Busy. Please wait.

Forgot Password?

Don't have an account?  Sign up 

show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.

By signing up, I agree to StudyStack's Terms of Service and Privacy Policy.

Already a StudyStack user? Log In

Reset Password
Enter the email address associated with your account, and we'll email you a link to reset your password.

Remove ads
Don't know (0)
Know (0)
remaining cards (0)
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how



Wells Criteria components Clinical evidence for DVT; PE=most likely dx; HR > 100; Immobilization/Surgery in past 4 wk; prior DVT/PE; cancer; hemoptysis
Wells Criteria: Score of <2: makes dx highly unlikely
Wells Criteria: Score of > 6: highly likely
Venous Thromboembolism: DVT common in patients with fractures of: spine, pelvic, hip, femur
Venous Thromboembolism: Risk factors Trauma, surgery, CVP line, smoking, prolonged immobility, PG/OCP/hormone tx, age, cancer, prior VTE, obesity, HF, coagulopathy/P vera/CTD nephrotic syndrome, prior DVT; NOT GENDER
Venous Thromboembolism: Calf pain: next step: Calf pain in post-op hip or knee patient deserves US
The first sign of DVT may be: PE
Antithrombotics include: Fibrinolytics, anticoagulants, antiplatelet drugs
Use of fibrinolytics in CAD is restricted to: STEMI only
Anticoagulants: acute & chronic Acute: UFH, LMWH, DTIs; chronic: warfarin
UFH vs LMWH re: inactivating thrombin UFH > LMWH
Irreversibly binds to ADP receptor on platelets; Full reversal requires removal of plts Clopidogrel
UFH: main risk = bleeding
UFH: used for: Both STEMI and NSTEMI
ATPIII/heparin has greatest effect on: Factor II (thrombin)
Can use to monitor LMWH: Factor Xa
UFH/LMWH AEs Bleeding, HIT, osteoporosis
UFH vs LMWH: which is inhibited by PF4 (thus limited effect vs ACS)? UFH
UFH vs LMWH: requires dose adjustment for renal: LMWH
Catheter thrombosis during PCI Fondiparinux
Bivalirudin used in STEMI in place of: UFH / LMWH
Add warfarin for: pts w/ USA or NSTEMI w/anticoag indication (to maintain INR 2.0-3.0)
Clopidogrel dosing usu loading & maint doses
Clopidogrel AEs Bleeding; Thrombocytopenia; Leukopenia; TTP
Clopidogrel: who gets: All STEMI/NSTEMI (2-4 wks to 1 yr)
GP IIb/IIIa inhibs: who gets: STEMI pts going for PCI
GP IIb/IIIa inhibs: not recommended if: PCI is not planned
What percentage of pts with PE present with clinical findings of LE VTE? 50%
Massive PE may presents as: RV failure and systemic hypotension
Factor V Leiden accounts for what percent of new VTE incidents? 20%
90% of patients with PE have a PaO2 of: <80 mmHg
Effusions in patients with PE: Small, seen in 30% of PEs, usually exudative & often hemorrhagic
Gold standard for diagnosing PE: pulmonary angiography
DVT Tx: start UFH, with warfarin started when? at the same time
Which lab test is used to monitor warfarin? PT (INR)
What is considered a latent finding in a PE? R wave pattern with strain on ECG
Most common site of origin of a PE: vein of a lower extremity
Patients on warfarin for PE should have INR checked every: 4 weeks
What med may interact with dabigatran? Carbamazepine
ECG findings in PE: S1 Q3 T3: S waves in lead I, Q waves and inverted T waves in lead III
DVT increases 12-month MI risk by: up to 60%
A proximal DVT is located: above the knee
For a patient with DVT, treat with ____ for about 5 days UFH or LMWH
For a patient with DVT treat with ____ for at least 3 months warfarin
Emboli from heart: destinations 50%-60% to LEs, 20% to cerebrovascular; 10-20% to UEs/ renal/ mesenteric circulation
DVT: sites 80% deep v. of the calf; 20% femoral or iliac vein
Wells Criteria: Clinical evidence for DVT = 3 points
Virchow’s triad = Venous stasis, vessel wall injury, hypercoagulability
Thromboembolus of deep veins of LEs (deep saphenous) or pelvis = DVT
Wells Criteria: Immobilization/Surgery in past 4 wk = 1.5 points
Wells Criteria: Previous DVT/PE = 1.5 points
Wells Criteria: Cancer = 1 point
Wells Criteria: Hemoptysis = 1 point
DVT Evaluation D-dimer; LE Doppler/ US; if PE suspected, VQ scan versus spiral CT; hypercoaguable w/u if no identifiable predisposing event
D-dimer results: negative result is helpful; pos results non-specific
DVT Tx Hep (vs LMWH) & concomitant warfarin loading; warfarin; Thrombolytic tx; embolectomy; IVC filter
warfarin tx for DVT (INR 2.0 – 2.5); idiopathic 6 mos 1st event; non-idiopathic or recurrent event: consider indefinite tx
DVT complications PE; ischemic limb; varicose v.; chronic venous insufficiency
DVT Prevention in Surg pts: Low risk: Minor surg in pt < 40 yrs w/ no additional risk factors
DVT Prevention in Surg pts: mod risk: Minor surg in pt < 40yrs w/ an additional risk factor or surg in pt 40-60 years of age
DVT Prevention in Surg pts: High risk: Surgery in pt > 60 years or in pt 40-60 with risk factors
DVT Prevention in Surg pts: Highest Risk: Surg in pt > 40 yrs w/ multiple risk factors or hip/knee arthroplasty or major trauma spinal cord injury
DVT Prophylaxis in Surg pts: Low risk: Early ambulation, pneumatic stockings
DVT Prophylaxis in Surg pts: Mod risk: SubQ unfract hep or LMWH +/- pneumatic compression
DVT Prophylaxis in Surg pts: High risk: SubQ LMWH
DVT Prevention in medical pts No formal risk assessment; pneumatic compression stockings for low risk pts; unfract hep or LMWH for other pts w/ systemic illness limiting mobility esp w/ other risk factors
Venous thrombosis Epi 1 in 1000?; M>F, AA>W
Venous thrombosis RF inherited (Factor V Leiden, Pro S or C def), surgery, bedrest/immobility, PG, OCP; malig
Venous thrombosis Sx/Sx DVT & PE; palpable cord (= thrombosed vein), calf or thigh pain, unilateral edema / difference in calf diameters, warmth, tenderness, erythema, superficial venous dilation; Homan sign
Venous thrombosis DDx Mx strain/injury; lymphangitis / lymph obstruction; venous insuff; Baker cyst; Cellulitis
Venous thrombosis Dx studies Contrast venography (gold standard); venous U/S (noncompressible veins); impedance plethysmography
Venous thrombosis Tx Anticoag (not tx but secondary prevention); heparin (monitor aPTT) followed by warfarin x6 mos (PT 2-3); possibly thrombolytics (streptokinase, urokinase, tPA)
VTE etiology: venous stasis, coagulopathies, genetic
Coagulopathies associated with VTE: Antiphospholipid Abs, protein C&S, Factor V Leiden & activated protein C resistance, antithrombin III deficiency
Venus Thromboembolism: Screen with: duplex Doppler venous ultrasound
Created by: Adam Barnard Adam Barnard