VTE pre

Question 1

Venous Thromboembolism

Answer 1

-clots formed in areas of slow/distrubed flow
-stasis blood promotes thrombus = dec clotting factor clearance

Question 2

Venous thrombi composition

Answer 2

-RBCs
-fibrin
-some platelets
-“red thrombi”

Question 3

thrombi sx start when

Answer 3

-flow obstructed
-vascular tissue inflammation
-thrombus occurs and affects venous blood flow
-emboli occur and enter pulmonary circulation

Question 4

not all DVTs lead to PEs

Answer 4

-all PEs come from DVTs
=need to be blood clot somewhere that becomes dislodged

Question 5

Virchow’s triad

Answer 5

-three conditions that inc risk of clot
1. hypercoaguable state
2. Endothelial injury
3. Circulatory stasis

Question 6

Hypercoaguable state

Answer 6

-abnormalities of clotting components
-pregnancy, cancer

Question 7

Endothelial injury

Answer 7

-abnormality of surfaces in contact with blood flow
-injury to blood vessel

Question 8

Circulatory stasis

Answer 8

-abnormal blood flow
-long periods of immobility
-common in AFIB

Question 9

Slide 5

Answer 9

slide 5

Question 10

Injury to healing

Answer 10

1. endothelium
2. platelet adhesion and aggregation
3. Coagulation cascade activation
4. Thrombin
5. Fibrin formation
6. stabilized fibrin clot
7. Fibrinolysis and clot degradation
8. Healing

Question 11

Agents that affect platelet adhesion and aggregation

Answer 11

-activators:VonW factor
-inhibitors: heparin, thrombomodulin

Question 12

Coagulation cascade activation

Answer 12

-tissue factor
-Factor VIIa, Xa, XIIa
-Thrombin (Factor II)

Question 13

Coagulation cascade inhibition

Answer 13

-antithrombin
-protein C
-protein S
-tissue factor pathway inhibitor

Question 14

Fibrin formation activator

Answer 14

-Factor XIIIa

Question 15

Fibrinolysis affected by

Answer 15

-activators: tissue plasminogen activator
-inhibitor: plasminogen-activator inhibitor-1

Question 16

Coagulation Cascade

Answer 16

1. initiation
2. amplification
3. propogation

-slide 5 bc i didnt explain well

Question 17

Coagulation cascade initiation

Answer 17

-tissue factor bearing cell
-IX to IXa and X to Xa by TF/VIIa
-prothrombin to thrombin by Xa

Question 18

Amplification of coagulation cascade

Answer 18

-collagen-activated platelet
-V to Va
-VIII to VIIIa
-XI to XIa

-all by thrombin

Question 19

Collagen/thrombin activated platelet

Answer 19

-IX to IXa by XIa
-X to Xa by IXa/VIIa
-prothrombin to thrombin by Xa/Va
-fibrinogen to fibrin

Question 20

coagulation cascade intrinsic factors

Answer 20

-kms

Question 21

coagulation cascade extrinsic

Answer 21

kys

Question 22

coagulation common pathway

Answer 22

kys

Question 23

Postthrombotic syndrome

Answer 23

-long term complications of DVT caused by damage to venous valves
-chronic V obstruction
-caused by venous HTN
-chronic pain and swelling
-stasis ulcers
-development of infection
-rule out recurrent thrombosis before diagnosis

Question 24

DVT risk factors

Answer 24

->40
-fam hx
-HF
-immobilization
-malignancy
-MI
-obesity
-orthopedic injury
-estrogen
-paralysis
-postop
-pregnancy
-prior DVT
-varicose veins

Question 25

Nonpharma tx DVT

Answer 25

-bed rest
-elevate feet
-pain management
-compression stockings

Question 26

nonpharma PE tx

Answer 26

-oxygen
-mechanical ventilation
-compression stockings