DVT/PE Flashcards
what kidney risk factor is there for DVT?
nephrotic syndrome
Is antiphospholipid syndrome an acquired or hereditary risk factor for DVT?
acquired
upper extremity DVT is a sign of what>
IVDU
DVT ppx in CKD?
heparin
DVT ppc in cancer patients?
Lovenox
Components of HIT?
Timing (5-10days), thrombocytopenia >50% reduction, thrombosis, no alternative cause.
STOP HEPARIN AND START DIRECT THROMBIN INHIBITOR- LEPIRUDIN, ARGATROBAN, DANAPAROID
What happens if we have HIT in the first 4 days and platelet nadir >100,000.
can continue tx– but must continue when it starts 4-10 days and have thrombotic events etc.
Symptoms of PE?
syncope, hypotension, JVD, right S3. Pleural friction rub or loud P2
ABG not diagnostic but low PaO2, Low PaCO2 and High pH, Respiratory alkalosis
Wells Criteria 1 pointers
cancer immobile bedridden/surgery tenderness along vein swelling entire leg swelling calf >3cm diff unilateral pitting edema collateral veins previous DVT
1-2= medium
3+ High
If well’s low risk what do we order…if high risk? DVT
D Dimer
Ultrasound (also order if positive D Dimer)
If well’s modified low risk for PE what do we do? high risk?
d Dimer
Spiral CT/ CTA (if Ddimer positve then too)
When do we use VQ scan?
contrast allergy or CKD
What do we do for PE in pregnant women?
CXR
V/Q scan if normal CXR
Spiral CTA if abnormal CXR
What do we monitor with heparin blood tests
PTT and platelets
What is anticoagulation treatment duration?
1st VTE provoked- 3 months
1st VTE unprovoked- 6 months
2nd VTE or high risk thrombophilia- indefinite
Cancer- indefinite
