Bleeding Disorders Flashcards
What is a DVT?
A blood clot that occurs in a deep vein, usually in the calf of one leg
What is a PE?
Detachment of blood clot which travels to the lungs and blocks the pulmonary artery
What is in the VTE risk assessment?
Immobility Obesity Malignant disease 60+ History of VTE HRT/COC Pregnancy
What is in the risk of bleeding assessment?
Thrombocytopenia Acute stroke Bleeding disorders Anticoagulants Systolic hypertension
When is mechanical VTE prophylaxis used?
For patients scheduled for surgery until sufficiently mobile
When is pharmacological VTE prophylaxis used?
For high risk VTE patients undergoing general/orthopaedic surgery
OR admitted as general medical patients
What are the parenteral anticoagulants?
LMWH
Unfractionated heparin in renal failure
Fondaparinux
When are DOACS used for VTE prophylaxis?
After knee/hip surgery
Edoxaban used for treatment and prevention of recurrent VTE
What is the duration of VTE prophylaxis?
General surgery 5-7 days or until mobile
Major cancer surgery in abdomen or pelvis 28 days
Knee/hip surgery extended duration
How do you treat VTE?
LMWH or unfractionated heparin in renal failure
For at least 5 days and until INR at 2+ for more than 24 hours
Start oral anticoagulant at same time, usually warfarin
How do you treat VTE in pregnancy?
LMWH
Lower risk of osteoporosis and heparin induced thrombocytopenia
Stop at Labour onset
What is an ischaemic stroke?
Blood clot obstructs blood supply
TIA or ischaemic stroke
What is a haemorrhagic stroke?
Weak blood vessel in brain bursts
Intracerebral haemorrhage
How do you manage a TIA?
MR dipyridamole and aspirin + statin
How do you manage an ischaemic stroke?
Clopidogrel + statin
In a. Fib related review anticoagulant need
