venous thromboembolism and haemostasis Flashcards
mode of inheritance haemophilia
X linked
who gets haemophilia
sons and daughters can have mild
which factor haemophilia a
viii
which factor haemophilia b
ix
what percentage haemophilia is de novo mutation
30%
which factor modulates the clotting cascade
thrombin
what turns fibrinogen to fibrin
thrombin
what is big lumpy bruises
ecchymoses
signs of h’philia
joint bleeds
ecchymosis
pain at joints
prolonged bleeing
treatment of h’philia
prophyllaxis and on demand
what is tranexamic acid
anti fibrinolytic
newest treatment for h’philia
gene therapy - virus administered - lasts 5 years
VW disease mode of inheritance which chromosome
autosomal chromosome 12
what does VW factor do (2)
platelet adherance and factor 8 chaperone
VW types modes of inherei
dominant 1,2
recessive 3
VW disease signs
nosebleeds
heavy periods
what is vte
venous thromboembolism
what is recombinant therapy
introduced in for example a virus
what do venous thrombi look like
red cells in fibrin mesh
what do arterial thrombi look like
white colour - platelets and fibrin
where is distal dvt
beyond popliteal
what causes dvt normally
lack of calf muscle exercise
dvt causes
pe
legs to?
lungs
where dvt is risk of pe hi
deep veins
which site are dvt most common
femoral, popliteal,
which factor mediates thrombin formation
Xa
clot buster proper name
thrombolytic
PE at lung bifurcation
saddle embolism
how many ppl in hospital died suddenly of PE
80%
risk for vte
inflammatino
immobilisation
obesity
what is Virchow’s triad
reduced/stagnant bloodflow
vessel wall pathology
hypercoagulability
dvt presentation
pain
erythema
oedema
warmth
tenderness
what do you use to diagnose likelihood of DVT
Wells Score
what anticoagulants does smooth endothelium release
Thrombomodulin
Tfp1
Heparin-like proteoglycan
what is d-dimer
degradation product of fibrin
if d-dimer is postitve, what does that mean
breakdown of fibrin has occureed. not necessarily vte - can be cancer/pregnancy
pe symptoms
dyspnoea
cough up blood haemoptysis
temp
pe signs
tachypnoea
tachycardia
cxr in pe is normally
normal
what do you use to image legs in dvt suspicion
ultrasound
what is the standard imaging for pe investigation
CTPA
treatment of PE
oxygen
then sub cut low molecular weight heparin
what does heparin do
activates antithrombin which inactivates Xa
thrombin and fibrin are inactivated
what is heparin not
thrombolytic
too much heparin where can you bleed which is very dangerous (2)
brain bleeds
retroperitoneal bleeds
risk of heparin rare
heparin induced thrombocytopenia
high risk pt treatment of pe
what is DOAC
eg rivaroXAban
oral factor Xa inhibitor
Direct-acting Oral AntiCoagulants
what is DOAC used for
AF
DVT
PE management
who can’t take rivaroxaban
end stage kidey
liver disease
what pe treatment in preg/lactation
LMWH
what vte treatment in cancer
DOAC fine
what is abelacimab
factor 11 and 11a binder. Anti coag both in-pt and prophylactic in at risk at home pt
what is IVC filter for
surgical intervention
high risk pt
large oesophageal bleed, haemorrhagic CVA, retroperitonealbleed, major brain surgery post-op
what does pe lead to
right sided heart strain
most common thrombolytic
tpa
tissue plasminogen activator
what is dabigatran
direct thrombin inhibitor
Prevent strokes in pt with AF
Also to treat dvt and pe. Newer warfarin equivalent
who takes rivaroxaban prophylactically
knee/hip replacment pts
how many types of VWD
3
what is type 1 vwd
quantitative
reduction in vw antigen and therefore factor 8
what is type 2 vwd
qualitative
vw antigen doesn’t work
low ricof
what is type 3 vwd
quantitavtive
absence of vw antigen and fatcor 8
very low ricof
