What general age factor increases the risk of VTE in pregnancy?
Age 35 years or older.
What device can be used to prevent further embolism in pulmonary embolism management?
Vena caval filter.
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p.3
Risk Factors for VTE in Pregnancy

What general age factor increases the risk of VTE in pregnancy?

Age 35 years or older.

p.10
Management of Pulmonary Embolism

What device can be used to prevent further embolism in pulmonary embolism management?

Vena caval filter.

p.3
Risk Factors for VTE in Pregnancy

What is a lifestyle factor that can increase the risk of VTE?

Smoking.

p.11
Thromboprophylaxis Guidelines

What does SMFM recommend for women with a history of VTE undergoing cesarean delivery?

Prophylactic LMWH (Low-Molecular-Weight Heparin).

p.5
Inherited Thrombophilias

What is the VTE risk per pregnancy for someone with antithrombin deficiency and a family history?

0.2-1.16%

p.10
Management of Pulmonary Embolism

What is one method of dissolving blood clots in pulmonary embolism?

Thrombolysis.

p.1
Thromboembolic Disorders Overview

What is an embolism?

The obstruction of a blood vessel by a clot or other material that has traveled from another site in the body.

p.3
Risk Factors for VTE in Pregnancy

What is a significant obstetrical risk factor for developing VTE during pregnancy?

Cesarean delivery.

p.2
Virchow's Triad

What does stasis refer to in the context of Virchow's Triad?

A condition where blood flow is reduced or stagnant.

p.5
Inherited Thrombophilias

What is the VTE risk per pregnancy for someone with hyperhomocysteinemia?

0%

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

Where is Deep Vein Thrombosis (DVT) most commonly located?

In the iliofemoral and iliac veins.

p.9
Deep Vein Thrombosis (DVT) Clinical Presentation

What are other predominant symptoms associated with pulmonary embolism?

Tachycardia, apprehension, and tachypnea.

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

What is Homans' sign?

A clinical sign that may indicate DVT, observed in 30-60% of confirmed cases.

p.2
Virchow's Triad

What does local trauma to the vessel wall indicate in Virchow's Triad?

Injury to the blood vessel that can promote clot formation.

p.8
Anticoagulation Regimens

What should be done postpartum regarding anticoagulation?

Prophylactic, intermediate, or adjusted-dose LMWH for 6-8 weeks as indicated.

p.7
Thromboembolic Disorders Overview

What does PE stand for in the context of venous thromboembolism?

Pulmonary embolism.

p.10
Management of Pulmonary Embolism

What is the immediate treatment for pulmonary embolism?

Full anticoagulation.

p.9
Deep Vein Thrombosis (DVT) Clinical Presentation

What are common clinical presentations of pulmonary embolism?

Dyspnea, chest pain, cough, syncope, hemoptysis.

p.9
Diagnostic Methods for VTE

What ECG findings may indicate pulmonary embolism?

Right axis deviation and T wave inversion in anterior chest lead.

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

What percentage of patients with confirmed DVT had asymptomatic pulmonary embolism?

30-60%.

p.3
Risk Factors for VTE in Pregnancy

How does immobility contribute to the risk of VTE?

Prolonged bed rest increases the risk.

p.8
Anticoagulation Regimens

What does aPTT stand for?

Activated partial thromboplastin time.

p.7
Diagnostic Methods for VTE

What imaging techniques are abbreviated as CT and CTA?

CT = computed tomography; CTA = computed tomography angiography.

p.4
Inherited Thrombophilias

What is the G20210A mutation associated with?

Increased prothrombin levels.

p.4
Inherited Thrombophilias

What does Antithrombin deficiency lead to?

Decreased thrombin neutralization.

p.4
Inherited Thrombophilias

What role does thrombin play in coagulation?

Thrombin binds to thrombomodulin on endothelial cells.

p.4
Inherited Thrombophilias

What is the effect of hyperhomocysteinemia on protein C?

It inhibits the activation of protein C.

p.11
Thromboprophylaxis Guidelines

What is the recommendation for women with low-risk thrombophilia and a family history of VTE?

Antenatal LMWH therapy.

p.7
Thromboembolic Disorders Overview

What does DVT stand for?

Deep-vein thrombosis.

p.9
Deep Vein Thrombosis (DVT) Clinical Presentation

What percentage of gravidas with pulmonary embolism had DVT?

70%.

p.1
Thromboembolic Disorders Overview

What can cause thromboembolic disorders?

Factors such as prolonged immobility, certain medical conditions, and genetic predispositions.

p.2
Virchow's Triad

What are the three components of Virchow's Triad?

1. Stasis 2. Local trauma to the vessel wall 3. Hypercoagulability.

p.8
Anticoagulation Regimens

What is the target anti-Xa level for therapeutic LMWH?

0.6-1.0 units/mL 4 hours after the last injection.

p.3
Risk Factors for VTE in Pregnancy

Which syndrome is included as a risk factor for VTE?

May-Thurner syndrome (iliac vein compression syndrome).

p.7
Diagnostic Methods for VTE

What does V/Q scan stand for?

Ventilation perfusion scan.

p.5
Inherited Thrombophilias

What is the VTE risk per pregnancy for a heterozygote of Factor V Leiden with no prior VTE history?

0.5-3.1%

p.11
Thromboprophylaxis Guidelines

What is the recommended duration for prophylactic LMWH according to RCOG for women undergoing cesarean delivery?

10 days.

p.8
Anticoagulation Regimens

What is the prophylactic dose of Enoxaparin?

40 mg SC once daily.

p.5
Inherited Thrombophilias

What is the cutoff value for free protein S antigen levels in the second trimester?

Less than 30%

p.8
Risk Factors for VTE in Pregnancy

What is the importance of VTE risk assessment during pregnancy?

It should be performed prepregnancy or early in pregnancy and repeated if complications develop.

p.11
Thromboprophylaxis Guidelines

What is the recommendation for thromboprophylaxis for all women undergoing cesarean delivery according to ACOG?

Pneumatic compression devices.

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

What are common symptoms of DVT?

Abrupt onset of edema and pain in the leg and thigh.

p.3
Risk Factors for VTE in Pregnancy

Which condition related to pregnancy can increase the risk of VTE?

Preeclampsia.

p.11
Thromboprophylaxis Guidelines

What additional risk factors are considered for thromboprophylaxis according to RCOG?

Age >35, parity >3, obesity, smoking, varicose veins, systemic infection, preeclampsia, preterm delivery, stillbirth, operative vaginal delivery, PPH, prolonged admission.

p.3
Risk Factors for VTE in Pregnancy

What is a common surgical procedure that can increase VTE risk?

Orthopedic procedures.

p.1
Thromboembolic Disorders Overview

What is a thrombus?

A blood clot that forms in a blood vessel.

p.5
Inherited Thrombophilias

What is the VTE risk for a double heterozygote of Factor V Leiden and prothrombin gene?

8.2%

p.9
Diagnostic Methods for VTE

What is a useful indicator for assessing pulmonary embolism?

Alveolar-arterial oxygen tension difference.

p.3
Risk Factors for VTE in Pregnancy

Name a medical condition that is a risk factor for VTE.

Diabetes mellitus.

p.7
Diagnostic Methods for VTE

What imaging method is recommended for evidence of DVT?

Compression ultrasound.

p.10
Management of Pulmonary Embolism

What surgical procedure may be performed for severe cases of pulmonary embolism?

Embolectomy.

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

Which side of the body is most affected by DVT?

The left side.

p.11
Thromboprophylaxis Guidelines

What factors should be considered for individualized therapy in thromboprophylaxis?

History of VTE, thrombophilia, and obesity.

p.5
Inherited Thrombophilias

Is testing for Protein C deficiency reliable during acute thrombosis?

No

p.5
Inherited Thrombophilias

What is the VTE risk for a homozygote of the prothrombin gene with no prior VTE history?

2-4%

p.7
Diagnostic Methods for VTE

What does the American Society of Hematology recommend for pulmonary evaluation?

Pulmonary V/Q scanning.

p.4
Inherited Thrombophilias

What is the effect of the Factor V Leiden mutation?

Factor V is resistant to degradation by protein C.

p.2
Pregnancy and Hypercoagulability

What state does pregnancy induce in terms of blood coagulation?

A state of hypercoagulability.

p.11
Thromboprophylaxis Guidelines

What is the recommendation for women with class III obesity and a history of VTE?

Individualized therapy.

p.8
Anticoagulation Regimens

What is the prophylactic dose of UFH in the first trimester?

5000-7000 units SC every 12 hours.

p.3
Risk Factors for VTE in Pregnancy

What condition related to blood can increase the risk of VTE?

Thrombophilia.

p.9
Management of Pulmonary Embolism

What percentage of maternal deaths is attributed to pulmonary embolism?

Approximately 10%.

p.6
Deep Vein Thrombosis (DVT) Clinical Presentation

What percentage of DVT cases involve the calf veins?

More than 80%.

p.4
Inherited Thrombophilias

What does Protein C deficiency inactivate?

Factor Va and Factor Villa.

p.5
Inherited Thrombophilias

Is testing for Factor V Leiden mutation reliable during pregnancy?

Yes

p.2
Pregnancy and Hypercoagulability

How does hypercoagulability contribute to thromboembolic disorders during pregnancy?

It increases the risk of blood clots forming.

p.7
Risk Factors for VTE in Pregnancy

What are the three YEARS criteria for evaluating suspected venous thromboembolism?

Clinical signs of DVT, hemoptysis, and PE as the most likely diagnosis.

p.1
Thromboembolic Disorders Overview

What are thromboembolic disorders?

Conditions that involve the formation of blood clots (thrombi) that can travel and obstruct blood vessels (embolism).

p.5
Inherited Thrombophilias

What is the VTE risk per pregnancy for a homozygote of Factor V Leiden with a family history?

2.2-14%

p.1
Thromboembolic Disorders Overview

What are common symptoms of thromboembolic disorders?

Symptoms can include swelling, pain, redness, and warmth in the affected area, or shortness of breath if a pulmonary embolism occurs.

p.8
Anticoagulation Regimens

What is the therapeutic dose of Enoxaparin?

1 mg/kg every 12 hours.

p.8
Anticoagulation Regimens

What is the adjusted dose of UFH for therapeutic range?

10,000 units or more SC every 12 hours, adjusted to target aPTT.

p.7
Diagnostic Methods for VTE

Which organizations recommend chest X-ray (CXR) for suspected pulmonary embolism?

The American Thoracic Society and Society of Thoracic Radiology.

p.3
Risk Factors for VTE in Pregnancy

What is a significant factor related to pregnancy that can lead to VTE?

Multifetal gestation.

p.7
Diagnostic Methods for VTE

What does MRI stand for?

Magnetic resonance imaging.

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