Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hospital Based Medicine And Surgery > L19: Venous Thromboembolism > Flashcards

L19: Venous Thromboembolism Flashcards

1
Q

What are the 2 pathways in the coagulation cascade

A

Intrinsic pathway

Extrinsic pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What factor does both extrinsic and intrinsic pathway actvate

A

Factor 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does activated factor 10 acitvate

A

Pro thrombin to thrombin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does thrombin do

A

Cleave fibrinogen to fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does fibrin do

A

With factor 10 it creates the clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the virchows triad describe

A

3 factors that cause a clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the virchows triad compose of

A

Hypercoagulabiltiy
Stasis
Vascullar wall injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can stasis (blood flow slowing down) be caused by

A 
Atrial fibrillation
Left ventricular dyfunction
Bed bound immbolity 
Venous insufficiency 
Venous obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If a thrombus forms in the veis where can it embolise to

A

Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If a thrombus form in the arterial system where can it embolise

A

Periphery (rest of the body)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is clots that embolise from deep veins to the lungs called

A

pulmonary embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are sings of deep venous thrombosis

A 
Pain
Swelling
Erythema
Tenderness
Wartmth
Pitting oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a WELLS score dvt for

A

A score that estimates whether dvt is likely or unlikely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What blood test can we do to look for dvt

A

D-dimer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does a positive d dimer mean

A

There is a clot somewhere but not necessarily due to a dvt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does a negative d dimer mean

A

There is no thrombosis i.e we can exclude dvt and pe

17
Q

What are the other methods to diagnose dvt

A

Ultrasound

Venography: invasive injecting a needle to the foot

18
Q

What is a pulmonary embolis

A

A block of a lung vessel by an embolism

19
Q

What is a complication of pe

A

Right ventricular Hypertrophy as the right ventricle is pumping harder

20
Q

What are the symptoms of pe

A

Minor: sudden onset of chest pain, shortness of breath, haemoptysis
Massive pe: right heart strain, haemodynamically unstable

21
Q

What are the signs of a pe

A 
Sob
Pleuritic chest pain
Cough
Tachynpoe
Tachycardia
Crepitations after a pe
Cyansosi
Collapse
22
Q

What is the wells pe score

A

A two level pe score that sees if pe is likely or unlikely. A score more than 5 is likely

23
Q

On an ecg what signs are you likely to see in a pulmonary embolism

A 
Sinus tachycardia
Right axis deviation
Right bundle branch block
T investion in v1,2,3
Or 
S1,q3,t3 (deep s waves in 1, q waves in 3 and t inversion in 3)
24
Q

What can a chest-xray show in pe

A

Can be normal
Big pulmonary infarct- wedge shaped infarct
Atelactasis
Small pleural effusion

Cxr are useful in excluding alternatives

25
Q

What blood test can you do to look for pe

A

D-dimer

Abg

26
Q

What sensitive and specific test can be carried out for diagnosing pe

A

Ct pa (ct pulmonary angiogram)

27
Q

If patient is presenting with acute chest pain what can be done to investigate

A

Ctca (ct coronary angiogram) to exclude coronary artery disease, aortic dissection and pulmonary embolism

28
Q

What other scan can we carry out to look at the perfusion of the lungs

A

Isotope lung scan - normal perfusion will exclude pe

29
Q

How can we prevent pe

A 
Hydration
Early mobilisaton
VTE prophylaxis 
Elastic compression stocking
Inferioir vena cava filters- a mesh that stops the clot from going from leg to the heart
30
Q

How do we prevent further clot formation

A

Heparin (anticoagulant)
Enoxaparin
Warfarin (long term anticoagulant)
Non vitamins oral anticoagulants

31
Q

To relieve circulatory obstruction what do we do for someone with a massive pe

A

Thrombolysis (drugs that are infused with iv to dissolve the thrombus and aid blood flow)- used in emergency

32
Q

If the wells score is more than 4 for pe what needs to be done

A

A ctpa

33
Q

If the wells score is less than 4 what needs to be done

A

a d-dimer blood test

34
Q

Whilst you wait for a d dimer blood test what needs to be offerred to the patinet

A

Apixaban

35
Q

If the d dimer is raised what needs to be done

A

A ctpa to rule out pe

36
Q

If a pe is confirmed what is the treatment

A

Anticoagualtion therapy for 3 months e.g low molecular weight heparin (enoxaprin)

Hospital Based Medicine And Surgery (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions