TEV

Question 1

Trombii arteriali si venosi

Answer 1

1. Arteriali: Albi - trombocite + fibrina

2. Venosi: Rosii - hematii + fibrina

Question 2

Factori implicati in tromboza venoasa

Answer 2

1. Staza

2. Hipercoagulabilitate

Question 3

Factori de risc puternici

Answer 3

1. Interventii chir majore
2. Traumatisme
3. Repaus absolut la pat

Question 4

Factori de risc slabi

Answer 4

1. Obezitatea

2. Calatoriile

Question 5

Cele mai frecv simptome in EP

Answer 5

1. Durere toracica de tip pleuritic
2. Dispnee +/- hemoptizie
3. Tahipnee, tahicardie
4. Raluri crepitante, frecatura pleurala

Question 6

Aspectul clasic EKG

Answer 6

S1Q3T3

!!! dar prezent la o minoritate

Question 7

Ultrasonografia confirma dg de TEV, dar este mai putin sensibila pentru

Answer 7

Venele distale

Question 8

Cea mai comuna tehnica imagistica in dg EP

Answer 8

Angiografia pulmonara prin CT

Question 9

Tratamentul initial in TEV

Answer 9

LMWH + Warfarina

Question 10

DOAC precedate de administrarea heparinei timp de 5 zile

Answer 10

Edoxaban, dabigatran

Question 11

Warfarina si DOAC traverseaza placenta, deci in sarcina trat de electie este

Answer 11

LMWH

Question 12

Primesc 1 pct in scorul PESI

Answer 12

1. Varsta > 80
2. Cancer
3. ICC
4. AV > 110
5. TAs < 100
6. SaO2 < 90%

Question 13

LMWH este mai eficienta ca warfarina in TEV la pacientii cu cancer activ

Answer 13

!!!

Question 14

Simptome in sindromul post trombotic

Answer 14

1. Durere + tumefiere
2. Senzatie de greutate
3. Claudicatie venoasa la efort
4. Prurit + modificarea culorii

Question 15

Forma cea mai severa a sindromului post trombotic

Answer 15

1. Afectarea permanenta a pierlii - roseata, hiperpigmentare
2. Ectazii venoase
3. Lipodermatoscleroza (fibroza cutanata)
4. Ulcere mb inf

Question 16

Ce inhiba antitrombina

Answer 16

Trombina si Xa

Question 17

Cei cu deficit de antitrombina pot fi rezistenti la

Answer 17

Heparina

Question 18

Ce inhiba prot C si S

Answer 18

Va si VIIIa

Question 19

DOAC mai putin eficiente decat warfarina in TEV recurenta in SAFL

Answer 19

!!!

Question 20

Trat SAFL in sarcina

Answer 20

Aspirina in doza mica + LMWH in doza profilactica pe tot parcursul sarcinii

Question 21

Care dintre heparine nu se excreta renal

Answer 21

Nefractionata

Question 22

Timp de injumatatre heparine

Answer 22

1. Nefractionata - 1h
2. LMWH - 4h
3. Fondaparina - 18h

Question 23

Fondaparina nu are antidot, dar pt celelalte 2 exista

Answer 23

Protamina sulfat

Question 24

APTT se foloseste pt monitorizarea ….. pt ca celelalte 2 inhiba Xa mai mult decat II (fondaparina inhiba doar Xa)

Answer 24

Heparinei nefractionate

Question 25

Trombocitopenia indusa de heparina apare la …

• tendinta protrombotik
• trombocitopenie usoara / moderata
• IgG impotriva heparina/FP4

Answer 25

Heparina nefractionata

Question 26

Anticoagulante alternative in caz de HIT

Answer 26

1. Danaparoid
2. Argatroban
3. Fondaparina

Question 27

Efectul warfarinei se evalueaza prin

Answer 27

INR (PT)

Question 28

Nu afecteaza nivelurile warfarinei, dar cresc riscul de sangerare

Answer 28

Aspirina si clopidogrel

Question 29

Cel mai mare timp de injumatatire dintre DOAC

Answer 29

Dabigatran - 15 h

Question 30

Pe ce cale se elimina warfarina

Answer 30

Hepatica

Question 31

Antidotul pt DOAC X

Answer 31

Andexanet