Deep vein thrombosis

Question 1

What is DVT?

Answer 1

blood clots developing in the venous circulation

Question 2

What are the risk factors for DVT

Answer 2

Immobility
recent surgery
pregnancy
long haul travel

Question 3

What are thrombophilias ?

Answer 3

conditions that predispose people into getting blood clots
Antiphospholipid syndrome
Factor V Leiden
Antithrombin deficiency
Protein C or S deficiency
Hyperhomocysteinaemia
Prothombin gene variant
Activated protein C resistance

Question 4

What do you give people at risk of venous thromboembolism

Answer 4

Prophylaxis- low molecular weight heparin such as enoxaparin
Anti-embolic compression stocking

Question 5

How does DVT present ?

Answer 5

unilateral
calf or leg swelling
oedema
colour changes to leg
tenderness to calf

Question 6

What is the wells score?

Answer 6

predicts risk of presenting with symptoms DVT

Question 7

How do we diagnose VTE?

Answer 7

D-dimer blood test - excludes VTE

Question 8

How do we diagnose DVT

Answer 8

• doppler ultrasound

Question 9

How do we manage DVT?

Answer 9

• anticoag- apixaban or rivaroxaban
  -catheter directed thrombolysis in symptomatic iliofemoral DVT

Question 10

How do we manage VTE long term?

Answer 10

• long term anticoag
• DOAC (oral and do not require monitoring e.g apixaban, rivaroxaban, edoxaban),
  -warfarin (vitamin K antagonist)
  -low molecular weight heparin (first line in pregnancy)
  for three months or longer if cause is unclear and 3-6 months in active cancer