Thrombosis and Anticoagulation Flashcards
Risk factors for SVT progressing to DVT (3)
Large clot (>5 cm)
Proximity (<5cm) to saphofemoral or saphenopopliteal junction
Medical RFs (Malignancy, estrogen, prior DVT)
Management of low risk SVT
Supportive care
Management of high risk SVT
Therapeutic AC for 45 days to 3 months
management of intermediate risk SVT
Prophylactic anticoagulation for 45 days
What imaging study should be ordered after diagnosing someone with an upper extremity DVT?
CXR to look for bony abnormalities
Management of someone with upper extremity DVT with moderate-severe acute symptoms
Thrombolysis + anticoagulation for 3 months
maybe thoracic outlet decompression
Management of upper extremity DVT in someone with a delayed presentation
AC for 3 months
Thoracic outlet decompression
Management of acute Portal Vein Thrombus in the setting of a transient thrombotic risk factor like pancreatitis.
AC for 6 months
What is May-Thurner syndrome?
External compression of IVC leading to increased risk of thrombosis
Management of May-Thurner syndrome without DVT but moderate-severe symptoms
Angioplasty and stent
Patient presents with flank pain, hematuria, significant AKI, and renal infarction on biopsy. Labs show markedly elevated LDH. Diagnosis and management?
Renal vein thrombus
Thrombolytic therapy +/- thrombectomy
Patient with nephrotic syndrome presents with renal vein thrombus but there is no AKI. Management?
Anticoagulation for 6-12 months or however long they are nephrotic
What are two options for VTE prophylaxis after completion of therapeutic anticoagulation?
Aspirin
Rivaroxaban
Which DTI does not have to be dose-adjusted for renal failure?
Argatroban
Which DTI is oral?
Dabigatran. Needs parental AC overlap
