Haemostasis and Thrombosis Flashcards
1
Q
What is Virchow’s Triad?
A
Predisposing factors to Thrombosis
- Endothelial damage
- Hypercoagubility
- Blood stasis/Reduced flow
2
Q
What is VTE?
A
Venous Thromboembolism
- Acute Venous obstruction due to thrombosis.
e. g, DVT or PE
3
Q
Clinical features and significance of DVT?
A
- Usually in lower limbs
- Swollen, pain, erythematous limb
- Below knee= lower rate of progression
- Above knee= higher risk of becoming PE
4
Q
Diagnosis of DVT?
A
- Ultrasound imaging
- MR Venogram (more sensitive)
- History and examination
5
Q
Clinical features and significance of PE?
A
- Acute chest pain
- Dyspnoea
- Tachycardia
- Haemoptysis
- Low O2 sat
6
Q
Diagnosis of PE?
A
- CXR
- CT Pulmonary angiogram (highest specifity)
- ECG
7
Q
Acquired risk factors for VTE?
A
- Pregnancy
- COCP, HRT, Tamoxifen
- Cancer
- Surgery
- Travel
- Hospital inpatients
- Myeloproliferative disorders, bechet’s disease, paroxysmal nocturnal haemoglobinuria, Antiphospholipid syndrome
8
Q
Treatment of VTE?
A
Anticoagulative Drugs 1. LMWH and Warfarin - Enoxiparin, Dalteparin OR 2. DOAC Drug - Rivaroxaban, Apixaban, Edoxaban or Dabigatran - More convenient - Oral meds
9
Q
What is DIC?
A
Disseminated intravascular coagulation
- Characterised by widespread thrombosis and haemorrhage
- Secondary phenomenon = Therefore treat the underlying condition
10
Q
Lab investigations in DIC?
A
- PT (increased)
- APTT (increased)
- Fibrinogen levels (low)
- D-dimer levels (High)
- Platelet count (low)
11
Q
What drugs are direct factor Xa inhibitors?
A
-Edoxaban, Apixaban, Rivaroxaban
Apixaban prescribed BD, others OD.
12
Q
What kind of anticoagulant is Dabigatran?
A
- Direct thrombin inhibitor
Dabigatran prescribed BD.
13
Q
How to treat DIC?
A
- Treat underlying cause
- Give fibrinogen until >1.5g/L
- Give fresh frozen plasma to reach normal PT and APTT
