Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
What are the 3 main risk factors for VTE according to Virchow's Triad? |
1. Abnormalities of blood flow 2. hypercoagulability of the blood 3. blood vessel wall damage Any alterations of these 3 can lead to the blood clotting. |
|
|
What are the situations that can cause stasis of the blood? |
1. reduced mobility (long distance travel, sedentary lifestyle, surgery) 2. venous stasis caused by a tumour, chronic heart failure and fibrillation |
|
|
What can be the cause of blood vessel wall damage? |
- Surgery - trauma - venous catheters |
|
|
What are the other personal risk factors for VTE? |
- Increased age above 40 - Family history - Smoking - Medications (oestrogen, SERMs, Heparin, alcohol and hypnotics) |
|
|
What are the symptoms of DVT? |
Can be asymptomatic but typically include: - Unilateral leg swelling - Pain and tenderness - erytherma and warmth - skin discolouration |
|
|
What are the possible complications of DVT? (risk to the patient) |
- Recurrent DVT - Post thrombotic syndrome (permanent damage to the venous valves) - Pulmonary embolism - DEATH |
|
|
What are the mechanical prophylaxis options for DVT? |
Generally not used alone, mainly to compliment pharmacological prophylaxis - graduated compression stockings - Intermittent pnemonic compression (pulsating compression boot) |
|
|
What is the pharmacological prophylaxis for a low risk situation? including: -Uncomplicated surgery with no risk factors - Major general surgery in patients < 40 - Minot surgery <60 |
No specific measures requires for the prevention of DVT. |
|
|
What is the pharmacological prophylaxis for a moderate risk situation? including: - Major general surgery in patients 40-60yrs with no clinical risk factors - Immobilised medical patients with additional risk factors (e.g cancer, past VTE, heart failure) |
Low dose SC heparin q12h or LMWH d E.g. Enoxaparin Sc 20mg once daily 7-10/7 |
|
|
What is the pharmacological prophylaxis for a high risk situation? including: - Major general surgery >60yrs - major general surgery > 40 yrs with a history of cancer and thromboembolism |
Low dose SC heparin q12h or LMWH d E.g. Enoxaparin Sc 40mg once daily 7-10/7 |
|
|
What is the pharmacological prophylaxis for orthapedic surgery of the pelvis, hip or lower limb? |
LMWH d E.g. Enoxaparin Sc 40mg once daily 7-10/7 |
|
|
What is the pharmacological prophylaxis for hip fracture, knee or hip replacement and abdominal surgery |
Fondaparinux 2.5 mg SC daily |
|
|
What is the pharmacological prophylaxis for an elective hip or knee replacement? |
NOACs: Apixaban 5 mg bd |
|
|
What are the aims for the treatment of DVT? |
The aim is to prevent - thrombus extension - pulmonary embolism - post-thrombotic syndrome - recurrent VTE |
|
|
What is the treatment plan for DVT? |
Graduated compression stokings for 18 months Anticoagulant therapy. e.g. Warfarin 5 mg d for 3 days then adjust to INR |
|
|
What is the duration of anticoagulant therapy if: - VTE was provoked by a transient major risk factor - Unprovoked distal VTE |
3 months |
|
|
What is the duration of anticoagulant therapy if: - Its the first unprovkked proximal DVt or PE |
6 months |
|
|
What is the duration of anticoagulant therapy if: - its a recurrent unprovoked VTE |
Indefinitely |
|
|
What is the duration of anticoagulant therapy if: - First VTE pluc cancer, multiple thrombophilias |
Indefinitely |
|
|
What are the symptoms of PE (pulmonary embolism) ? |
Common: - SoB - palpitations - dull central chest pain Less common: - haemoptysis - syncope - fever |
|
|
What is the treatment of PE? |
- Oxygen at high flow rates - Analgesia for chest pain - Anticoagulant e.g. IV heparin (streptokinase IV) then start warfarin |
