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Epidemiology
Pathophysiology of VTE
Diagnosis of DVT and PE
VTE Treatment
Clinical data in VTE
100
There are approximately-------cases of VTE each year in the United States..
What is 300,000 to 600,000
100
True or False The majority of VTEs occur in the deep veins of the legs?
True
100
What percenatage of people with DVT have no symptoms at all?
What is 50%
100
what are the phases of duration of anticoagulation as defined by the ACCP
What is initial 0-7 days Long term 7 days to 3 months Extended 3 months to indefinite
100
How was rivaroxaban dosed in the EINSTEIN-DVT study
What is rivaroxaban was given twice daily orally at 15mg for the first 3 weeks then switched to 20mg once daily for the intended 3,6, or 12 months period
200
What percentage of of people with one episode of VTE will have a recurrence within 10 years
What is 30%
200
Name three of the larger veins at or above the knee
What is popliteal, femoral, and iliac veins
200
Name three signs or symptoms of DVT
What is pain, tenderness, swelling and edema, skin discoloration or redness and increased skin temperature
200
Unprovoked VTE is a predictor for recurrence of VTE, although recurrence occurs within 10 years for approximately what percentage of all people with VTE?
What is 1/3
200
In the EINSTEIN-DVT study what therapy was rivaroxaban compared to?
What is standard therapy (enoxaparin and VKA)
300
Name three of the acquired risk factors, which can lead to provoked VTE
What is patient factors, comorbid conditions and medications
300
------- is thought to be a trigger for activation of the coagulation cascade, resulting in a local area of hypercoagulability
What is blood pooling
300
Ruptured------is a more likely diagnosis if there is sudden severe calf pain
What is Baker cyst
300
What is the goal of treatment for DVT?
What is to prevent formation of additional thrombi and PE in the short term and to prevent recurrence in the long term
300
in EINSTEIN-EXT study rivaroxaban was compared to what?
What is placebo
400
Risk factors that are inherited characterisitics include deficiencies in -------- (a key inhibitor of clotting)
antithrombin
400
What are the three factors that make up Virchow Triad?
What is Abnormal blood flow, hypercoagulability, and endothelial dysfunction
400
This blood test is performed in patients with a low probability of PE
What is D-dimer test
400
What would be the ACCP recommendations for acute DVT of the leg or PE?
What is early initiation of VKA recommended over delayed initiation and continuation of parenteral anticoagulation for a min of 5 days and until INR is greater or equal to 2.0 for at least 24 hours
400
In the RE-COVER study what two drugs were compared?
What is dabigatran twice daily 150mg and warfarin
500
DVT can also develop into a chronic illness termed ------which is characterized by chronic ankle or calf pain and swelling in the legs.
What is postthrombotic syndrome
500
What is the most common cause of superficial VTE in an arm?
What is damage from an intravenous catheter
500
When diagnosising PE when is ventilation-perfusion scanning usually done?
What is when a patient has a contraindication for CTPA, such as those who cannot receive contrast agents
500
What is ACCP guidelines for unprovoked DVT or PE?
What is 3 months anticoagulation with the possibility of extended therapy upon evaluation
500
What were the results for the RE-COVER trial?
What is dabigatran was noninferior to warfarin at reducing the risk of recurrent VTE or VTE related death in patients with acute, symptomatic, proximal DVT or PE and there was no difference between the 2 study drugs for risk if major bleeding