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Risks
Pharmacology
Mechanical
Management
Pharmacologic
100

When should you assess a patient's risk for thrombosis?

Prior to surgery

100

True or False: SERMS are associated with an increased risk of VTE? 

True

100

How do SCDs prevent thromboses?

Reduce venous stasis and produce endogenous fibrinolytic molecules

100

What type of prophylaxis is recommended for patients who have a low risk of VTE ?

Mechanical- Sequential compression device > graduated compression stockings

100

What medication can be used in the perioperative period if a patient cannot tolerate UFH or LMWH?

Fondaparinaux 

200

How long are patients at risk for VTE after surgery?

4 weeks

200

How is unfractionated heparin reversed? 

Protamine sulfate

200
True or False: Compression stockings need to be fitted to the patient

True

200

How should patients with moderate risk of VTE and a high risk of bleeding be managed?

Mechanical prophylaxis

200

What are the advantages of LMWH compared to UFH?

Longer half-life & greater bioavailability

Less frequent dosing

Lower risk of HIT

300

How many days after surgery do patients usually present with VTE?

6-15 days

300

Name a direct factor Xa inhibitor

Rivaroxiban or Apixaban


300

Why are SCDs preferred to Compression stockings?

SCD efficacy is similar to pharmacoprophylaxis

Lower risk of skin complications

300

How should patients with a moderate risk of VTE and low risk of bleeding be managed?

Either pharmaco- or mechanical prophylaxis

300

True or false: Transfusion rates are higher in those receiving UFH compared to SCDs. 

False

400

What are the two most common inherited thrombophilia mutations found in patients with a new thrombosis?

Factor V Leiden & G20210A

400

What is the mechanism of action of Fondaparineux?

Indirect factor Xa inhibitor

400

When should mechanical prophylaxis be used in the perioperative period?

Placed prior to surgery and continued until fully ambulatory

400
How are patients with high risk of VTE and low risk of bleeding managed?
Mechanical and pharmacoprophylaxis
400

What type of pharmacoprophylaxis is preferred in patients with renal dysfunction? 

Low dose unfractionated heparin

500

What is the risk of thrombosis if a patients Caprini score is in the low risk category?

1.5%

Moderate risk- 3% & High risk- 6% 

500
The guidelines suggested that LMWH may have a reduced bleeding risk compared to UFH. Why?

LMWH has more anti-factor Xa activity and less antithrombin activity

500
RANDOM- How long after discontinuation of CHC does it take for VTE risk to return to baseline?

4-6 weeks

500

How should patients with GYN Malignancies be managed? 

Mechanical & pharmacoprophylaxis followed by 4 months of pharmacoprophylaxis

500

A study was quoted that reviewed risks of bleeding in patients receiving UFH. What was the rate of reoperation for bleeding complications in this study? 

1% (compared to 0.7% in those without medication)