1. Step 9
1.1. Review session 2
1.2. mechanism flow chart
1.3. 20 minutes
2. Step 10
2.1. Management (for the individual)
2.1.1. goals of the treatment
2.1.1.1. prevent the death
2.1.1.2. prevent recrrunce
2.1.1.3. normal life quilty
2.1.1.4. give the most effective with less side effect treatment
2.1.1.5. staplize the patient
2.1.1.6. follow up
2.1.1.7. the need of administrition ?
2.1.1.8. BP
2.1.1.9. return normal iron levels
2.1.2. drugs avoided
2.1.2.1. warfarin
2.1.2.2. fundaheparin
2.1.3. anti-coagulant
2.1.3.1. heparin
2.1.3.1.1. low molecular
2.1.3.1.2. unfractinated
2.1.3.1.3. poteniate the activity of antithrommbin 3 + inhibts activated factor 9.10.11.12
2.1.3.1.4. SQ or IV
2.1.3.1.5. start with low moluclar
2.1.3.1.6. before miner anesthesia
2.1.3.1.7. renal insuffincy
2.1.3.1.8. HIT
2.1.3.2. contraindicated
2.1.3.2.1. inferior vena cava filter
2.1.3.3. initiate the therapy in emergency cases
2.1.4. thrombolytic
2.1.4.1. last choice
2.1.4.2. with massive PE
2.1.4.3. submassive PE with right venticulat dusfunction
2.1.4.4. cause sudden haemorrage
2.1.4.5. !% mortality in pregnant ladies and 6% fetal loss
2.1.4.6. risk of intercranial bleeding
2.1.4.7. side effect rash and haemorrage
2.1.5. embolectomy
2.1.5.1. for patient with contraindicated for the drugs
2.1.5.2. last last thing to do
2.1.5.3. high mortality 40%
2.1.5.4. catheter embolectomy
2.1.5.5. for very massive embolus and submassive coulde be consider
2.1.6. ferrus sulphate for iron def
2.1.7. genetics detection of the cause of DVT
2.1.8. educate the patient
2.1.8.1. warfarin teratogenicty
2.2. Prevention (for the population)
2.2.1. primary
2.2.1.1. good health
2.2.1.1.1. healthy food
2.2.1.1.2. obesty control
2.2.1.1.3. smoking
2.2.1.2. immoblization
2.2.1.3. patient with cast
2.2.1.4. heparin prophylaxis(inpatient)
2.2.1.4.1. 0.2-0.6 mg
2.2.2. secondray
2.2.2.1. for oedema
2.2.2.1.1. compression not for one with active DVT
2.2.3. teritry
2.2.3.1. keep the INR at 2
2.2.3.2. check the liver