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Cardiovascular Conditions (JBR) > Venous Thromboembolic Disease (DVT/PE) > Flashcards

Venous Thromboembolic Disease (DVT/PE) Flashcards

1
Q

What is a thrombus?

A

Intra-vascular coagulation of blood

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2
Q

What is prothrombin time?

A

Measure of clotting tendency of the blood

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3
Q

What are risk factors for DVT?

A 
Age
Pregnancy
Trauma
Surgery
Obesity
Cancer
Immobility
Thrombophilia 
(smoking/contraceptive pill/renal-nephrotic syndrome/cardiomyopathy)
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4
Q

What is Factor V Leiden?

A

(Genetic) Thrombophilia

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5
Q

What are the three components of Virchow’s triad?

A

Endothelial injury
Circualtory stasis
Hypercoaguability

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6
Q

What are causes of endothelial injury?

A 
Venous valve damage
Trauma
Surgery
Indwelling catheter
Central line
venous damage 
Smoking
Toxins 
Infectious agents
Autoimmune 
Vasculitis
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7
Q

What are causes of circulatory stasis?

A 
Venous insufficiency
Varicose veins
Venous obstruction
Immobility
Paresis
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8
Q

What are causes of hypercoagulability?

A 
Malignancy
Pregnancy
HRT
IBD
Sepsis
Thrombophilia
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9
Q

Thrombi typically occur in the ______

A

Venous system

venous valve pockets and other sites of presumed stasis

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10
Q

What are symptoms / signs of DVT?

A

Calf leg - pain, swelling, hot, inflamed

Localised tenderness of deep veins

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11
Q

What are investigations to diagnose DVT?

A

D-dimer
Duplex scanning
Venous plethysomography

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12
Q

What is D-dimer?

A

Breakdown product of cross-linked fibrin

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13
Q

What are complications of DVT?

A 
Pulmonary embolism (PE)
Post-thrombotic syndrome (PTS)
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14
Q

What is post-thrombotic syndrome (PTS)?

A

Pain, oedema, hyper pigmentation, exczema, varicose, collateral veins, venous ulceration
Damage to deep vein valves and valvular reflux
Causes venous hypertension

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15
Q

How do you treat DVT?

A

Anticoagulation with LMWH and Warfarin
Compression stocking
IVC filters
Prevention screening

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16
Q

What is the purpose of compression stockings?

A

Increase venous blood flow

+/- help with pain

17
Q

What is an IVC filter and what is its purpose?

A

Blockage ‘cage’ in IVC to stop clots entering

metal device - can cause problems itself

18
Q

What causes a PE?

A

Superadded thrombus ad plaque material may break off and embolism
Usually originates from a DVT in the legs/pelvis - detaches and travels to the right side of the heart to block vessels in the lungs

19
Q

A massive PE causes?

A

Shock / Syncope

20
Q

A major PE causes?

A

Right ventricular dysfunction

21
Q

What are the three types of PE?

A

Massive
Major
Minor

22
Q

What are the symptoms of a PE?

A 
Acute dyspnoea
Collapse
Pleuritic chest pain
Haemoptysis
Sudden death
23
Q

What are the signs of a PE?

A 
Tachypnoea
Hypertension
Cardiorespiratory arrest
Tachycardia
S4 
Accentuated pulmonic component of S2
Pleural rub
24
Q

What would be seen on CXR for a PE?

A

Westermark sign (oligemia)
Wedge-shaped infarced
Pleural effusion
Consolidation on CXR

25
Q

Which investigations can be done to diagnose a PE?

A 
ABGs
CXR - wedge-shaped infarct, often normal
V/Q scan
CTPA
ECHO 
(Angiogram rarely)
Bloods: FBC, U&Es, baseline clotting, D-dimer
26
Q

What is the Westermark sign?

A

Collapse of a vessel

27
Q

How do you treat a minor PE?

A

Anticoagulants

28
Q

How do you treat a massive PE?

A

Thrombolysis

Surgery

29
Q

How do you treat a major PE?

A

Anticoagulants

Thrombolysis

30
Q

Which drug can be given to prevent venous thrombosis post-op/hip replacement?

A

Daigatran etexilate or Rivaroxaban

31
Q

Dabigatran etexilate is?

A

An orally active thrombin inhibitor

32
Q

What is the major disadvantage of dabigatran and rivaroxaban

A

No predictable agent to reduce haemorrhage in overdse

33
Q

Rivaroxaban is a?

A

Factor Xa inhibitor

Cardiovascular Conditions (JBR) (20 decks)

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