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Hugh's MD2 Core Conditions and Presentations > DVT/PE > Flashcards

DVT/PE Flashcards

1
Q

How do you reverse warfarin?

A

Prothrombin X (25 units per Kg)

FFP (one bag)

Vitamin K

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2
Q

What are some treatment options for PE?

A

Therapeutic clexane

Heparin

Alteplase

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3
Q

What is the mechanism of action of rivaroxaban?

A

Inhibitor of factor 10a

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4
Q

What are some presenting symptoms of PE?

A

SOB

Chest pain

Calf pain

Haemoptysis

Cough

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5
Q

What are some options for prophylaxis?

A

Chemical prophylaxis - exonaparin

Mechanical - TEDS, intermittent pneumatic compression

Early mobilisation

IVC filter

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6
Q

What is the mechanism of action of clopidogrel?

A

Blocks the P2Y12 receptor on platelets that ADP binds to

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7
Q

What constitutes major surgery?

A

Abdominal surgery >45minutes

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8
Q

What are some risk factors?

A

Hospialised/not ambulating

Pelvic/laproscopic surgery

Malignancy

Hypercoagulable states

Obesity

Pregnancy

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9
Q

What anticoagulation is required for stents?

A

Bare metal

  • Life long aspirin
  • 4 months clopridogrel

Drug eluding

  • Life long aspirin
  • 12 months clopridogrel
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10
Q

What is the mechanism of action of heparin?

A

It activates antithrombin III causing inactivation of thrombin and factor 10a and hence reduced clotting

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11
Q

When do you use an IVC filter?

A

Patient with Hx of DVT/PE where anticoagulation is contraindicated

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12
Q

Does chemical prophylaxis increase the risk of bleeding in surgery?

A

Not for major bleeds

Some haematomas

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13
Q

What is co-plavix?

A

Clopridogrel + aspirin

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14
Q

How does warfarin work?

A

Inhibits vitamin K reductase thereby blocking synthesis of vit K dependent clotting factors - 2,7,9, and 10

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15
Q

What is the mechanism of action of apixaban?

A

Factor 10a inhibitor

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16
Q

What is the mechanism of action of dabigitran?

A

Direct thrombin inhibitor

17
Q

Why is laproscopic surgery higher risk for DVT?

A

Venous stasis

18
Q

How long do you place someone on prophylaxis?

A

5-7 days or until fully mobile

Extended prophylaxis for major pelvic surgery/in the setting of malignancy

19
Q

What are some primary disease of hypercoagulation?

A

Factor V leiden

Anti-phospholipid syndrome

Protein C/S deficiency

Lupus anticoagulant

20
Q

What are the WELLS criteria? What is their purpose?

A

Symptoms of DVT (3pt)

Symptoms not attributable to another pathology (3pt)

Immobilisation (>3days) or surgery in prev four weeks (1.5pt)

Tachycard >100 (1.5pt)

PHx of DVT or PE (1.5pt)

Presence of haemoptysis (1pt)

Presence of malignancy (1pt)

To determine pretest probability when performing a CTPA - >6 is high risk and a CTPA can be performed without D-dimer

Hugh's MD2 Core Conditions and Presentations (67 decks)

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