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Hematology > Thromboembolism ,DVT > Flashcards

Thromboembolism ,DVT Flashcards

1
Q

When do you consider an hypercoagulable state

A

Spontaneous thrombosis with no obisous risk factors
Family history of recurrent venous thrombosis at early age
Thrombosis with risk factors at early age
Thrombosis at unusual site (upper extremities , viscera)
Recurrent thrombosis

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2
Q

Why is there balance towards thrombosis in hyper coagulable state

A

Increase in procoagulant element

Decrease in anticoagulant element

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3
Q

What is a thrombus

A

Solid mass formed in circulation from blood constituents

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4
Q

Complications of thrombus

A

Ischemia

Embolization

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5
Q

Can a thrombus be venous or arterial

A

Yes

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6
Q

What’s virchow triad in venous thrombosis

A

Stasis
Hypercoagulopathy
Vessel wall damage

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7
Q

Risk factors for venous thrombosis s

A 
Coagulation abnormality 
Stasis 
Age 
Sex
Obesity
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8
Q

What are some coagulation abnormalities

A

Hereditary hemostatic disroders like factor V Leiden

Hereditary or acquired hemostatic disroders raising levels of factors VII, VIII

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9
Q

Condition that can cause blood stasis

A

Cardiac failure

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10
Q

Protein that can’t cleave in factor V mutation (FV leiden )

A

Protein C complex

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11
Q

Most common genetic risk factor for thrombosis

A

FV Leiden

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12
Q

Prevalence in caucasians of FV Leiden

A

5%

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13
Q

Risk for heterozygotes compared to homozygotes in FV Leiden

A

6-8 fold for heterozygotes

80 folds for homo

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14
Q

Can elevated FVIII increase risk of thrombosis

A

Yes

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15
Q

Elevation of this coagulation factor is an indépendant risk factor for MI and stroke

A

vWF

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16
Q

What are the inhibitors of hemostasis

A

Tissue factor pathway inhibitor ( TFPI)
Protein C
Protein S
Antithrombin

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17
Q

If there is decrease in anticoagulants elements , what you should expect

A

Thombrosis

18
Q

Which medical and supportive management is a risk factor for deep vein thrombosis

A

Central venous catheter

19
Q

Why is thromboembolism so common inn cancer

A 
Factors interaction complexity 
Malignancy 
Chemotherapy and side effects 
Increased Infections 
Increased dehydration
20
Q

What are some acquired prothrombic conditions

A 
Sepsis 
Congenital heart diseas
Hypovolemia 
Trauma 
Surgery 
Immobilization 
Estrogen in contraceptives 
Steroid
Nephrotic syndrome
21
Q

Screen test for thrombotic condition

A 
FBC - elevated 
PBF - myeloproliferative disorders 
PR / APTT - shorter 
Factor assay 
Activated protein C resistance test in FV Leiden 
Assay for protein C and S
22
Q

What is DVT

A

Formation of blood clot in deep leg vein

May lead to post thrombotic syndrome or PE

23
Q

Mortality rate of DVT

A

1/100 person with DVT dies

24
Q

What condition is called economy class syndrome

A

DVT

25
Q

Main location of DVT

A

Center of leg

26
Q

DVT risk factors

A 
Previous DVT 
Family hx
Immobilization 
Recent surgery 
More than 40 yo 
Hormone therapy
Oral contraceptive 
Pregnancy 
Postpartum 
Previous/ current cancer
Limb trauma 
Coagulation abnormalities 
Obesity
27
Q

DVT symptoms

A 
Leg discoloration 
Calf pain 
Leg  pain 
Swelling of leg
Warm skin 
Visible surface veins 
Leg fatigu
28
Q

Diagnosis technique for DVT

A 
Serial compression USG 
Doppler
Contrast venography 
Plasma D dimer concentration 
MRI
29
Q

Drugs used in DVT

A

Unfractioned heaprin - continuous IV, or intermittent SC - to monitor with APTT

Low molecular weight heparin - no monitoring

30
Q

Parentéral Drug given if there is bleeding with heparin

A

Protamine 1mg/100 units

31
Q

Oral drugs given in DVT

A

Warfarin

32
Q

In which clinical state do you give warfarin with INR 2.5

A 
DVT
Pulm
Embolism 
Atrial fibrillation 
Cardioversion
33
Q

Clinical state in which warfarin should in INR 3.5

A

Recurrent DVT
Mechanical heart valves
APS

34
Q

If warfarin INR is 3-6 what should you do

A

Reduce dose

Or stop

35
Q

If warfarin INR is 6-8 or 4-6 what should you do

A

Stop and Start when <5

36
Q

If warfarin INR is more than 8 what should you do

A

Can vit k

Restart when les than 5

37
Q

If warfarin give major bleeding what should you do

A

FFP
Vit k
Prothrombin n complex

38
Q

Other than heparin, what are other the parties available

A

Thrombolytic therapy with streptokinase/urokinase

Surgical embolectomy in extensive thrombosis

39
Q

What is post thrombotic syndrome

A

Complication of DVT treated with anticoagulation alone where clot remain in vein since anticoagulation do not dissolve clot but just prevent their formation

Damage of blood veins by body dissolution of clot

40
Q

Percentage of people that develops post thrombotic syndrome

A

60-70%

41
Q

Can DVT cause pulmonary embolism

A

Ywa

Hematology (24 decks)

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