8.Evaluation of thrombosis Flashcards
Homan’s sign
calf discomfort on foot dorsiflexion (DVT)
what is considered chronic thromboembolic disease?
recurrent PE events presenting with signs of pulmonary hypertension and right-sided HF
How is Wells criteria for DVT scored?
score ≤ 0 –> low probability
score 1-2 –> moderate probability
score ≥3 –> high probability
How is Wells criteria for PE scored?
score ≤ 2 –> low probability
score 2.5-6 –> moderate
score ≥ 6 –> high
High negative predictive value for low-risk DVT
D-dimer
cut off value 500 ng/mL
high sensitivity, poor specificity
why is a Chest X-ray used in PE?
For DD of acute chest pain
PE pattern seen on V/Q scan
multiple areas of perfusion defects, not matched with defects in ventilation (ventilated but not perfused)
*used when CT is not available or CI
Most widely used imaging modality for the diagnosis of PE
CT angiography
>90% sensitivity
>95% specificity
Most widely used imaging modality for the diagnosis of PE
CT angiography
>90% sensitivity
>95% specificity
12% of patients with idiopathic DVT/PE will have?
malignancy
12% of patients with idiopathic DVT/PE will have?
malignancy
treatment for superficial venous thrombosis
anticoagulant for 4 weeks (high risk for DVT)
-elevate extremity—> warm compresses, NSAID’s
treatment for lower extremity DVT
proximal–> anticoagulante
distal–> anticoagulant if severe symptoms
*upper extremity and PE (anticoagulant)
complications of PE
- Chronic thromboembolic pulmonary hypertension (CTEPH)
- Right-sided HF (secondary to pulmonary HTN)
- persistant Pleural effusion
- post-thrombotic syndrome - chronic venous insufficiency
- Recurrent DVT
