Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CDVD > Thromboembolism > Flashcards

Thromboembolism Flashcards

1
Q

Venous thromboembolism

What is VTE?

A

Blood clot in vein which obstructs blood flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is DVT?

A

-Deep vein thrombosis
-In legs or pelvis
-Unilateral localised pain +/or swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is PE?

A

-Pulmonary embolism
-In lungs
-chest pain or SoB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors for thromboembolism?

A
  • Surgery
  • trauma
  • significant immobility
  • malignancy
  • obesity
  • pregnancy
  • -hormonal therapy (COC/HRT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which diagnositic test is done to test for VTE?

A

D-Dimer test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the two methods of prophylaxis for VTE?

A

Mechanical
Pharmacological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is mechanical prophylaxis for VTE?

A

-graduated compression stockings wear till mobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When do you start pharmacological prophylaxis for VTE?

A

-within 14hr of admission
-only use if risk factor for VTE outweighs risk of bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long is mechanical surgical prophylaxis for VTE used for?

A

all pt should continue until sufficiently mobile or discharged from hospital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Examples of pharmacologiccal surgical prophylaxis for VTE

A

-low molecular weight heparin (LMWH)
-unfractionated heparin (UH)
-fondaparinux sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when is LMWH suitable in prophylatic surgery

A

suitable in all types of general, orthopaedic and pregnancy surgeries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when is unfractionated heparin preferred in prophylatic surgery

A

in renal impairment as it has a low half life so if need to stop fluidity of blood quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when is fondaparinux sodium preferred in prophylatic surgery

A

lower limb immobilisation or pelvis fragility fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how long is pharmacological prophylaxis used for in surgery

A
  • at least 7 days post surgery or until suf mobility
  • 28DY after major cancer surgery in abdomen
  • 30DY in spinal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tx for elective hip replacement?

A

1) LMWH 10DY * 75mg aspirin 28DY
2) LMWH 28DY + stockings until discharge
3) rivaroxaban = common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

tx for elective knee replacement?

A

1) 75mg aspirin 14DY
2)LMWH 14DY+ stockings until discharge
3)rivaroxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if pt has as high risk of VTE what should you give for prophylaxis and how long for?

A

-Mechanical until mobile
-Pharmacological for 7DY at least

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the VTE prophylaxis in pregn?

A

1) LMWH during hosp admission
- prophylaxis until no risk of VTE or till discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is VTE prophylaxis in pt who have given birth, miscarried or termination within 6 weeks

A

start LMWH 4-8hr after event and continue for min 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

tx of VTE in pregnancy

A
  • LMWH
  • Unfractionated heparin if high risk of haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how long is additional mechanical prophylaxis if immobilised

A

until mobile or discharged

22
Q

1st line tx if confirmed proximal DVT or PE

A

apixaban
rivaroxaban

23
Q

2nd line tx if confirmed proximal DVT or PE

A

LMWH for 5DY then dabigatran or edoxaban

24
Q

3rd line tx if confirmed proximal DVT or PE

A

LMWH + warfarin for 5DY till INR 2.0 for 2x readings then warfarin alone

25
What is the duration of distal DVT (calf) tx?
6 weeks
26
what is duration of proximal DVT/PE
3MT (3-6MT in active cancer)
27
what is duration of provoked DVT/PE
stop at 3MT if factors stopped
28
what is duration of unprovoked DVT/PE
3MT+
29
what is duration of recurrent DVT/PE
long term
30
When do you need to maintain and INR of 2.5 (+/-0.5)?
- VTEs - AF - cardioversion - MI - cardiomyopathy
31
When do you need to maintain and INR of 3.5
recurrent VTE or mechanical heart valves
32
What do you do in a major bleed?
stop warfarin + give IV vit K (phytomenadione) + dried prothrombin
33
What do you give if INR >8 and is minor bleed?
stop warfarin and give IV vit K
34
What do you give if INR >8 and no bleed?
stop warfarin and give oral vit K
35
What do you give if INR 5-8 and is minor bleed?
stop warfarin and give IV vit K
36
What do you give if INR 5-8 and no bleed?
withhold 1-2 doses of warfarin and restart when INR is <5
37
MHRA s/e warning of warfarin
skin necrosis and calciphylaxis (pale skin rash)
38
s/e of warfarin
- haemorrhage; prolonged bleed give vit K antidote - pregn = avoid in 1st + 3rd trimester (use contraception
39
Interactions of warfarin
-vit k rich foods (reduce efficacy) -pomegranate + cranberry juice (inc INR) -miconazole (inc INR) -CYP450 inhibitors/inducers (inc/dec conc of warfarin)
40
if it is minor procedure with low risk of bleeding what do you do (warfarin surgery)
only perform if INR less than 2.5 - restart warfarin within 24 hr of surgery
41
What do you do in (warfarin) procedures where there is severe risk of bleeding?
1) stop warfarin 3-5DYs before 2) vit K if INR is > or = to 1.5 the day before surgery 3) pt = high risk of thromb stop LMWH 24hr before + restart 48hr after
42
if it a emergency surgery do you do in regards with warfarin
if it can be delayed by 6-12hr give IV vit K if not then give IV vit k + dried prothrombin complex
43
What are the doses for apixaban?
10mg BD 7DY then 5mg BD
44
which DOACs are given after 5DYs of heparin?
edoxaban and dabigatran
45
What do all heparins do?
- avoid in heparin induced thrombocytopenia - can cause hyperkalaemia - haemorrhage tx protamine sulphate (unfractionated)
46
what do unfractionated heparins do?
- quick initation + elimiation ideal for high bleeding risk (monitor APTT) - high risk of heparin induced thrombocytopenia
47
dose for rivaroxaban
15mg BD 3WK then 20mg OD
48
dose for dabigatran when 18-74yr
150mg BD
49
dose for dabigatran when 75-79yr
110-115mg BD
50
dose for dabigatran when 80yr+
110mg BD
51
dose for edoxaban
- 60mg OD - if under 6kg then 30mg

CDVD (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions