
Q

symptoms of DVT

A

painful, swollen leg
eythema, warmth

31
Q

patient complains of pain when dorsiflexing foot

A

homan’s sign

non specific for DVT

32
Q

indwelling central line is a risk factor for

A

DVT

33
Q

considerations for outpatient DVT treatment

A
  • compliance to anticoagulants
  • do not have the potential to worsen
34
Q

pleuritic pain is concerning for

A

pulmonary infarct

35
Q

significant leg swelling is concerning for

A

large thrombus with potential to embolize

36
Q

patients with malignancy are high risk for VTE and require

A

long term anticoagulation

37
Q

best efficacy for long term anticoagulation is seen with

A

enoxaparin injections

38
Q

unexplained weight loss is concerning for

A

malignancy

39
Q

if you cannot find obvious cause of DVT follow up with

A

scans to rule out cancer

40
Q

does heterozygosity for factor V leiden increase the risk of recurrent embolism?

A

no

41
Q

increasing incidence and decreasing mortality of PE is due to

A

increase in use of CTA chest for mild suspicion of PE

42
Q

when should IVC filters be removed

A

as soon as no longer necessary

43
Q

risks of IVC filters

A
  • migration
  • fragmentation
  • infection
44
Q

when should an IVC filter be left in place long term?

A

patients who have ongoing high risk for VTE and contraindication for anticoagulation

45
Q

if risk of recurrence is low and factors are reversible, how long should the patient take anticoagulants?

A

3 months

46
Q

risk of VTE increases significantly at what age

A

55

47
Q

are men or women more affected by VTE?

A

men

48
Q

key driver in OCCs for increased VTE risk

A

estrogen

49
Q

virchow’s triad

A
  • hypercoagulability
  • stasis
  • vessel wall damage
50
Q

how does a DVT cause stroke?

A

embolized DVT can enter arterial circulation via patent foramen ovale

51
Q

direct thrombin inhibitor

A

dabigatran

52
Q

do IVC filters reduce mortality?

A

no

53
Q

do IVC reduce recurrence rate of PE?

A

yes

not DVT

54
Q

antiphospholipid syndrome requires

A

lifelong anticoagulation

55
Q

thromboxane and serotonins cause

A

pulmonary vasocontriction

leads to RV strain

56
Q

in patients with a low pretest probability of DVT or PE, what test should be done first?

A

d dimer

57
Q

right ventricular stain causes decreased

A

cardiac output

58
Q

right ventricular strain is caused by

A

increased PA pressure and RV wall ischemia from hypoxia

59
Q

used to indentify severity of PE by showing RV strain

A

echocardiogram

60
Q

in critically ill patients with massive PE, what two therapies are life saving?

A

surgical embolectomy
ECMO

61
Q

severe and life threatening condition that can be seen years after PE

A

chronic thromboembolic pulmonary hypertension

62
Q

CTEPH results in

A

pulmonary hypertension

63
Q

CTEPH is more likely following

A

incomplete resolution of thrombus due to:
-high thrombus burden
-repeated PE episodes

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