Venous Thrombosis

Question 1

most common areas of arterial thrombotic events

Answer 1

brain
heart
peripheral circulation

Question 2

most common areas of venous thrombosis

Answer 2

lungs

legs

Question 3

why do you get angina/claudication in atherosclerosis?

Answer 3

less O2 getting to tissues from narrowed vessels from the plaque

Question 4

platelets are activated in arterial/venous thrombosis

Answer 4

venous

Question 5

secondary haemostasis is more active in arterial/venous thrombosis

Answer 5

venous

Question 6

main component of an arterial thrombosis

Answer 6

platelets

Question 7

main component of a venous thrombosis

Answer 7

fibrin

Question 8

Tx venous thrombosis

Answer 8

heparin (acutely)
warfarin (chronically)
NOACs

Question 9

Tx arterial thrombosis

Answer 9

aspirin and other antiplatelets

Question 10

why are you at increased risk of thrombosis in pregnancy

Answer 10

oestrogen pushes up production of clotting factors to stop bleeding AND
gravid uterus compressing BVs

Question 11

DDx DVT

Answer 11

cellulitis

Question 12

why do you get pleuritic chest pain in PE

Answer 12

infarcted edge of the lung wont allow it to slide during breathing as well

Question 13

ECG changes of PE

Answer 13

S1Q3T3
S wave in lead 1
Q wave and T wave inversion in V3

Question 14

name virchows triad for risk of VTE

Answer 14

vessel Wall - damaged valves
hypercoagulability - inc CFs
stasis - not moving around

“WH Smith”

Question 15

risk of having another blood clot if youve had one before is _%

Answer 15

25

Question 16

when is the highest time for developing VTE in oregnancy?

Answer 16

PUERPERIUM

Question 17

primary haemostasis is affected in arterial thrombosis T or F

Answer 17

T, overdrive of the platelet plug

Question 18

define thrombophilia

Answer 18

familial increased tendency to thrombose

Question 19

mechanisms of thrombophilia

Answer 19

inc coagulation activity eg platelet/fibrin clot formation
decreased fibrinolysis
decreased anticoagulant activity

Question 20

primary/secondary haemostasis is more commonly affected in thrombophilia

Answer 20

secondary

Question 21

protein C releases what to switch off factor 5?

Answer 21

factor 5 leiden

Question 22

factor 5 leiden deficiency causes a _ fold increase in VTE risk

Answer 22

5

Question 23

factor 2 can also be called

Answer 23

prothrombin

Question 24

causes of hereditary thrombophilias

Answer 24

F5L deficiency
prothrombin mutation
antithrombin deficiency
protein C deficiency
protein S

Question 25

what substances switch off fibrin production

Answer 25

protein c
protein s
antithrombin

Question 26

what symptoms would prompt you to consider hereditary thrombophilia screening?

Answer 26

venous thrombosis <45 yo
recurrent VTE
unusual VTE
FH of VTE/thrombophilia

Question 27

Tx hereditary thrombophilia

Answer 27

risk avoidance
short term prophylaxis eg in pregnancy
short term anticoagulation
long term anticoagulation if recurrent events only

Question 28

if you have 2 risk factors for VTE will your risk be much higher than it was with 1 or only a little?

Answer 28

a lot more

Question 29

clinical features of APLS

Answer 29

recurrent thromboses
recurrent miscarriage
mild thrombocytopenia

Question 30

pathogenesis APLS

Answer 30

change in beta 2 glycoprotein 1 which activates haemostasis and vessel wall abnormalities

Question 31

Tx APLS

Answer 31

aspirin
warfarin
causes arterial and venous thrombi

Question 32

how long should you anticoagulate for?

Answer 32

3 months if provoked

6 months to lifelong depending on risk factors

Question 33

name drugs that can cause a DVT

Answer 33

hormonal eg HRT/COCP
IV drug use
high dose steroids
antipsychotics in the elderly
chemo drugs

Question 34

most high risk surgery for DVT?

Answer 34

orthopaedic

Question 35

why wouldnt you give warfarin prophylactically for surgery?

Answer 35

it takes a will for it to get to the therapeutic range

higher bleeding risk than LMWH

Question 36

1st line anticoagulant for post-surgery prophylaxis for DVT/PE risk

Answer 36

rivaroxaban

Question 37

first, second and third line anticoagulant for AF

Answer 37

1. edoxaban
2. apixaban
3. warfarin

Question 38

why wouldnt you use a DOAC in AF

Answer 38

end stage CKD

dialysis

Question 39

what FBC value would suggest more of a production rather than production problem

Answer 39

all would be low

Question 40

why does VWF disease cause prolonged APTT?

Answer 40

it carries around factor 8 so if its low factor 8 cant be carried around

Question 41

APLS causes a prolonged PT/APTT

Answer 41

APTT (antibody on it prolongs it)