CVD - Thromboembolism

Question 1

Antidote for Low MWT Heparin?

Answer 1

Protamine Sulphate

Question 2

VTE Surgery - Hip replacement treatment options?

Answer 2

Low MWT Heparin for 10 days then 75mg Aspirin for 28 days

Or

Low MWT Heparin for 28days then stockings

Or

Rivaroxaban

Question 3

VTE Knee replacement management plan?

Answer 3

75mg Aspirin for 14 days

Or

Low MWT Heparin for 14 days + stocking

Or

Rivaroxaban

Question 4

General surgery management?

Answer 4

At least 7 days
or mechanical until Mobile

Question 5

VTE Prophylaxis in Pregnancy?

Answer 5

Low MWT Heparin during Hospital

Prophylaxis till no risk or discharge

Question 6

VTE prophylaxis in: Birth, Miscarriage, Termination?

Answer 6

4-8 Hours Low MWT Heparin then continue for 7 days

Question 7

Unfractionated Heparin Risk?

Answer 7

Haemorrhage

Question 8

Which Heparin has the quickest reversal in anticoagulant effect?

Answer 8

Unfractionated Heparin due to short Half life

Reversed with Protamine Sulphate

Question 9

If DVT is confirmed, what’s the treatment?

Answer 9

Apixaban or Rivaroxaban

Question 10

If Apixaban/Rivaroxaban unsuitable in confirmed VTE?

Answer 10

Low MWT heparin can be used for 5 days followed by either Dabagratan or Edoxaban

Or

Low MWT heparin for 5 days or until INR 2.0 for two readings followed: Warfarin

Question 11

Maximum Tranexamic acid dose?

Answer 11

4g

Question 12

What is given before General or Orthopaedic surgery prophylactically?

Answer 12

Low MWT Heparin

Question 13

Preferred Heparin in Renal
Impairment?

Answer 13

Unfractionated Heparin

Due to lower half life

Question 14

Preferred Heparin in pregnancy?

Answer 14

Low MWT Heparin

Stop during onset of Labour

Question 15

Examples of low MWT Heparin?

Answer 15

Tinzeparin
Enoxoparin
Dalteparin

TED

Question 16

Risk factors of thromboembolism?

Answer 16

HRT
History of DVT
Cancer
Over 60’s
Overweight/obese
Males
Heart failure
Immobility
Varicose vein
Smoking
Pregnant
Surgery

Question 17

Thromboembolism Diagnosis test?

Answer 17

D-Dimer test

Question 18

Low limb fracture/immobile Heparin?

Answer 18

Fondaparinux

Question 19

How long to continue pharmalogical prophylaxis for VTE Post normal surgery?

Answer 19

7 days or until
Mobility is established

Question 20

How long to continue pharmalogical prophylaxis for VTE after Major cancer surgery in abdomen?

Answer 20

Usually 28 days

Question 21

How long to continue pharmalogical prophylaxis for VTE after spinal surgery?

Answer 21

Usually 30 days

Question 22

Doac monitoring?

Answer 22

None!!! :)

Question 23

Apixaban dose for Thromboembolism?

Answer 23

10mg BD for 7 days

Then

5mg BD longterm

Question 24

Rivaroxaban dose for Thromboembolism?

Answer 24

15mg BD for 3 weeks

Then
20mg OD LONGTERM

TO BE Taken with FOOD

Question 25

Which DOAC needs to be taken with food?

Answer 25

Rivaroxaban

Question 26

Dabigatran Dosing for Thromboembolism?
Hint: Age dependent

Answer 26

18-74yrs : 150mg BD

75-79yrs: 110-150mg BD

80yrs+: 110mg BD

Question 27

Edoxaban Dosing for Thromboembolism?
Hint: Weight dependent

Answer 27

60mg OD

OR if pt is under 61kg ( HALF DOSE )
»>30mg od

Question 28

Heparins Negative things?

Answer 28

Can cause Hyperkalaemia

Can cause a Haemorrhage

Avoid in Heparin induced Thrombocytopenia

Question 29

Heparin induced Thrombocytopenia signs?

Answer 29

• Reduction in platelet count approx 30%
• Thrombosis
• Skin allergy

Question 30

What to do in the case of Thrombocytopenia?

Answer 30

Stop Heparin, Start Danaparoid!!

(Alternative anticoagulant)