Vascular problems

Question 1

When to treat AF patient with anticoagulation

Answer 1

CHADS-VAS score

if >2, warfarin, or other anti-coag.

Question 2

calculate bleeding risk how? Combine with CHADS-VAS for AF, discuss results

Answer 2

HAS BLED
If >3, high risk of bleed

If high stroke risk, and low risk bleeding, anticoag
If low risk stroke, but high risk of bleeding, do not anticoag

Question 3

Anticoagulation time frame in DVT/PE versus AF

Answer 3

DVT: urgent, usually as inpateint with LMWH
AF: not so time sensitive, no LMWH, warfarin vs dabigatran

Question 4

Circulatory shock

Answer 4

Sustained fluid loss causing ischaemia and difficult to reverse damage
Loss of vascular tone due to: inadequate perfusion to vasa vasorum around blood vessels; impaired adrenergic NT as NE stores have been depleted; perivascular accumulation of metabolites that vasodilate