thrombosis Flashcards

1
Q

if you have a peripheral arterial thrombosis what is it called

A

gangrene

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2
Q

what is the biggest risk factor for a DVT

A

previous one

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3
Q

what type of clots are seen in the arterial system

A

platelet rich

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4
Q

what drugs are used in arterial clots

A

aspirin and anti-platelet

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5
Q

are platelets activated in venous clots ?

A

no as no endothelial damage

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6
Q

what type of clots seen in venou ssytem

A

fibrin rich

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7
Q

what causes venous clots

A

valve degeneration

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8
Q

treatment of venous clots

A

heparin, warfarin, DOAC

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9
Q

what is given in acute VTE

A

heparin - immediate action

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10
Q

what us the annual risk of a vte

A

1/1000
young 1/10,000
old 1/100

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11
Q

symptoms of VTE

A

pitting oedema, swelling , red ,tender

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12
Q

examples of hereditary thrombophilias

A
factor V Leiden 
prothrombin 20210 mutation 
anti-thrombin deficiency 
protein S deficiency 
protein C Deficiency
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13
Q

name an acquired thrombophilia

A

anti-phospholipid syndrome

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14
Q

what is more likely to casue clot inherited or acquired thrombophilia

A

acquired anti-phospholipid

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15
Q

what is prolonged in anti-phospholipid APTT or PTT

A

APTT

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16
Q

treatment of anti-phospholipid syndrome

A

aspirin and warfarin as both venous and arterial clots seen

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17
Q

what clot do heparin and warfarin target

A

fibrin clot - venous system

18
Q

indications for anti-coagulants

A

VTE or AF

19
Q

action of heparin

A

potentiates anti-thrombin

20
Q

how is heparin delivered

A

IV or SC

21
Q

how does unfractionated heparin work

A

inactivating thrombin and activated factor X (factor Xa) through an antithrombin (AT)-dependent mechanism

22
Q

how does LMWH work

A

binds to anti-thrombin and creates a conformational change. This change accelerates its inhibition of activated factor X

23
Q

what should be used for monitoring heparin and LMWH respectively

A

heparin - APTT

LMWH - Factpr Xa assay - monitoring not rquired

24
Q

side effects of heparin

A

bleeding
induced thrombocytopenia
osteoporosis long term

25
Q

how to reverse heparin

A

stop heparin

protamine sulphate

26
Q

what class of anticoagulant is warfarin

A

coumarin anticoag

27
Q

what must be given alongside warfarin at initiation

A

heparin

28
Q

how is warfarin delivered

A

Oral

29
Q

mechanism of action of warfarin

A

Vitamin K inhibitor

30
Q

why does heparin need to be given alongside warfarin at intitiation

A

warfarin inhibitd vitamin K which carboxylases protein c and s so transient increase in clotting chance at beginning

31
Q

when shoudl warfarin be taken

A

same time everyday 6pm recommended

32
Q

what is used to monitor warfarin

A

PTT as factor 7 most sensitive

33
Q

how is warfarin metabolised

A

by CYP450 in liver

34
Q

side effects of warfarin

A

bleeding

lots of interactions

35
Q

what do you do if INR too high on warfarin

A

vit k admin

36
Q

what is dabigatran

A

oral direct thrombin inhibitor

37
Q

how is dabigatrann excreted

A

renally

38
Q

give examples of oral Xa inhibitors

A

apixaban , rivaroxiban , edoxaban

39
Q

mechanism of action for aspirin

A

cox inhibtior - cox makes thromboxane A 2

40
Q

side effects of aspirin

A

bleeding
GI ulcer
brnchospasm - not in asthma

41
Q

mechanism of action for clopidergrel

A

ADP receptor antag - P2Y12 receptor

42
Q

what receptors do platelets bind to in aggregation

A

GPIIb, IIa (abciximab - an inhibitor of this used prior to surgery)