Misc. Problems Flashcards

1
Q

when is the full antithrombotic effect of warfarin seen?

A

5-7 days

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2
Q

what should be used in place of warfarin in pregnant women?

A

heparin

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3
Q

benefit of LMWH

A

doesn’t require coontinuous monitoring of the PT time

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4
Q

when can heparin be d/c (when overlapped with warfarin)

A

once the INR is >2.0 on at least 2 consecutive days

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5
Q

when is warfarin best taken

A

on an empty stomach at a specific time each day , administration at bedtime works well

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6
Q

once stabilized how often an INR be checked

A

every 3-4 weeks

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7
Q

what is the target INR for most patients

A

2.0-3.0

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8
Q

how to reverse INS of less than 10 rapidly

A

oral vitamin K (faster than subQ vitamin K) about same speed as IV vitamin K

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9
Q

how to reverse and INR of >20

A

fresh frozen plasma

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10
Q

how to change warfarin dose before elective surery

A

have them stop 4 days before so INR drops to around 1.5

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11
Q

what should be avoided w/ warfarin

A

NSAIDs and excessive amounts of alcohol

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12
Q

when is biopsy appropriate in LAD

A

if an abnormal node hasn’t resolsved after 4 weeks and patient has other findings w/ malignancy- fever, night sweats, weight loss

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13
Q

what does left supraclavicular adenopathy suggest (Virchow’s node)

A

abdominal malignancy

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14
Q

what does right supraclaviular adenopathy suggest

A

cancer in the mediastinum, lungs, esophagus

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15
Q

what are common causes of axillary LAD

A

cat scartach dz, infections, breast cancer , silicone breast inplants

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16
Q

causes of generalized LAD

A

HIV, tuberculosis, mono, LE

17
Q

common causes of edema

A

heart failure, cirrhosis, nephrotic syndrome

18
Q

PE with pulmonary edema

A

tachypneic, diaphoretic patient with wet rales, and possibly a diastolic gallop (s3) and heart murmurs

19
Q

patient with nephrotic syndrome may havew hat kind of edema?

A

periorbital

20
Q

what does nonpitting peripheral edema suggest

A

lymphatic obstruction or hypothryoidism

21
Q

causes of nonpitting edema

A

lyphemedma, pretibial myxedema (thyroid dz)

22
Q

presents with decrease platelet levels and is mediated by the production of IgG autoantibodies directed against platelets. PE findings are normal, may have slightly enlarged spleen

A

Idiopathic thrombocytopenic purpura

23
Q

disorder that results in clotting of the small blood vessels from spontaneous platelet aggregation. The clots formed can be damaging since they can interfere with the proper flow of blood to the body’s vital organs. People with this type of disorder have insufficient amounts of enzymes necessary in inhibiting a blood clotting protein.

A

thrombocytic thrombocytopenic purpura

24
Q

symptoms with TTP

A

confusion, tachy, weakness, fever

25
Q

Tx for ITP

A

prenisone of IVIG, many adult require spenlectomy

26
Q

tx for TTP

A

corticosteroids and plasmapharesis

27
Q

what is seen on blood smear with DIC

A

schistocytes

28
Q

what lab with elevated with hemophilia A

A

aPTT

29
Q

Hemophilia A is a deficiency in what?

A

Factor VIII

30
Q

what will be elevated with a Vitamin K deficiency?

A

PT

31
Q

what is factor VIII concentrate used for?

A

hemophilia A

32
Q

tx for vWF deficiency

A

intranasal desmopressin

33
Q

what causes anemia with a high reticulocyte count

A

acute blood loss