Category A
What is the primary imaging tool used to diagnose a DVT?
Compression Ultrasound w/ Doppler
PE is a common complication of what condition?
DVT
What criteria is used for DVT risk stratification?
Wells Criteria for DVT
What two criteria are used for PE risk stratification?
Wells Criteria for PE
Pulmonary Embolism Severity Index (PESI)
A DVT is most likely located in what part of the body?
The lower extremities/legs.
What constitutes a positive US finding in a patient with a DVT?
Inability to fully compress vein, due to DVT.
What is the range of how many Americans die from a PE/DVT each year?
60,000-100,000
At what CrCl is IV UFH considered the preferred anticoagulant?
CrCl < 30.
What anticoagulant needs to be bridged with Heparin when initially started?
Warfarin
What is the desirable INR range for Warfarin?
2.0 - 3.0
Patient is PE positive, what is the highly tested/unique ECG finding?
S1Q3T3
Per Dr. Medina, how quickly can it theoretically take for a person to develop a DVT while sitting?
2-3 hours
What are the three categories of Virchow's Triad?
Stasis of blood flow
Endothelial Injury
Hypercoagulability
A proximal DVT is a thrombus in either of these three veins?
How many days prior to a procedure do you stop Warfarin for a low/moderate/high risk procedure?
5 days
What imaging tool is used to evaluate for a PE if a patient is allergic to contrast or has a CrCl of < 30?
V/Q Scan
Around how many people in the US are affected by a DVT/PE per year?
Around 900,000.
What are the two prophylactic dose options for Lovenox?
30 mg BID
40 mg daily
What is the initial starting dose of Apixaban for DVT/PE txt and for how many days? What is the maintenance dose?
Apixaban 10 mg BID for seven 7 days.
Maintenance is 5 mg BID
What are the two therapeutic dose options for Lovenox?
1 mg/kg BID preferred
1.5 mg/kg daily in selected non-obese inpatient
What is the GOLDEN diagnostic imaging test of choice to evaluate for a PE?
CT Pulmonary Angiogram.
What is the probability a patient with Hx of DVT/PE will develop another one within 10 years?
33% or 1/3.
Fill in the blank:
If bridging is needed for a high thromboembolic risk patient, start LMW heparin at therapeutic dose approximately *** days before surgery, with the last preoperative dose approximately *** hours before surgery.
3 days
24 hours
What are two potential heart complications 2/2 PE?
Acute Cor Pulmonale
Atrial Fibrillation
What is the initial starting dose of Rivaroxiban for DVT/PE txt and for how many days? What is the maintenance dose?
Rivaroxaban 15 mg by mouth BID for 21 days.
Maintenance 20 mg once daily.