Pulmonary Embolism and Anticoagulation Review (Video Notes)

A comprehensive set of flashcards covering LMWH vs unfractionated heparin, PE symptoms and diagnosis, warfarin therapy, thrombolytics, Virchow's triad, VTE prevention, monitoring, IVC filters, and practical prophylaxis options.

Why is LMWH often preferred over unfractionated heparin?

Predictable effect, fewer bleeding risks, no routine lab monitoring.

Most common PE symptom?

Dyspnea.

What is the INR therapeutic range for warfarin?

2–3.

Do anticoagulants dissolve clots?

No — only thrombolytics dissolve clots.

Give two examples of Factor Xa inhibitors.

Rivaroxaban (Xarelto); Apixaban (Eliquis).

Which three factors make up Virchow’s triad?

Venous stasis, hypercoagulability, endothelial injury.

First-line VTE prevention for low-risk patients?

Early ambulation.

What is the antidote for warfarin?

Vitamin K.

Where do you look for earliest signs of bleeding with thrombolytics?

Mucous membranes (gums, nose, eyes, ears).

How long is the 'initial' anticoagulation phase?

First 7 days.

Name one retroperitoneal bleed sign linked to IVC filters.

Gray Turner’s sign (flank bruising).

CTA with contrast is gold standard for diagnosing what?

Pulmonary embolism.

What blood test is elevated in PE?

D-dimer.

What four labs should be monitored for all anticoagulants?

Platelets, hemoglobin, hematocrit, kidney function.

Why monitor kidney function with anticoagulants?

Many are renally cleared; poor function increases bleeding risk.

Example of a thrombolytic drug?

tPA or urokinase.

Why isn’t warfarin used for immediate clot prevention?

Takes 5–10 days to work.

Standard UFH prophylaxis dose?

5,000 units subQ every 8 hours.

Most PEs originate where?

Deep veins of the legs (femoral, iliac).

Does diet matter with warfarin?

Yes — keep vitamin K intake consistent.

What’s the biggest risk of thrombolytic therapy?

Bleeding.

When are IVC filters indicated?

When anticoagulants are contraindicated or ineffective.

Factor Xa inhibitors — INR monitoring needed?

No.

PE signs: dyspnea, hypoxemia, tachypnea, cough, chest pain — which one is most common?

Dyspnea.

In anticoagulation therapy, which phase can last up to 6 months?

Extended phase.

How do anticoagulants prevent complications in PE?

Stop clot growth and prevent new clots.

Name one lifestyle factor that makes anticoagulants unsafe.

Contact sports.

HIT stands for what, and why is it serious?

Heparin-induced thrombocytopenia; can cause severe bleeding and clotting.

Give one moderate-risk VTE prophylaxis option.

Lovenox 40 mg daily or UFH 5,000 units q8h.

Warfarin blocks which vitamin K–dependent clotting factors?

II, VII, IX, X, and proteins C & S.