Risk Factors & Diagnosis
Name two components of the Wells DVT score.
What is active cancer, paralysis, or recent plaster cast, immobilization >3 days or surgery in previous 12 weeks, tenderness along the venous system, entire leg swollen, calf swelling >3 cm, pitting edema, collateral superficial veins, prior history of DVT, or alternative diagnosis?
First-line non-pharmacologic VTE prophylaxis in hospitalized patients.
What is early ambulation?
Bolus and starting rate for IV UFH.
What is 80 units/kg bolus (max 10,000 units), then 18 units/kg/hour (max 2,000 units/hour)?
Target INR for most patients on warfarin for VTE.
What is 2-3?
This anticoagulant requires INR monitoring and is reversed with vitamin K.
What is warfarin?
What is a provoked VTE?
VTE caused by an identifiable risk factor. Examples: active cancer, stasis due to long car ride, and trauma.
Padua score ≥___ indicates high risk in medical inpatients.
What is 4?
The dosing schedule of rivaroxaban for treatment of VTE.
What is 15 mg BID x 21 days then 20 mg daily with evening meal?
Name one lab test monitored for UFH therapy.
What is aPPT or anti-Xa?
This DOAC must be taken with food.
What is rivaroxaban?
Lab test commonly used to rule out VTE in low-risk patients.
What is a D-dimer?
Name one contraindication to pharmacologic VTE prophylaxis.
What is active bleed, high bleed risk (risk vs. benefit), plt <50K (thrombocytopenia)?
Anticoagulant that is preferred in pregnant patients.
What is enoxaparin?
Reversal agent for heparin.
What is protamine sulfate?
This drug is the preferred anticoagulant in patients on hemodialysis.
What is heparin?
Definition of a massive PE.
What is PE with sustained hypotension (SBP <90 mmHg) or need for vasopressors?
Patient was started on enoxaparin for VTE prophylaxis while inpatient. No indications for prophylaxis outpatient. Continue at home or discontinue?
What is discontinue?
The dosing for therapeutic dosing and frequency for enoxaparin.
What is 1 mg/kg Q12H?
What should be checked at baseline for all patients starting anticoagulation?
What is CBC, renal function, hepatic function?
This oral anticoagulant is contraindicated in patients with mechanical heart valves.
What are DOACs?
Name Virchow's triad.
What is venous stasis, endothelial injury, and hypercoagulability?
Duration of anticoagulation for patient with mechanical heart valve.
What is indefinite?
This thrombolytic agent is given as a single IV bolus with weight-based dosing and is sometimes used off-label for PE.
What is tenecteplase?
This is given to patients on a DOAC and have a bleed to "reverse" them.
What is 4F-PCC (four-factor prothrombin complex concentrate)?
This thrombolytic agent is given as 100 mg IV over 2 hours for massive PE.
What is alteplase?