Venous Thromboembolism Flashcards
Virchow’s Triad
Hypercoagulable State
Vascular Injury
Circulatory Stasis
Types of venous clots/VTEs
Pulmonary embolism
Deep vein thrombosis
Risk factors causing a hypercoagulable state
Malignancy
Pregnancy
Inflammatory state
Factor V Leiden
Protein C/S deficiency
Oral contraceptives
Risk factors causing circulatory stasis
Hospitalization
Surgery
Obesity
Long distance travel
Risk factors causing vascular injury
Orthopedic surgery
Trauma
Venous catheters
Smoking
Risk factors contributing to multiple components of Virchow’s Triad
Age
History of VTE
Scoring tool used in hospitalized patients to determine need for VTE prophylaxis
PADUA Score
PADUA score that indicated thromboprophylaxis intitiation
/> 4
Heparin for VTE prophylaxis dose (BMI < 40 kg/m^2)
5,000 units q8-12h SQ
Heparin for VTE prophylaxis dose (BMI /> 40 kg/m^2)
7,500 units q8-12h SW
Enoxaparin for VTE prophylaxis dose
30 units BID or 40 units QD SQ
Anticoagulants that can be used in high-risk outpatients with cancer (Khorana score /> 2)
apixaban
rivaroxaban
LMWH
Anticoagulants that can be used for thromboprophylaxis in low-risk patients with multiple myeloma receiving thalidomide- or lenalidomide- based regimens with chemotherapy
aspirin or LMWH
Anticoagulants that can be used for thromboprophylaxis in higher-risk patients with multiple myeloma receiving thalidomide- or lenalidomide- based regimens with chemotherapy
LMWH
DVT signs and symptoms
Unilateral leg pain and/or swelling and warmth
Positive Homan’s Sign
Elevated D-dimer
VTE with no cancer treatment options (4)
dabigatran, rivaroxaban, apixaban, edoxaban
(over warfarin)