Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS
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pass through lipid cell membrane -> increased reaction is
lipid soluble drugs
possible as it can directly enter the cell
venous stasis: happens from no movement, post surg, or
Virchow triad: three features that categorize common car ride
causes of VTE vascular endothelial wall injury: athlete, surg, HTN
hypercoagability: smoking, genes, med induced, cancer
apply Virchow triad clinically:
meds: what med is appropriate, fall risk, bleeding risk
meds
duration: provoked or unprovoked clot>
duration
when do we worry more about a DVT- when it is proximal PROXIMAL
or distal? it is more concerning and more of a burden on the lungs
mechanical- need warfarin
thromboembolic event: prosthetic heart valve
bioprosthetic (pork or bovine)- take aspirin daily
if the patient comes in with stroke like sxs and they are on
INR & glucose
warfarin (with mechanical valve) - what labs do you draw?
tx if pt comes into ed with stroke like sxs and are on ateplase
warfarin *make sure they are candidates for fibronolysis
loss of coordination of electrical activity and mechanical
Afib- what is it & whats the clot risk activity of atria
*clot in left atrial appendage is a risk
12% of ischemic strokes
a fib id what % of ischemic strokes DOACS & rate controlling
dx & tx some patients cant feel afib
diagnose with EKG
proximal: popliteal, femoral or iliac (above the knee)
DVT- common locations and major complication?
major complication: risk for PE
Factor V Leiden - treated with baby aspirin
hypercoagulable state: 2 most common genetic factors
G20210A (rare)
acquired hypercoagulable state: 1/8
, aPL antibody syndrome
*autoantibodies that bind to membrane proteins and ini-
tiate thrombosis
sudden or progressive onset of neuro sxs from lack of
blood supply to the brain
sxs of ischemic stroke
*sxs: tingling, numbness, weakness on one side, slurred
speech, signs of lack of O2 to the brain
pt comes into Ed with sxs of ischemic stroke: what labs/dx glucose, electrolytes, ECG, troponin, PT/PTT, INR , brain
tests imagine, carotid US
cornerstone of stroke prevention in those with afib> anticoag therapy
injectable anticoag unfractionated heparin or LMW heparin (Lovenox)
Warfarin (vitamin K antagonist)
oral anticoag DOACS, direct thrombin inhibitor and oral fact Xa in-
hibitors)
-major bleeding
-recent intracranial hemorrhage
contraindications for anticoag therapy -recent trauma
-end stage liver disease (thrombocytopenia risk & INR
increase)
elequis
abixiban
DOACs: examples
xarelto
ribiroxiban
who do we give DOACs to pt with DVT, PR or nonvalvular afib
what information the healthcare provider should teach
the patient regarding the management of minor external bleeding site should be manually compressed.
bleeding episodes with DOAC
2/8