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7262 MS Block 2 > Orthopedic surgery > Flashcards

Orthopedic surgery Flashcards

1
Q

Meds to hold prior to surgery:

A

antithrombotic therapy
cardiac meds
antidiabetic meds
herbal meds

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2
Q

The higher the thromboembolic risk the greater the importance of minimizing the interval without anticoagulation.

a. true
b. false

A

a. true

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3
Q

Which are higher thromboembolic risk mechanical or natural heart valves?

A

mechanical

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4
Q

What Afib CHADS VASC score is high thrombotic risk?

A

7-9

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5
Q

Afib Stroke or TIA within __ months is high thromboembolic risk

A

3

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6
Q

__ valvular heart disease is high thromboembolic risk

A

rheumatic

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7
Q

Recent VTE within __ months is high thromboembolic risk

A

3

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8
Q

Stroke or TIA within __ months of mechanical heart valve is high thromboembolic risk

A

6

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9
Q

What Afib CHADS VASC score is moderate thromboembolic risk?

A

4-6

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10
Q

What Afib CHADS VASC score is low thromboembolic risk?

A

0-3

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11
Q

VTE within __ to __ months is moderate thromboembolic risk

A

3, 12

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12
Q

Orthopedic (joint arthroplasty, foot/hand/shoulder) surgery __ surgical bleed risk

a. high
b. low

A

a. high

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13
Q

D/c warfarin __ days prior to elective surgery in pts requiring temporary interruption of therapy

A

5

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14
Q

Consider bridging warfarin with what in preoperative pts at high risk for thromboembolism?

A

LMWH or heparin products

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15
Q

In pts receiving bridge therapy with UFH stop therapy __ to __ hours before the surgery

A

4, 6

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16
Q

In pts seeking bridge therapy with LMWH stop therapy __ hours before the surgery

A

24

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17
Q

Resume LMWH therapy __ to __ hours after surgery if pt is undergoing high bleeding risk surgery

A

48, 72

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18
Q

Preoperative DOACs: CrCl > 50

hold DOACs how many days before minor surgery?

A

1

19
Q

Preoperative DOACs: CrCl < 50

Which DOAC is held 4 days for major surgery if CrCL < 50?

A

dabigatran

others are 3-4

20
Q

Preoperative DOACs:

Which DOAc is held at least 2 days if CrCl < 50?

A

dabigatran

others are 1-2 days

21
Q

Preoperative DOACs:

Which DOAC is held 2-4 days before major surgery if CrCl is < 50?

A

dabigatraN

22
Q

Do not have to d/c warfarin if minimal bleeding risk

a. true
b. false

A

a. true

just have to make sure there are no bleeding signs

23
Q

Stop aspirin __ to __ days before surgery if pt is at low risk for cardiovascular event

A

7, 10

24
Q

consider deferring surgery if patient has a __ on dual antiplatelet therapy

A

coronary stent

at least 6 weeks after bare metal stenting and 6 months after drug eluting

25
Q

Stop P2Y12 inhibitors (clopidogrel, prasugrel) __ to __ days before surgery

A

5, 10

26
Q

Stop ticagrelor __ days before surgery

A

5

27
Q

Stop cilostazol how many days before surgery?

A

2-3

28
Q

2 major general surgery VTE risk factors:

A

major orthopedic surgery (total knee or hip arthroplasty)

fracture of pelvis, hip, long bones

29
Q

Age > __ years is a cancer VTE risk factor

A

40

30
Q

What is the Caprini risk assessment used for?

A

assessing VTE risk

31
Q

What is preferred Tx for VTE prophylaxis in pts undergoing total hip/knee arthroplasty?

A

DOACs

DOACs > LMWH > warfarin

32
Q

Is LMWH or UFH preferred for pts undergoing total hip/knee arthroplasty?

A

LMWH

33
Q

Pts undergoing hip fracture repair should use __ or __ for VTE prophylaxis

A

LMWH, UFH

34
Q

Avoid rivaroxaban and dabigatran for VTE prophylaxis if CrCl is < __

A

30

35
Q

Avoid what two DOACs for VTE prophylaxis if CrCl < 30?

A

rivaroxaban

dabigatran

36
Q

What is warfarin INR goal for VTE prophylaxis?

A

1.5-2 or 2-3

37
Q

Rivaroxaban, apixaban, dabigatran should be used minimum of how long for VTE prophylaxis?

A

10-14 days

can be extended to 35 days

38
Q

LMWH (enoxaparin), UFH, and fondaparinux are used for minimum of how long for VTE prophylaxis?

A

10-14 days

can extend to 35 days

39
Q

Avoid __ use for VTE prophylaxis if CrCl < 30

a. enoxaparin (LMWH)
b. UFH
c. fondaparinux

A

c. fondaparinux

40
Q

VTE prophylaxis enoxaparin (LMWH) dose?

A

30mg SQ once daily

41
Q

All pts should receive prophylactic antibiotic within how long before surgical incision?

A

1 hour

42
Q

Prophylactic antibiotics are d/c within how long after cardiac surgery?

A

48 hours

24 hours for others

43
Q

Two prophylactic antibiotics for pts with beta lactam allergy?

A

clindamycin

vancomycin

44
Q

What antibiotic is given for surgery prophylaxis?

A

cefazolin

7262 MS Block 2 (10 decks)

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