DVT and PE risk and diagnosis, thrombophilias, heparin, warfarin and DOAC dosing, monitoring and reversal agents, and HIT, ITP and TTP differentiation.
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- What are the three components of Virchow's triad?
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Venous stasis, endothelial injury, and hypercoagulability.- What clinical tool estimates the pretest probability of DVT or PE before ordering imaging?
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The Wells score.- Why is an elevated D-dimer alone not sufficient to diagnose venous thromboembolism?
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It is nonspecific and can be elevated in many conditions besides clotting, such as infection, pregnancy, or recent surgery.- What imaging test is the gold standard for diagnosing pulmonary embolism?
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CT pulmonary angiography (CTPA).- What imaging test is first-line for diagnosing DVT?
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Compression (duplex) ultrasound of the leg veins.- What clinical score estimates 30-day mortality risk once a patient is diagnosed with PE?
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The PESI (Pulmonary Embolism Severity Index) score.- What term describes recurrent or migratory venous thrombosis as a sign of occult malignancy?
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Trousseau syndrome.- What is the molecular defect in Factor V Leiden?
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A point mutation in Factor V that makes it resistant to inactivation by activated protein C.- What is the most common inherited thrombophilia?
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Factor V Leiden.- What is the effect of the prothrombin G20210A mutation?
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It raises prothrombin levels, increasing the risk of venous thrombosis.- What is the main function of protein S in coagulation?
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It acts as a cofactor for activated protein C in degrading factors Va and VIIIa.- Why does antithrombin III deficiency cause resistance to heparin therapy?
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Heparin works by potentiating antithrombin, so without adequate antithrombin its anticoagulant effect is blunted.- What two categories of findings are required to diagnose antiphospholipid syndrome?
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At least one clinical event (thrombosis or pregnancy morbidity) plus persistently positive antiphospholipid antibodies on two occasions 12 weeks apart.- Why is lupus anticoagulant a paradoxical name?
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It prolongs the aPTT in a test tube but is associated with an increased risk of clotting in the body.- How can ITP and TTP be distinguished when both present with thrombocytopenia?
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ITP shows isolated thrombocytopenia with a normal peripheral smear, while TTP adds microangiopathic hemolytic anemia with schistocytes and organ involvement.
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