Brainscape's Knowledge GenomeTM

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


See full index

Exam 1 Year 3 > Venous Thrombosis - DVT and PE > Flashcards

Venous Thrombosis - DVT and PE Flashcards

1
Q

What is venous thromboembolism?

A

Thromboembolic event occurring within the venous system
-DVT
-PE

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

1 in 1000 people have this a year, what is it?

A

DVT

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

What causes venous thromboembolism’s?

A

-Stagnation of blood flow (immobilisation)
-Hypercoagulability (inherited)
-Vascular injury (trauma/surgery)
-Endothelial injury

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

How does endothelial injury cause venous thrombosis?

A

-Collagen exposure
-Platelet aggregation
-Thrombus

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

What risk factors put a patient at risk of venous thrombosis ?

A

Age, Obesity, Varicose veins, Long haul flights, Immobility, Pregnancy and puerperium, Previous VTE, Male Sex

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

What predisposing conditions put a patient at more of a chance of having venous thrombosis?

A

-Trauma or surgery
-Malignancy
-CCF, recent AMI
-Infection
-Hormone therapy
-Inherited acquired disorders
-Vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What score is used to diagnose venous thrombosis?

A

Wells clinical score
*Higher or equal to 3, High probability
* 1 or 2 moderate probability
*Less than 0, low probability

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

What does the Wells Clinical score, clinical parameters?

A

-Active cancer
-Paralysis or recent plaster immobilisation
-Bedridden for more then 3 days/major surgery on past 4 weeks
-Entire leg swelling
-Localised tenderness along distribution of deep venous system
-Calf swelling of more than 3cm compared to asymptomatic leg
-Pitting oedema
-Previous DVT
-Collateral superficial veins

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

How can levels of D-dimer assay diagnose a venous thrombosis?

A

1) Thrombus formation
2) Fibrinolytic response
3) Plasmin generation
4) Fibrin breakdown
5) Release of fibrin degradation products (predominately D-dimer)

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

Who commonly will have a false positive of the D-dimer assay?

A

Elderly

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

What can affect the D-dimer assay?

A

Position of the clot, and heparin use

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

What imagining is used first to diagnose venous thrombosis?

A

Duplex ultrasonography (Dopler)
-Non-invasive
-High sensitivity

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

If a patient appears to have symptoms of venous thrombosis, but it isn’t that what else could it be?

A

-Physical trauma
-Cellulitis
-Ruptured Baker’s cyst
-Oedema

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

How are Venous Thrombosis managed?

A

-Identify and treat any underlying cause
-Prevent damage to valves of veins
-Allow normal circulation to limbs
-Prevent PE
-Immediate management with injectable anticoagulant

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

What is the first choice anticoagulant for a venous thrombosis?

A

Heparin

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

How does unfractionated heparin (UFH) work?

A

On the intrinsic pathway
-Binds to antithrombin III,
-Inhibits factor Xa (10a)
-thrombin

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

What are the side effects of unfractionated heparin?

A

Haemorrhage, Thrombocytopenia, Hyperkalaemia, Osteoporosis, Alopecia

18
Q

What should be monitored when the concern could be thrombocytopenia?

A

Monitor platelets if the patient is on UFH for more than 5 days!

19
Q

What is the normal activated partial thromboplastin time (APTT)?

A

30-40 seconds

20
Q

What is the APTT ratio?

A

Pts APTT at a given time / APTT reference value

21
Q

What are some examples of low molecule weight heparin? (LMWH)

A

Enoxaparin, Tinzaparin

22
Q

What type of heparin has less effect on Thrombin?

A

LMWH

23
Q

What heparin has more effect on factor Xa?

A

LMWH

24
Q

What heparin has a decreased risk of thrombocytopenia and osteoporosis?

A

LMWH

25
Q

What oral anti-coagulation is used after LMWH?

A

Coumarins
-Warfarin
-Acenocoumarol
-Phenindione
DOACS

26
Q

How long is oral anti-coagulation after a venous thrombosis event given?

A

Usually 3 months (can be longer)

27
Q

How does Warfarin work?

A

Inhibits metabolism of vitamin K and affects the activation of factors II, VII, IX, X

28
Q

What is the onset of action for warfarin?

A

8-12 hours, full effect not seen for 48-72 hours

29
Q

What needs monitoring when a patient is on warfarin?

A

Baseline: Clotting screen, Hb, Plts, LFTs
INR and signs of bleeding

30
Q

What is the normal INR ratio?

A

1-1.2

31
Q

What does Dabigatran Etexilate work on?

A

Direct thrombin inhibitor
DOAC

32
Q

What does Rivaroxaban, Apixaban, Edoxaban work on?

A

DOAC
Direct inhibitor of activated factor X

33
Q

What do compression stockings do?

A

*Assist calf muscle pump
*Decrease venous hypertension
*Decrease venous valvular reflux
*Decrease leg oedema
*Aids microcirculation
*Prevention of venous ischemia

34
Q

Why do pulmonary embolisms occur?

A

Blood clot or thrombus formed in the venous systems, normally clot originates in the calf
-These break free and embolise to lung
-There are normally multiple clots

35
Q

What happens when a pulmonary embolism obstructs the pulmonary artery system?

A

*Increase pulmonary artery pressure
*Right heart failure
*Infarction of lung tissue

36
Q

What are the symptoms of a PE?

A

*Acute onset chest pain
*General malaise
*Dyspnoea
*Haemoptysis
*Cough
*Wheeze
*RR above 16
*Abdo pain
*Anxiety
*Cardiac arrhythmias
*Syncope

37
Q

How are PE’s diagnosed?

A

*Chest X-ray
*V/Q Scan
*Lab tests
-PaO2 decreased
-WCC, ESR, D-dimer levels increased
*ECG
-Could be tachy!!

38
Q

If a patient doesn’t have a PE what other diagnosis could they have?

A

ACS, Pneumonia, CCF, AF, Acute Anaemia, COPD/Asthma!

39
Q

What do they give immediately when someone has a PE?

A

*Immediate anticoagulation in DVT

40
Q

What Fibrinolytics are given for PE?

A

-Urokinase
-Steptokinase
-Alteplase
-Reteplase

41
Q

How do Fibrinolytic drugs work?

A

-Activate plasminogen, breakdown of formed fibrin
-Only used for really big PE’s

Exam 1 Year 3 (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions