Pharmacotherapy Test: Venous Thromboembolism (VTE)
A condition in which a blood clot forms most often in the deep veins of the leg is known as Venous thromboembolism (VTE. This causes pain for the patient and can be corrected through different ways. Below is a pharmacotherapy test on Venous Thromboembolism. Give it a shot and get to refresh your memory on all that we have learnt do far.
- 1.Incidence of VTE almost doubles each decade after age __.
- 2.Hypercoagulation disorders can be hereditary or acquired. Genetic may be deficiencies in anticoagulant proteins and acquired may be things such as pregnancy or _____.
- 3.VTE risk factors include: (Check all that apply.)
- A.
HRT meds
- B.
Acute medical illness
- C.
Immobility
- D.
Trauma
- E.
Pregnancy
- F.
Cancer
- 4.Warfarin inhibits the practical synthesis of biologically active forms of the vitamin K-dependent clotting factors: __, __, __, and __, as well as the regulatory factors proteins C and S. (Check all that apply.)
- A.
II
- B.
IV
- C.
V
- D.
VII
- E.
VIII
- F.
IX
- G.
X
- H.
XI
- I.
XII
- 5.The severity of pain correlates with the size of the thrombus.
- A.
True
- B.
False
- 6.Which lab test tests for a fibrin degradation product?
- A.
Doppler
- B.
ESR
- C.
D-dimer
- D.
WBC
- 7.A D-dimer can be used as a sole diagnostic test. A doppler is not necessary for diagnosis if the d-dimer is positive.
- A.
True
- B.
False
- 8.What is the gold standard used to diagnose DVT?
- A.
Ultrasonography
- B.
D-dimer
- C.
Venography
- 9.Venography is an expensive, invasive test that carries the risk of anaphylaxis and nephrotoxicity.
- A.
True
- B.
False
- 10.Which of the following is true regarding ultrasonography? Select all that apply.
- A.
Non-invasive
- B.
Commonly used for DVT diagnosis
- C.
Not commonly used for DVT diagnosis
- D.
Cannot detect small blood clots in distal veins
- E.
Can detect small blood clots in distal veins
- F.
Invasive
- 11.If a patient's assessment indicates DVT but a doppler does not show DVT, what is your next step?
- A.
Check for Homan's sign.
- B.
Check lab tests.
- C.
Do an invasive test (such as angiography or venography).
- D.
Nothing, if the doppler is negative there is no need to go further.
- 12.Heparin dissolves clots.
- A.
True
- B.
False
- 13.Which of the following is true regarding UFH? (Check all that apply.)
- A.
SQ onset of action 1-2 hours.
- B.
Good bioavailability.
- C.
IV if need rapid anticoagulation.
- D.
Intra- and interpatient variability to response.
- E.
T ½ is dose dependent.
- F.
Treatment dose related to patients weight.
- G.
Use actual body weight if not obese.
- H.
The therapeutic range is 1.5 to 2.5x the control aPTT value.
- I.
Check aPTT baseline, 4 hours after starting UFH infusion, and 4 hours after each dose change.
- J.
Pregnancy category X.
- K.
Pregnancy category B.
- 14.Long term use of UFH can cause? (Check all that apply.)
- A.
Alopecia
- B.
Hyperkalemia
- C.
Osteoporosis
- 15.If platelets decrease, 50% from baseline or fall below 240,000, then suspect HIT.
- A.
True
- B.
False
- 16.If you suspect that a patient is excessively anticoagulated, what would your next step be?
- A.
Monitor Hgb, Hct, and BP. Lower the dose of UFH. Administer IV protamine sulfate.
- B.
Monitor Hgb, Hct, and BP. Discontinue UFH. Administer IV protamine sulfate.
- C.
Monitor Hgb, Hct, and BP. Lower the dose of UFH. Administer IV Vitamin K and fresh frozen plasma.
- D.
Monitor Hgb, Hct, and BP. Discontinue UFH. Administer IV Vitamin K and fresh frozen plasma.
- 17.A woman has just given birth and is breastfeeding. The doctor wants to know if you can provide her UFH or LMWH? You tell the doctor. (Select all that apply.)
- A.
Not UFH, because it is not safe during breastfeeding.
- B.
Not UFH, because there is a risk of maternal hemorrhage.
- C.
LMWH is a better alternative because it does not cross the placenta.
- D.
These drugs cross the placenta.
- 18.The doctor decides to give the woman an LMWH. What should we monitor?
- A.
APTT
- B.
Anti-factor Xa
- C.
Factor IIa
- D.
INR
- 19.LMWH has a longer half-life than UFH.
- A.
True
- B.
False
- 20.When would you give BID dosing when using an LMWH? Select all that apply.
- A.
Obesity
- B.
Pregnancy
- C.
< 50kg
- D.
Cancer
- E.
Renal failure
- 21.When would you use anti-Xa analysis when using LMWH? Select all that apply.
- A.
In every patient
- B.
Renal impairment
- C.
Renal impairment
- D.
Weight < 50 kg
- E.
Morbid obesity (BMI > 50 or > 150kg)
- F.
Pregnancy
- G.
Adults
- H.
Children
- 22.If monitoring anti-Xa activity when a patient is on an LMWH, get sample __ hours after SC dose was given (peak concentration).
- 23.Prior to LMWH therapy, we should monitor? Select all that apply.
- A.
Serum creatinine
- B.
Baseline PT/INR
- C.
APTT
- D.
CBC with platelet
- 24.You can use an LMWH if a patient has a history of HIT.
- A.
True
- B.
False
- 25.Guidelines recommend UFH if CrCl < 30 mL/min.
- A.
True
- B.
False
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