Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year Three - Haematology > Deep Vein Thrombosis > Flashcards

Deep Vein Thrombosis Flashcards

1
Q

What is deep vein thrombosis (DVT)?

A

It is defined as a condition in which there is formation of a blood clot in the venous circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In which region of the body, does deep vein thrombosis tend to develop?

A

Deep veins of the lower limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What twelve risk factors are associated with deep vein thrombosis?

A

Older Age

Family History

Obesity

Pregnancy

Immobility

Hospitalisation

Malignancy

Thrombophilia

Antiphospholipid Syndrome

Polycythaemia

Drug Administration

Central Venous Catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which six drugs are associated with deep vein thrombosis?

A

Combined Oral Contraceptive Pill

Hormone Replacement Therapy

Tamoxifen

Raloxifene

Antipsychotics

Anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the four clinical features of deep vein thrombosis?

A

Calf Tenderness

Calf Swelling > 3cm

Dilated Superficial Veins

Lower Limb Pitting Oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do we measure calf swelling, in suspected cases of deep vein thrombosis?

A

We measure the circumference of the calf 10cm below the tibial tuberosity and compare this measurement with the asymptomatic calf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What three investigations are used to diagnose deep vein thrombosis?

A

Wells Score

D-Dimer Blood Test

Proximal Leg Vein Ultrasound Scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is the ‘Wells Score’ used to investigate pulmonary embolism?

A

It is used to predict the risk of deep vein thrombosis in suspected cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the ten criteria of the ‘Wells Score’?

A

Active Cancer = Ongoing Treatment, < 6 Months, Palliative (1 Point)

Paralysis, Paresis, Plaster Immobilisation Of Lower Extremities (1 Point)

Bedrest > 3 Days, Major Surgery Within 12 Weeks Requiring General/Regional Anaesthesia (1 Point)

Localised Tenderness Of Deep Venous System (1 Point)

Entire Swollen Leg (1 Point)

Calf Swelling > 3cm Compared To Asymptomatic Side (1 Point)

Pitting Oedema Confined To Symptomatic Leg (1 Point)

Collateral Superficial Veins, Non-Varicose (1 Point)

Previously Document Deep Vein Thrombosis (1 Point)

An Alternative Diagnosis Is At Least As Likely As Deep Vein Thrombosis (-2 Points)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does a ‘Wells Score’ > 2 indicate?

A

It indicates that a diagnosis of deep vein thrombosis is likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should be conducted following a ‘Wells Score’ > 2?

A

A proximal leg vein ultrasound scan should be conducted within 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should be conducted when the proximal leg vein ultrasound scan is positive for deep vein thrombosis - Wells Score > 2?

A

A deep vein thrombosis diagnosis is obtained and anticoagulant treatment should be commenced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should be conducted when the proximal leg vein ultrasound scan is negative for deep vein thrombosis - Wells Score > 2?

A

D-Dimer blood tests should be conducted

When these blood tests are negative, an alternative diagnosis should be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be conducted when the proximal leg vein ultrasound scan cannot be conducted within 4 hours - Wells score > 2?

A

The D-Dimer blood test should be conducted and interim therapeutic direct oral anticoagulation (DOAC) should be administered, whilst waiting

This ultrasound scan should be performed within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should be conducted when the proximal leg vein ultrasound scan is negative and then the D-Dimer blood tests are positive- Wells score > 2?

A

It is recommended that the interim therapeutic anticoagulation is stopped, and a repeat ultrasound scan is conducted 6 – 8 days later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does a ‘Wells Score’ < 1 indicate?

A

It indicates that a diagnosis of deep vein thrombosis is unlikely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should be conducted when a ‘Wells Score’ < 1?

A

The D-Dimer blood test can be conducted within 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should be conducted when the D-Dimer blood test results are negative - Wells Score < 1?

A

An alternative diagnosis should be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should be conducted when the D-Dimer blood test results are positive - Wells Score < 1?

A

A proximal leg vein ultrasound scan should be conducted within 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be conducted when the proximal leg vein ultrasound scan cannot be conducted within 4 hours - Wells Score < 1?

A

An interim therapeutic anticoagulation should be administered whilst waiting

This ultrasound scan should be performed within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When are D-Dimer blood tests used to investigate deep vein thrombosis?

A

They are used to exclude a diagnosis of deep vein thrombosis when there is low clinical suspicion

However, due to the fact that it can be elevated in other conditions, it cannot provide a definitive diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What D-Dimer blood test result indicates deep vein thrombosis?

A

> 0.5 ug/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the feature of deep vein thrombosis on proximal leg vein ultrasound scans?

A

There is an absence of blood flow to the affected limb

24
Q

What are the three pharmacological management options of deep vein thrombosis?

A

Oral Anticoagulants (DOACs)

Low Molecular Weight Heparin (LMWH)

Vitamin K Antagonists (VKAS)

25
Q

When are direct oral anticoagulants (DOACs) used to manage deep vein thrombosis?

A

They are the first line management option of deep vein thrombosis, which should be offered once a diagnosis is suspected and continued when the diagnosis is confirmed

26
Q

What are the two first line direct oral anticoagulants used to manage deep vein thrombosis?

A

Apixaban

Rivaroxaban

27
Q

What are the two second line direct oral anticoagulants used to manage deep vein thrombosis? When are they administered?

A

Dabigatran

Edoxaban

They are administered following low molecular weight heparin administration

28
Q

When is low molecular weight heparin (LMWH) used to manage deep vein thrombosis?

A

It is the second line management option of deep vein thrombosis

29
Q

Name three low molecular weight heparins used to manage deep vein thrombosis

A

Dalteparin

Enoxaparin

Tinzaparin

30
Q

Describe the course of low molecular weight heparin used to manage deep vein thrombosis

A

They should be administered for a 5 – 10 days, followed by direct oral anticoagulants OR vitamin K antagonists for a period of 3 - 6 months

31
Q

When are vitamin K antagonists (VKAs) used to manage deep vein thrombosis?

A

They are the second line management option of deep vein thrombosis – which are administered following low molecular weight heparin administration

32
Q

Name a vitamin K antagonist used to manage deep vein thrombosis

A

Warfarin

33
Q

What is the pharmacological management option of deep vein thrombosis in active cancer patients?

A

Direct oral anticoagulant - unless this is contraindicated

34
Q

What are the three pharmacological management options of deep vein thrombosis in severe renal impairment eGFR < 15?

A

Low Molecular Weight Heparin

Unfractioned Heparin

Low Molecular Weight Heparin Followed By Vitamin K Antagonist

35
Q

What is the pharmacological management option of deep vein thrombosis in antiphospholipid syndrome patients?

A

Low Molecular Weight Heparin Followed By Vitamin K Antagonist

36
Q

What is provoked deep vein thrombosis?

A

It is deep vein thrombosis secondary to an obvious precipitating event

37
Q

How long is anticoagulant course treatment in provoked deep vein thrombosis?

A

3 Months

38
Q

In which circumstance is provoked deep vein thrombosis treated with an anticoagulation treatment course of 6 months?

A

Active cancer

39
Q

What is an unprovoked deep vein thrombosis?

A

It is deep vein thrombosis not due to an obvious precipitating event

40
Q

How long is anticoagulant course treatment in unprovoked deep vein thrombosis?

A

6 months

41
Q

What is a high risk factor of deep vein thrombosis in pregnant patient?

A

Previous history of deep vein thrombosis

42
Q

What prophylactic management should be administered in pregnant patients with high risk factors for deep vein thrombosis?

A

Low molecular weight heparin should be administered throughout the antenatal period, alongside expert input

43
Q

What are the four intermediate risk factors of deep vein thrombosis in pregnant patients?

A
  • Recent Hospitalisation
  • Recent Surgery
  • Co-Morbidities
  • High Risk Thrombophilia
44
Q

What prophylactic management should be administered in pregnant patients with intermediate risk factors for deep vein thrombosis?

A

Low molecular weight heparin should be considered throughout the antenatal period, alongside expert input

45
Q

What are the eleven low risk factors of deep vein thrombosis in pregnant patients?

A
  • Age > 35 Years Old
  • Deep Vein Thrombosis Family History
  • Parity > 3
  • Multiple Pregnancy
  • In Vitro Fertilisation Pregnancy
  • Pre-Eclampsia
  • Immobility
  • Low Risk Thrombophilia
  • Gross Varicose Veins
  • Body Mass Index > 30
  • Smoker
46
Q

What prophylactic management should be administered when individuals have three low risk factors of deep vein thrombosis?

A

Low molecular weight heparin should be administered from 28 weeks’ gestation and continued until 6 weeks postnatal

47
Q

What prophylactic management should be administered when individuals have more than four low risk factors of deep vein thrombosis?

A

Immediate management with low molecular weight heparin should be administered until 6 weeks postnatal

48
Q

Which two pharmacological management options of deep vein thrombosis are contraindicated in pregnancy?

A

Direct Oral Anticoagulants

Warfarin

49
Q

When is prophylactic management of deep vein thrombosis administered in hospitalised patients?

A

When the deep vein thrombosis risk is deemed greater than the bleeding risk – determined on an individual case basis

50
Q

What is the prophylactic management option of deep vein thrombosis in medical hospitalised patients?

A

Pharmacological anticoagulation, such as fondaparinux, low molecular weight heparin or unfractioned heparin should be administered

51
Q

What is the prophylactic management option of deep vein thrombosis in surgical hospitalised patients?

A

The anti-embolism stockings are the first line management option

However, when deemed at high risk pharmacological management should be additionally administered

The post-surgical pharmacological prophylaxis administered is dependent upon the surgical procedure

52
Q

What is the complication assoicated with deep vein thrombosis?

A

Post-Thrombotic Syndrome

53
Q

What is post-thrombotic syndrome?

A

It is defined as a condition in which there is venous outflow obstruction and venous insufficiency, resulting in chronic venous hypertension

54
Q

When does post-thrombotic syndrome develop after deep vein thrombosis?

A

> Years

55
Q

What are the five clinical features of post-thrombotic syndrome?

A

Calf Pain

Calf Swelling

Varicose Veins

Varicose Ulceration

Pruritus

56
Q

What are the two management options of post-thrombotic syndrome?

A

Limb Elevation

Wear Compression Stockings

Year Three - Haematology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions