T2 L7: Thrombosis Flashcards
Order from abdomen to foot: Femoral vein, Tibial vein, Popliteal vein and Iliac vein
Iliac vein, femoral vein, popliteal vein and Tibial vein
What is Virchows triad?
3 factors that are critically important in the development of venous thrombosis: venous stasis, activation of blood coagulation, and vein damage.
Why is pregnancy a thrombotic risk factors?
It causes a hypercoagulative state
What is a baker’s cyst (popliteal cyst)?
A fluid-filled swelling that develops at the back of the knee.
What are the 5 clinical presentations of a deep vein thrombisis?
Unilateral calf swelling, heat, pain, redness, hardness
How is an ultrasound used as a diagnosis for deep vein thrombosis?
The veins will be non-compressible and this is visible with an ultrasound
What is a venogram?
A dye is injected into the vein and then x-rays are taken
What is the Wells score?
It measures the risk of developing an acute pulmonary embolism. Can be used for deep vein thrombosis too
What is a D-dimer test?
Looks for D-dimer in the blood (a protein fragment that’s made when a blood clot dissolves in your body)
What does a high Wells score and positive D-dimer test indicate?
Likelihood of deep vein thrombosis so ultrasound is needed to confirm
What type of drug is Tinzaparin?
A LMW Heparin
What type of drug is Enoxaparin?
A LMW Heparin
When is IV unfractionated heparin given?
When other heparin can’t be given because the patient has insufficient kidney function
What is the adequate EGFR for kidney function?
> 30ml/min
What is EGFR?
Estimated glomerular filtration rate
Why is someone given Heparin when being switched to Warfarin first as treatment for deep vein thrombosis?
When the INR is >2.0 for 2 days. Heparin is only used to start the patient of anticoagulants
What is INR?
International normalised ratio (INR) is the prothrombin time. It’s used to see how long blood takes to clot
What is the treatment when someone is having their first DVT?
Anticoagulants for 6 months
What is the treatment when someone is having their second DVT?
Lifelong coagulants
What should the INR normally be?
2-3
What are the classic symptoms of a medium PE?
Pleuritic pain, dyspnoea, and haemoptysis
What is dyspnoea?
Uneasy breathing which can cause shortness of breath
What are the classic symptoms of a massive PE?
Syncope and death
What is haemoptosis?
Coughing up blood
What are the presentations of a PE on examination?
Tachycardia, tachypnoea, and hypotension
What is Tachycardia?
Fast heart rate
What is Tachypnoea?
Rapid breathing
What is a V/Q mismatch?
A ventilation/ perfusion mismatch. The lung receives O2 without the blood or the other way around. It means that perfusion is not efficient
What is a V/Q scan?
A ventilation/perfusion radio-isotope scan. Not done anymore