Deep Vein Thrombosis

Question 1

Risk factors for DVT

Answer 1

> 60, smoking, cancer, dehydration, recent surgery, long distance travel, obesity, previous DVT, family history of VTE, thrombophilias, COCP, pregnancy

Question 2

Clinical features of DVT

Answer 2

Unilateral warm swollen calf or thigh, pain on palpation of deep veins, distension of superficial veins, pitting oedema

Question 3

What system is used to score for DVT

Answer 3

Well’s score

Question 4

What is included in Well’s scoring system

Answer 4

Active cancer, paralysis/paresis/limb immobiliation, bedridden for >3 days/major surgery within 12 weeks, localised enderness along DVT system, entire leg swollen, pitting oedema confined to symptomatic leg, prev DVT, collateral superficial veins.
If alternate diagnosis is just as likely then - 2 points

Question 5

Interpretation of Well’s score

Answer 5

If >2 likely, if <1 unlikely

Question 6

Diagnosis and investigations into DVT

Answer 6

D-dimer can exclude VTE, doppler US can give diagnosis, digital subtraction or CT/MR venogram is Gold standard but rare

Question 7

Treatment for DVT

Answer 7

DOAC, rivaroxiban for 3 months or more

Question 8

Treatment for massive DVT

Answer 8

Percutaneous mechanical thrombectomy

Question 9

Treatment for DVT when other treatments are contraindicated

Answer 9

IVC filter

Question 10

Complications of DVT

Answer 10

PE, venous insufficiency, recurrence, post-thrombotic syndrome