venous thromboembolism and haemostasis

Question 1

mode of inheritance haemophilia

Answer 1

X linked

Question 2

who gets haemophilia

Answer 2

sons and daughters can have mild

Question 3

which factor haemophilia a

Answer 3

viii

Question 4

which factor haemophilia b

Answer 4

ix

Question 5

what percentage haemophilia is de novo mutation

Answer 5

30%

Question 6

which factor modulates the clotting cascade

Answer 6

thrombin

Question 7

what turns fibrinogen to fibrin

Answer 7

thrombin

Question 8

what is big lumpy bruises

Answer 8

ecchymoses

Question 9

signs of h’philia

Answer 9

joint bleeds
ecchymosis
pain at joints
prolonged bleeing

Question 10

treatment of h’philia

Answer 10

prophyllaxis and on demand

Question 11

what is tranexamic acid

Answer 11

anti fibrinolytic

Question 12

newest treatment for h’philia

Answer 12

gene therapy - virus administered - lasts 5 years

Question 13

VW disease mode of inheritance which chromosome

Answer 13

autosomal chromosome 12

Question 14

what does VW factor do (2)

Answer 14

platelet adherance and factor 8 chaperone

Question 15

VW types modes of inherei

Answer 15

dominant 1,2
recessive 3

Question 16

VW disease signs

Answer 16

nosebleeds
heavy periods

Question 17

what is vte

Answer 17

venous thromboembolism

Question 18

what is recombinant therapy

Answer 18

introduced in for example a virus

Question 19

what do venous thrombi look like

Answer 19

red cells in fibrin mesh

Question 20

what do arterial thrombi look like

Answer 20

white colour - platelets and fibrin

Question 21

where is distal dvt

Answer 21

beyond popliteal

Question 22

what causes dvt normally

Answer 22

lack of calf muscle exercise

Question 23

dvt causes

Answer 23

pe

Question 24

legs to?

Answer 24

lungs

Question 25

where dvt is risk of pe hi

Answer 25

deep veins

Question 26

which site are dvt most common

Answer 26

femoral, popliteal,

Question 27

which factor mediates thrombin formation

Answer 27

Xa

Question 28

clot buster proper name

Answer 28

thrombolytic

Question 29

PE at lung bifurcation

Answer 29

saddle embolism

Question 30

how many ppl in hospital died suddenly of PE

Answer 30

80%

Question 31

risk for vte

Answer 31

inflammatino immobilisation obesity

Question 32

what is Virchow's triad

Answer 32

reduced/stagnant bloodflow vessel wall pathology hypercoagulability

Question 33

dvt presentation

Answer 33

pain erythema oedema warmth tenderness

Question 34

what do you use to diagnose likelihood of DVT

Answer 34

Wells Score

Question 35

what anticoagulants does smooth endothelium release

Answer 35

Thrombomodulin Tfp1 Heparin-like proteoglycan

Question 36

what is d-dimer

Answer 36

degradation product of fibrin

Question 37

if d-dimer is postitve, what does that mean

Answer 37

breakdown of fibrin has occureed. not necessarily vte - can be cancer/pregnancy

Question 38

pe symptoms

Answer 38

dyspnoea cough up blood haemoptysis temp

Question 39

pe signs

Answer 39

tachypnoea tachycardia

Question 40

cxr in pe is normally

Answer 40

normal

Question 41

what do you use to image legs in dvt suspicion

Answer 41

ultrasound

Question 42

what is the standard imaging for pe investigation

Answer 42

CTPA

Question 43

treatment of PE

Answer 43

oxygen then sub cut low molecular weight heparin

Question 44

what does heparin do

Answer 44

activates antithrombin which inactivates Xa thrombin and fibrin are inactivated

Question 45

what is heparin not

Answer 45

thrombolytic

Question 46

too much heparin where can you bleed which is very dangerous (2)

Answer 46

brain bleeds retroperitoneal bleeds

Question 47

risk of heparin rare

Answer 47

heparin induced thrombocytopenia

Question 48

high risk pt treatment of pe

Answer 48

Question 49

what is DOAC

Answer 49

eg rivaroXAban oral factor Xa inhibitor Direct-acting Oral AntiCoagulants

Question 50

what is DOAC used for

Answer 50

AF DVT PE management

Question 51

who can't take rivaroxaban

Answer 51

end stage kidey liver disease

Question 52

what pe treatment in preg/lactation

Answer 52

LMWH

Question 53

what vte treatment in cancer

Answer 53

DOAC fine

Question 54

what is abelacimab

Answer 54

factor 11 and 11a binder. Anti coag both in-pt and prophylactic in at risk at home pt

Question 55

what is IVC filter for

Answer 55

surgical intervention high risk pt large oesophageal bleed, haemorrhagic CVA, retroperitonealbleed, major brain surgery post-op

Question 56

what does pe lead to

Answer 56

right sided heart strain

Question 57

most common thrombolytic

Answer 57

tpa tissue plasminogen activator

Question 58

what is dabigatran

Answer 58

direct thrombin inhibitor Prevent strokes in pt with AF Also to treat dvt and pe. Newer warfarin equivalent

Question 59

who takes rivaroxaban prophylactically

Answer 59

knee/hip replacment pts

Question 60

how many types of VWD

Answer 60

3

Question 61

what is type 1 vwd

Answer 61

quantitative reduction in vw antigen and therefore factor 8

Question 62

what is type 2 vwd

Answer 62

qualitative vw antigen doesn't work low ricof

Question 63

what is type 3 vwd

Answer 63

quantitavtive absence of vw antigen and fatcor 8 very low ricof