E4. VTE

Question 1

Virchow’s Triad

Answer 1

1) Hypercoagulable State
2) Circulatory Stasis
3) Vascular Injury

Question 2

Arteries are ____ rich.

Answer 2

Platelet

Question 3

Veins are ____ rich

Answer 3

Fibrin

Question 4

How are venous clots treated?

Answer 4

Anticoagulants.

Question 5

What is the treatment goal of VTE?

Answer 5

To prevent VTE from occurring in patients who are at high risk.

Question 6

How is VTE treated?

Answer 6

1) Low dose anticoagulation
2) Mechanical prophylaxis.

Question 7

How do we decide which patients required thromboprophylaxis for VTE?

Answer 7

1) Those with a PADUA score greater than 4, who do not have any contraindications.

Question 8

PADUA Score:
Active Cancer

Answer 8

3

Question 9

PADUA Score:
Previous VTE

Answer 9

3

Question 10

PADUA Score:
Reduced Mobility

Answer 10

3

Question 11

PADUA Score:
Known Genetic Hypercoagulable condition

Answer 11

3

Question 12

PADUA Score:
Recent Trauma/Surgery (within 1 month)

Answer 12

2

Question 13

PADUA Score:
>70 years old

Answer 13

1

Question 14

PADUA Score:
Cardiac or respiratory failure

Answer 14

1

Question 15

PADUA Score:
Acute MI or Ischemic Stroke

Answer 15

1

Question 16

PADUA Score:
Acute Infection or Rheumatologic disorder

Answer 16

1

Question 17

PADUA Score:
Obesity (>30)

Answer 17

1

Question 18

PADUA Score:
Hormonal Treatment

Answer 18

1

Question 19

Non-pharmacologic VTE Treatment

Answer 19

1) Ambulation
2) Graduated Compression Stocking
3) Sequential Compression Devices
4) Inferior Vena Cava Filter

Question 20

VTE Heparin DOsing

Answer 20

5000 units Q8-12 H
BMI >40 = 7,500 units.

Question 21

VTE Enoxaparin Dosing

Answer 21

30 units twice daily or 40 units daily.

Question 22

What cancer patients should be treated with anticoagulant therapy?

Answer 22

Khorana score greater than 2.

Question 23

What anticoagulants are recommended if khorana score is greater than 2 in active cancer?

Answer 23

1) Apixaban
2) Rivaroxaban
3) LMWH

Question 24

Patients with multiple myeloma receiving thalidomide or lenalidomide based regimens based regimens with chemotherapy should be offered what anticoagulants?

Answer 24

1) Aspirin or LMWH (low risk)
2) LMWH (high risk)