VTE and Stroke

Question 1

True or false: being over 60 years old is a risk factor for VTE

Answer 1

TRUE - as is pregnancy/post partum, obesity, reduced mobility and malignant disease

Question 2

Pharmacological VTE prophylaxis should be started ASAP or within _____hours of hospital admission

Answer 2

14 hours

Question 3

True or false: LMWH are preferred in renal impairment

Answer 3

FALSE - unfractionated heparin is preferred in renal impairment

Question 4

VTE prophylaxis:

_______ are suitable for all types of general and orthopaedic surgery

Answer 4

LMWH

UFH preferred in renal impairment

Question 5

What is the antidote for unfractionated heparin (UFH)

Answer 5

Protamine

May also reverse some effects of LMWHs
Ineffective for fondaparinux sodium

Question 6

Patients with suspected TIA should immediately receive _______

Answer 6

Aspirin 300mg

Question 7

Alteplase must be given within ____ hours following an ischaemic stroke

Answer 7

4.5 hours

Must rule out intracranial haemorrhage first

Question 8

Which drug is indicated for long term management of ischaemic stroke or TIA?

Answer 8

Clopidogrel

Dipyridamole + Aspirin if clopidogrel is contraindicated or not tolerated

Question 9

What is the alternative to clopidogrel for long term management of ischaemic stroke or TIA ?

Answer 9

Dipyridamole + Aspirin

Question 10

True or false: anticoagulants are also indicated in the long term prevention of recurrent stroke

Answer 10

FALSE - anticoagulants are not routinely recommended unless the patient has AF

Question 11

What is the target Blood pressure following an acute ischaemic stroke

Answer 11

< 130/80 mmHg

Question 12

True or false:

Pomegranate juice increases INR with warfarin

Answer 12

TRUE
Increased INR = greater bleeding risk
Cranberry products also raise INR

Question 13

True or false:

Enoxaparin can cause hyperkalaemia

Answer 13

TRUE
This true for all heparins
Enoxaparin can raise potassium levels due to it inhibiting aldosterone secretion.