Create
Learn
Share

CC March 2016 Thombophilia evaluation

rename
echoecho's version from 2016-07-03 17:23

Section

Question Answer
*** Thrombophilia work-up guidelines vary. However, there is agreement on what?that patients with venous thromboembolism (VTE) should NOT be routinely be evaluated for hypercoaguable disorders
What have studies shown regarding thrombophilia testing and it's reduction of risk of recurrent VTE or mortality?thrombophilia testing does NOT reduce the risk of recurrent VTE or mortality
In what patient is the risk of recurrent VTE is highest?1) those with unprovoked event 2) is independent of the presence of inherited thrombophilia
Does the presence of thrombophilia affect anticoagulation management in most patients?no
If extended (indefinite duration) anticoagulation therapy has already been deemed necessary, is thrombophilia testing necessary?no
What is the most common inherited thrombophilia? Followed by what other inherited thrombophilia?1) Factor V Leiden (most common) 2) prothrombin gene mutation 3) protein C deficiency 4) protein S deficiency 5) antibhrombin III deficiency
*** When is a thrombophilia work-up recommended in a VTE patient?if the VTE occurred at a young age (before 40-45 y.o.) and if there is a strong family hx in 2 or more first-degree relatives OR in patients who have recurrent VTE
In one study of 2,132, patients with VTE, the rate of thrombophilic disorders was almost ______ in those with VTE before the age of 45 years old compared to those with thrombosis after 45 years of age?doubled
Is an unprovoked event alone an indication for testing? Why?1) no 2) because many of these patients will be candidates for extended anticoagulation, thus making testing unnecessary
Thrombophilia testing may be considered in patients with thrombosis at unusual sites, name these sites?1) cerebral venous sinus 2) abdominal vein thrombosis
In one study, ____% of patients with a portal vein thrombosis had a thrombophilia?45 (it is still unclear how dx of a thrombophililia in this setitng would influence therapy)
What 2 patient types is routine thrombophilia testing not recommended?1) upper extremity DVT 2) central venous catheter-related thrombosis
More than ____% of upper extremity deep venous thrombosis are catheter-related and the risk of recurrence with central venous catheter related thrombosis is low?60
The remainder of upper extremity deep venous thrombosis are due to what?1) idiopathic 2) due to thoracic outlet syndrome 3) due to effort (Paget-Schroetter syndrome)
Why is a thrombophilic work-up not indicated in patients with arterial thrombosis? With an exception of what condition? 1) because the presence of hereditary thrombophilia is principally a risk fx for venous thrombosis 2) exception to this is the antiphospholipid syndrome which may present with arterial thrombosis
What testing should be performed in a young women with arterial or venous thrombosis, recurrent fetal loss or thrombocytopenia?antiphospholipid antibody testing
If a thrombophilia work-up is needed, why should it be avoided during the acute phase of thrombosis? avoided in the first 3 months of Warfarin treatment?1) acute thrombosis impacts the results of thrombophilia testing (can decrease protein C, protein S and antithrombin. Can increase factor 8, lupus anticoagulant and anticardiolipin antibodies). 2) Heparin and warfarin can alter assays for antithrombin, protein C, protein S and lupus anticoagulant
Will the results of the thrombophilia work-up impact intial treatment recommendations for anticoagulation?no
*** SUMMARY = Evaluation for thrombophilia should be done on a _____ basis. Does the presence of a thrombophilia affect anticoagulation management in most patients?1) selective 2) no
*** SUMMARY = Thrombophilia is recommend in what patient type?young patients (< 40-45 years of age) with VTE
*** SUMMARY = Is an unprovoked event alone an indication for thrombophilia testing? why?1) no 2) because many of these patients will be candidates for extended anticoagulation, thus making testing unnecessary
*** SUMMARY = Is a thrombophilia work-up indicated in patients with arterial thrombosis?no
memorize
*** SUMMARY=