Thromboembolic Disorders

Question 1

leading cause of maternal mortality

Answer 1

deep venous thrombosis

pulmonary embolism

Question 2

the most constant predisposing factor for venous thrombosis

Answer 2

stasis

Question 3

coagulation factors increased in pregnancy

Answer 3

fibrinogen
factor VII
factor VIII
von willebrand

Question 4

the most important risk factor in developing thromboembolism

Answer 4

genetically determined thrombophilia

Question 5

thrombin (IIa) acts in what coagulation cascade pathway?

Answer 5

intrinsic pathway

common pathway

Question 6

the most thrombogenic of the heritable thrombophilia

Answer 6

antithrombin deficiency

Question 7

antithrombin deficiency type that results in reduced synthesis of biologically normal antithrombin

Answer 7

type I deficiency

Question 8

antithrombin deficiency type that is characterized by normal levels of antithrombin with reduced functional activity

Answer 8

type II deficiency

Question 9

lethal antithrombin deficiency

Answer 9

homozygous antithrombin deficiency

Question 10

treatment function of antithrombin

Answer 10

target towards the COMMON PATHWAY

Question 11

treatment for antithrombin

Answer 11

low molecular weight heparin (LMWH)

recombinant human antithrombin concentration infusion

Question 12

helps inactivates procoagulant Va and VIIa

Answer 12

protein S

Question 13

vitamin K dependent glycoprotein that increases throughout the fist half of pregnancy

Answer 13

protein C

Question 14

anticoagulant and inflammatory regulatory pathways

Answer 14

protein C

Question 15

inhibits the synthesis of of PAI

Answer 15

activated protein c

Question 16

activated protein c

Answer 16

thrombin + thrombomodulin

Question 17

extensive thromboses in the micronutrition soon after birth leading to skin necrosis

Answer 17

purpura fulminans

Question 18

activated protein c resistance aka

Answer 18

factor leiden mutation

Question 19

most common heritable thrombophilia

Answer 19

heterozygous inheritance for factor V leiden

Question 20

mutation in factor v gene; substitution of _________ for aginine at position 506

Answer 20

glutamine

Question 21

second most inherited thrombophilia

Answer 21

prothrombin G20210A mutation (PGM)

Question 22

mutation in prothrombin = excessive prothrombin accumulation

Answer 22

PGM

Question 23

mutation of enzyme 5,10-methylene-tetrahydrofolate reductase

Answer 23

hyperhomocysteinemia

Question 24

deficiencies of folic acid, vitamin b6, vitamin b12

Answer 24

hyperhomocysteinemia

Question 25

fasting threshold to define hyperhomocysteinemia

Answer 25

> 12umol/L

Question 26

most common acquired thrombophilia

Answer 26

antiphospholipid antibody syndrome

Question 27

antibodies against phospholipid-binding proteins such as B2-glycoprotein I

Answer 27

antiphospholipid antibody syndrome

Question 28

APAS clinical feature; vascular thromboses

Answer 28

• one unexplained fetal death at or beyond 10 weeks
• one preterm before 34 weeks because of eclampsia, severe preeclampsia, placental insufficiency
• unexplained consecutive spontaneous abortion before 10 weeks

Question 29

most commonly involve in APAS

Answer 29

lower extremity

Question 30

when other veins are involved in APAS

Answer 30

catastrophic APAS

Question 31

thrombophilia screening is indicated for persons:

Answer 31

with history of venous thromboembolism
first degree relative before 50
experienced fetal loss

Question 32

most common venous thromboses that are confined to the deep veins of the lower extremity

Answer 32

DVT

Question 33

most commonly affected vein in DVT

Answer 33

iliofemoral vein

Question 34

homans sign

Answer 34

DVT

Question 35

initial diagnostic test of DVT

Answer 35

compression ultrasonography

Question 36

diagnosis for DVT is based on

Answer 36

based on:
the compressibility
typical echoarchitecture of a thrombosed vein

Question 37

useful diagnosis for DVT

Answer 37

MRI

Question 38

gold standard to exclude lower extremity DVT

Answer 38

venography

Question 39

initial treatment for thromboembolism

Answer 39

unfractionated heparin

Question 40

preferred test to assess heparin anticoagulation

Answer 40

anti-factor Xa levels

Question 41

greater activity against factor Xa than thrombin

Answer 41

LMWH