Progress 6 (Page 75-79)

mbch4kz2's version from 2016-05-08 14:31


Question Answer
What is DVLA stance on hypertension?Can drive if no side effects (if resting BP >180 or >1000 then disqualifies
DVLA stance on angioplasty1 week off
DVLA stance on coronary artery bypass graft4 weeks off
DVLA stance on ACS4 weeks off (1 week if successfully treated by angioplasty)
DVLA stance on anginaMust stop if symptoms occur at wheel
DVLA stance on pacemaker insertion1 week off
DVLA stance implantable cardioverter-defibrillator (ICD)For sustained ventricular arrhythmia - Stop 6 months For prophylaxis- 1 month
DVLA stance successful catheter ablation for arrhythmia2 days off
DVLA stance aortic aneurysm of >6cmMust notify DVLA for annual review (greater than 6.5 disqualifies)
DVLA stance heart transplantNo need to notify DVLA
What are the 2 main types of heparin?1. Unfractionated (standard) 2. LMWH
How is unfractionated heparin administered and is it short or long duration?IV and short
How is LMWH administered and is it long or short acting?Subcutaneous and long
What is the mechanism of action of unfractionated heparin?Activates antithrombin III, inhibits thrombin factors Xa, IXa, Xia and XIIa
What is the mechanism of action of LMWHActivates antithrombin III, inhibits factor Xa
What are the side-effects of unfractionated heparin?Bleeding, heparin induced thrombocytopaenia, osteoporosis
What are the side-effects of LMWH?Bleeding, decreased risk of heparin induced thrombocytopaenia and oesteoporosis
How do you monitor unfractionated heparin?APTT- useful where there is a high risk of bleeding as anticoagulation can be terminated rapidly
How do you monitor LMWH?Anti-factor Xa (routing monitoring not required). Now standard in the management of venous thromboembolism treatment and prophylaxis and ACS
What is heparin induced thrombocytopaenia?Immune mediated antibody formed against complex of platelet factor 4 (PF4) and heparin. Associated with platelets but is a prothrombotic condition (>50% decrease in platelets, thrombosis and skin allergy). Treat with alternative anticoagulation (e.g.. lepirudin)
What is a side affect of both LMWH and unfractionated heparin?Hyperkalaemia (both inhibit aldosterone secretion)
How would you reverse a heparin overdose?Protamine sulphate- only partially reverses the effect of LMWH

Recent badges