Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ICU > Venous Thromboembolism > Flashcards

Venous Thromboembolism Flashcards

1
Q

What is the cause done VTE after major surgery?

A

Thromboplastin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the medical conditions with the highest risk of VTE?

A

Right heart failure
Stroke with lower extremity weakness
Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is responsible for the variable anticoagulant effect of heparin?

A

Plasma protein levels

Heparin binds these, macrophage, and endothelial cells. This messes with its bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the MOA of unfractionated heparin?

A

Bind to antithrombin III and this complex inactivates factor 2a (thrombin) and Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the standard dosing of LDUH?

A

5,000 units q8 or q 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the advantages of LMWH?

A
  1. More potent anticoagulant
  2. More predictable effect
  3. Longer duration of action (doesn’t bind endothelial cells or macrophage)
  4. Reduced binding of platelets (lower risk of HIT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the disadvantage of LMWH?

A

Cleared renally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of surgeries is LMWH superior to LDUH for?

A

Major orthopedic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the dosage of enoxaparin in obese patients?

A

0.5 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the advantages of dalteparin over lovenox?

A

Given only once daily in higher doses

Can be continued without dose reduction in renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long should you hold LMWH before an epidural?

A

If twice a day dosing - 12 hours

If once a day dosing - 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long do you wait after an epidural to restart LMWH?

A

2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do graded compression stockings work?

A

Create a gradient of external pressure to force venous outflow of the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Can graded compression stockings be used alone for thromboprophylaxis?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Can intermittent pneumatic compressions be used alone?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical symptoms of PE?

A

Tachypnea, tachycardia, hypoxemia, dypsnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the principal method for finding venous thrombosis in the leg?

A

Compression us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What technique can be used as adjunct for identifying thrombosis?

A

Color Doppler US

19
Q

What is the test of choice for an upper extremity clot?

20
Q

What can be missed in a CTA?

A

Smaller, segmental clots

21
Q

How do you manage a PE?

A

Bolus of IV heparin

22
Q

What is the target PTT?

A

46-70 seconds

23
Q

What is the target PTT ratio test?

24
Q

When does HIT appear?

A

5-10 days afte the initiation of heparin therapy

25
Q

What can reverse heparin?

A

Protamine sulfate

26
Q

How much protamine would you give?

A

1 mg covers 100 units
If been running for 30 minutes - do 0.5 mg per 100 units
If been running for more than 2 hours - do 0.27-0.375 mg per 100

27
Q

How would you dose protamine for a continuous heparin infusion?

A

Use the heparin dose that ran over last 2 hours and give 1 mg per 100

28
Q

What does protamine cause?

A

Bradycardia
Hypotension
Hypersensitivity (ask about fish products)

29
Q

How can use asses the effectiveness of protamine?

A

Get activated PTT 5-15 minutes after administration

30
Q

How can you avoid Brady and hypotension when giving protamine?

A

Give it slowly over 10 minutes

31
Q

What is the therapeutic dose of LMWH for a PE?

A

1 mg/kg q 12 h

32
Q

How do you monitor the effect of LMWH?

A

Anti-Xa levels

33
Q

What is the desired range of anti-Xa for clot?

A

0.6-1 unit/ml if twice a day dosing

Over 1 if once a day

34
Q

Why is continuous heparin infusion the treatment modality if choice for PE?

A

Rapid acting
Easily reversible
Doesn’t require dose adjustment in renal patients

35
Q

What is the initial dose of warfarin?

A

5-10 mg for first 2 days

36
Q

What is the standard thrombolytic regimen?

A

Alteplase 100 mg infused over 2 hours

37
Q

What is the goal thrombolytic therapy for a PE?

A

Limit clot extension
Does not break up existing clot
Can reduce right heart strain

38
Q

What are the indications for thrombolytic therapy?

A

Hemodynamic deterioration and RV dysfunction

39
Q

What are the indications for an IVC filter?

A

Absolute contraindication to anti coagulation
PE during full anticoag
A large free-floating thrombus
Limited cardiopulmonary reserve

40
Q

What is the shape and name of the filter used?

A

Greenfield filter, looks like a bad mitten birdie

Allows it to fill without compromising the lumen of the IVC

41
Q

How are IVC filters inserted?

A

Percutaneously through the IJ or femoral vein

42
Q

Where in the IVC is it placed?

A

Below the renal veins

43
Q

What are the risk factors for VTE.

A 
Surgery
Trauma
Malignancy
Estrogen drugs
EPO
Acute medical illness
Prior hx
Obesity
Pregnancy
Sepsis
Vasopressors
Platelet transfusions 
Immobility

ICU (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions