drugs
this parenteral drug potentiates antithrombin-3 and is a first-line treatment
LWMH (heparin)
this complication causes varicose veins in the lower extremity alongside edema
Chronic venous insufficiency
most specific imaging technique for PE diagnosis (specific)
Chest CT angiography
this type of medication prescribed to young women can increase the risk for emboli
oral contraceptives
What 3 professions are involved in imaging for DVT/PE
Ultrasound technician, CT or radiology tech and Diagnostic radiology
least number of days heparin and warfarin should be given together
5 days, (target INR of 2-3 for at least 48 hours)
most common cause of PE
DVT
Is D-dimer sensitive or specific
sensitive (normal< 500 ng/mL)
which hormone increases the risk for emboli?
Estrogen
3 common lab values to assess the coagulation cascade
PT time: extrinsic pathway (8)
PTT time: intrinsic pathway (2,7,9,10)
Thrombin time: common pathway (fibrinogen)
powerful anticoagulants given to stroke patients and in cases of massive PE
tPA (tissue-type plasminogen activator)
this complication is treated with supplemental O2 through nasal canula
Hypoxemia (<95%) leads to hyperventilation which leads to Respiratory alkalosis
abnormal LE US finding indicative of DVT
Non compressibility of the obstructed vein and Absent venous flow (complete obstruction) or abnormal venous flow (partial obstruction) on doppler
Placental abruption puts patient at risk for this type of embolism
Amniotic fluid embolism
3 professionals involved in treatment of DVT/PE
nurses (parenteral medicine administration), Physicians (Catheter-directed thrombolysis) and physical therapist (massage, electrotherapy, hydrotherapy)
first-line oral anti-coagulants used for long term treatment (category)
direct factor Xa inhibitors
massive PE can cause which sided heart failure?
right sided
2 common physical exam signs indicative of DVT
Homans sign: calf pain on dorsal-flexion of the foot
Meyer sign: Compression of the calf causes pain.
Payr sign: pain when pressure is applied over the medial part of the sole of the foot
what 2 lifestyle factors increase DVT/PE risk
sedentary lifestyle, obesity, recent long travel, smoking
3 non medical measures to lower emboli risk
Exercise (decrease venous stasis), compression stockings during long travels and smoking cessation
drug that reverses effects of heparin
protamine sulfate. (First-line treatment in heparin-induced thrombocytopenia is discontinuing heparin)
heparin use can cause this complication
Heparin-induced thrombocytopenia. (Heparin and platelet factor 4 (PF4) form a complex which leads to the production and binding of IgG antibodies. leads to platelet activation/consumption and thus thrombosis)
what imaging should be ordered in case of a massive PE
Echocardiography (Dilatation and hypokinesis of the right ventricle)
Closed long bone fractures increase risk for this type of embolism
fat embolism (fat cells from bone marrow enter the systemic circulation)
3 principles of Virchow's triad
hypercoagulability, endothelial damage, and venous stasis