Thrombosis

Question 1

Indications of thrombophilia work up (4)

Answer 1

• Unprovoked thrombo-embolism (after therapy)
• Recurrent thrombo-embolism (after therapy)
• Neonatal purpura fulminans (acute)
• Strong family history of thrombophilia, in child able to consent

Question 2

Definition of antiphospholipid syndrome

Answer 2

Presence of vascular thrombosis (at least 1 venous, arterial or microvascular thrombosis) or pregnancy complications (fetal loss or placental abruption)
and
Persistent antiphospholipids Ab (­at least 12 weeks apart)

Question 3

Laboratory testing of lupus anticoagulants

Answer 3

1) Abnormal results of a phospholipid dependent test e.g. aPTT, RVVT
2) Absence of correction with mixing study
3) Confirmatory test, usually with addition of excessive exogenous phospholipids

Question 4

Thrombolysis contraindications

Answer 4

Active bleeding
Recent head injury
Recent trauma or surgery
Recent childbirth
Recent cardiopulmonary resuscitation
Congenital bleeding disorder
Uncontrolled systolic hypertension

Question 5

What is the starting dose of warfarin?

Answer 5

0.2 mg/kg
(For patients post-Fontan or with liver dysfunction, start with 0.1 mg/kg)
Then adjust as per INR