Deep Vein Thrombosis Flashcards by Maryam Abdulhameed

What is deep vein thrombosis (DVT)?

The formation of a thrombus in the deep venous system, commonly in the lower limbs.

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What is another name for DVT?

Phlebothrombosis.

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What percentage of DVT cases occur in the lower limb veins?

0.9

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What is the most serious complication of DVT?

Pulmonary embolism (PE).

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What are the components of Virchow’s triad?

Venous stasis, endothelial injury, and hypercoagulability.

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What are common risk factors for DVT?

Immobility, surgery, malignancy, pregnancy, oral contraceptives, and inherited thrombophilia.

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What is the Wells score used for?

Assessing the probability of DVT.

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What Wells score indicates a likely DVT?

≥2 points.

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What is the first-line imaging test for suspected DVT?

Compression ultrasound with Doppler.

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What is the preferred anticoagulant for initial DVT treatment?

Low molecular weight heparin (LMWH).

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What is the gold standard test for DVT diagnosis?

Contrast venography.

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What is the role of the D-dimer test in DVT?

Used to rule out DVT in low-risk patients.

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What are the main symptoms of DVT?

Leg swelling, pain, warmth, redness, and tenderness.

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What is the most common inherited thrombophilia associated with DVT?

Factor V Leiden mutation.

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What condition results from chronic venous obstruction after DVT?

Post-thrombotic syndrome.

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What medication is used for long-term anticoagulation in DVT?

Warfarin or direct oral anticoagulants (DOACs).

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What is the target INR for warfarin therapy in DVT?

2.0-3.0.

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What is the antidote for heparin overdose?

Protamine sulfate.

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What is the recommended duration of anticoagulation for a first-time DVT?

At least 3-6 months.

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What is the preferred treatment for recurrent DVT?

Lifelong anticoagulation therapy.

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How can DVT be prevented in hospitalized patients?

Early ambulation, compression stockings, and prophylactic anticoagulation.

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What is the role of an inferior vena cava (IVC) filter in DVT?

Prevents pulmonary embolism in patients who cannot receive anticoagulation.

What are the common surgical treatments for DVT?

Thrombectomy, catheter-directed thrombolysis, and IVC filter placement.

What lifestyle changes can help prevent DVT?

Regular exercise, hydration, avoiding prolonged immobility, and weight management.

What is the recommended first-line treatment for DVT in pregnancy?

LMWH (Low Molecular Weight Heparin).

What is phlegmasia cerulea dolens?

A severe form of DVT with limb ischemia and cyanosis.

What is the role of compression stockings in DVT management?

Reduces swelling and prevents post-thrombotic syndrome.

What is the main cause of secondary hypercoagulability?

Malignancy (Trousseau’s syndrome).

What is the most sensitive imaging test for pulmonary embolism?

CT pulmonary angiography.

What is the classic ECG finding in pulmonary embolism?

S1Q3T3 pattern (deep S in lead I, Q wave in lead III, inverted T wave in lead III).

What is the best initial test for suspected pulmonary embolism?

D-dimer test in low-risk patients, CT pulmonary angiography in high-risk patients.

What is the preferred thrombolytic agent for massive PE?

Alteplase (tPA).

What are contraindications for thrombolysis in DVT or PE?

Recent surgery, active bleeding, history of hemorrhagic stroke.

What is the role of aspirin in DVT prevention?

Used in high-risk patients to reduce clot formation.

What anticoagulant can be used without INR monitoring?

Direct oral anticoagulants (DOACs) like rivaroxaban and apixaban.

What is the primary mechanism of action of heparin?

Inhibits thrombin and factor Xa via antithrombin.

What is the function of protein C and protein S in coagulation?

They inhibit clotting factors V and VIII to prevent excessive clot formation.

What is the most common location of DVT in the lower extremities?

The deep veins of the calf (popliteal, femoral, and iliac veins).

How does pregnancy increase the risk of DVT?

Increased clotting factors, venous stasis, and compression of the IVC by the uterus.

What are the long-term complications of untreated DVT?

Post-thrombotic syndrome, chronic venous insufficiency, and recurrent DVT.

What is the preferred anticoagulant in patients with cancer-associated DVT?

Low molecular weight heparin (LMWH).

What is the effect of obesity on DVT risk?

Increases risk due to decreased venous return and higher clotting factor levels.

What is the most common presenting sign of pulmonary embolism?

Dyspnea (shortness of breath).

What is the classic triad of symptoms for pulmonary embolism?

Dyspnea, chest pain, and hemoptysis.

How does nephrotic syndrome increase the risk of DVT?

Loss of anticoagulant proteins (antithrombin III, protein C, and protein S) in urine.

What is the mechanism of action of warfarin?

Inhibits vitamin K-dependent clotting factors (II, VII, IX, X).

What is the effect of estrogen therapy on DVT risk?

Increases risk by promoting a hypercoagulable state.

What is the role of exercise in DVT prevention?

Improves venous circulation and reduces clot formation.

What is the typical onset of DVT symptoms?

Gradual onset of leg swelling, pain, and tenderness.

Why is prolonged immobility a risk factor for DVT?

Decreases venous return and promotes clot formation.

What is the best preventive measure for DVT in long-haul flights?

Frequent leg exercises, hydration, and compression stockings.

What is the primary concern in patients with a history of unprovoked DVT?

Higher risk of recurrence and need for long-term anticoagulation.

What is the treatment for heparin-induced thrombocytopenia (HIT)?

Stop heparin and start a direct thrombin inhibitor (e.g., argatroban).

What is the significance of a negative D-dimer test in suspected DVT?

Helps rule out DVT in low-risk patients.