Chapter 2 BNF (Bleeding Disorders) Flashcards

1
Q

VTE risk factors?

A
Immobility
obesity BMI >30
Malignant diseases 
60+ years 
personal history
HRT/COC
Pregnancy
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2
Q

Bleeding risk factors?

A

Thrombocytopenia
stroke
liver failure, haemophilia, von williebrands
systolic hypertension

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3
Q

Different durations of VTE prophylaxis?

A

General surgery - 5-7 days

Major cancer surgery in abdomen or pelvis - 28 days

knee/ hip - extended

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4
Q

Treatment of VTE?

A

LMWH or Unfractionated in renal failure

atleast 5 days until INR is 2 for 24hours

start oral warfarin at the same time

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5
Q

What should be monitored in unfractionated heparin?

A

APTT

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6
Q

VTE in pregnancy?

A

LMWH

lower risk of osteoporosis and thrombocytopenia

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7
Q

When are unfractionated heparins preferred?

A

High risk of bleeding
renal impairment

as shorter duration

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8
Q

Heparin antidote?

A

Protamine

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9
Q

Heparin side effects?

A

Haemorrhage
hyperkalemia
osteoporosis
Thombocytopenia

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10
Q

Warfarin tablet colours?

A

0.5 white
1mg brown
3mg blue
5mg pink

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11
Q

warfarin onset of action?

A

48-72hours

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12
Q

Warfarin dose and monitoring?

A

dose: 5mg initially adjust to 3mg-9mg at same time each day

monitor INR every 3 months

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13
Q

Warfarin duration of treatment in different indications?

A

Isolated calf DVT - 6 weeks

provoked VTE - 3 months

Unprovoked (AF) - at least 3 months

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14
Q

Warfarin MHRAs?

A

Antivirals
Daktarin oral gel
Calciphylaxis

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15
Q

Warfarin in surgery?

A

stop 5 days before
give phytomenandione if INR above 1.5

emergency: delay 6 - 12 house if not give vit K and dried prothrombin complex

If high risk of VTE, bridge with LMWH and stop 24 hours before surgery

high risk of bleeding, start LMWH 48hours after surgery

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16
Q

Transient ischaemic attack long term management?

A

Dipyridamole MR and aspirin

Statin

17
Q

Ischaemic Stroke?

A

Clopidogrel

in af review management

18
Q

Dipyradamole counselling

A

MR caps should be taken 30 - 60 minutes before food

6 week expiry

keep in original pack