Pathophysiology Flashcards
1
Q
Antiplatelets
A
Prevent platelet aggregation => less chance of clot formation
2
Q
Anticoagulation
A
Prevent fibrin formation
3
Q
Thrombolytics
A
break down fibrin/thrombus/clot but have a high risk of bleeding
4
Q
Heparin works on which pathway
A
- Intrinsic pathway
- Inactivates IIa and Xa
5
Q
Warfarin inhibits which pathway
A
- Extrinsic pathway
- Inactivates factor 2, 7, 9, and 10
6
Q
APTT or PTT
- Normal:
- Therapeutic Level
A
- Measure how effective Heparin is working as a blood thinner/anticoagulant
- Normal PTT = 20-40s
- Therapeutic PTT: 1.5-2.5 x N = 45-70s
7
Q
INR/PT
- Normal level w/o anticoagulation
- Level w/ coagulation
A
- Measure of anticoagulation. It’s affected by coumadin
- Normal person NOT on warfarin: 1
- On Warfarin: 2-3.5
8
Q
INR goal:
- A. fib/A. flutter:
- Elective CV of a.fib
- DVT or PE:
- Mechanical prosthetic heart valve:
A
- A. fib/A. flutter: 2-3
- Elective CV of a.fib: 2-3
- DVT or PE: 2-3
- Mechanical prosthetic heart valve: 2.5-3.5
9
Q
How to treat DVT?
How to treat PE?
A
- DVT: Heparin/LMWH follow by PO anticoagulant x 3 mo. ACCP rec warfarin over dabigatran (Indication for non-valvular a.fib) or rivaroxaban (off label for DVT). Thrombolytics are NOT rec in DVT => risk of bleeding outweight benefits
- PE: same as DVT but thrombolytic may be in massive PE w/ HYPOTN
10
Q
Risk factors for DVT?
A
- Immobilization/Prolong bed rest
- Estrogen: OCP/HRT/Pregnany
- Cancer
- HIP/Knee surgery
- Advanced age
- High risk medical illness: CHF, MI, AF
- Valvular disorder
- Blood disorder: protein C, S, or anti-thrombin III deficiency & antiphospholipid antibody syndrome.
11
Q
ACCP guidelines 2012 for tx of DVT/PE
- Distal Leg DVT (below knee)
- Proximal leg DVT (thigh) or Arm DVT
A
Distal Leg:
- No, mild, or mod sx: no treatment => monitor
- Severe sx: tx x 3mo
Proximal leg DVT
- Tx regardless of sx
- 3 mo for provoked by a transient risk factor
- “extended” tx if unprovoked.
