HAEM: Venous Thrombosis (not finished) Flashcards
What % deaths does PE account for?
5-10%
25000 deaths per annum related to VTE, difficult to reverse but preventable
What is the recurrence rate of VTE?
20% within 2 years and 4% pa after
What is the occurence of pulmonary hypertension with VTE?
4% at 2 years
What is Virchow’s triad?
- blood - hypercoagulability
- vessel wall - damage
- blood flow - stasis
What factors in blood increase risk of VTE?
List some procoagulant and anticoagulant factors.
Is VTE preventable in thrombophilias?
In thrombophilias, VTE is precipitated in 50% of cases so these are still preventable e.g. Factor V leiden, Protein C/S deficiency, antithrombin deficiency
What factors in vessel wall increase risk of VTE?
List some endothelial and subendothelial factors invovled in coagulation
How does inflammation make the endothelium procoagulant?
What is the role of neutrophils in immunothrombosis?
Netosis under inflammatory stimuli causes neutrophils to release DNA and provides a surface for coagulation pathway activation, TFPI cleavage (anticoagulant).
What factors in blood flow increase risk of thrombosis?
What are the causes of blood stasis?
How does flight distance/time affect PE occurrence?
The longer the flight the higher the risk of PE.
Which of the inherited thrombophilias has the highest risk of thrombosis?
Antithrombin deficiency
What is the difference between high and low dose anticoagulant regimens?
- high - therapeutic
- low - prophylactic
What are the “immediate” and “delayed” anticoagulant drugs?
What factors does warfarin act on?
2, 7 , 9 , 10
How do heparins act?
Increase activity of antithrombin
What are the disadvantages of heparin?
What anticoagulant factors does warfarin inhibit?
How is warfarin monitored? Why can warfarin not be taken in pregnancy?
INR, Teratogenic
What is a safe INR?
Balance between thrombosis (low INR) and bleeding (high INR) must be achieved
What are the types of thromboprophylaxis?
