Deep vein thrombosis Flashcards
1
Q
Clinical features
A
Localised tenderness along the distribution of the deep venous system in calf/ leg
Pitting oedema
Entire leg swollen
2
Q
Diagnosis
A
Calculate Wells score:
- 2 or more: DVT likely so do:
Proximal leg vein ultrasound within 4 hours
If cannot be done within 4 hours, give LMWH whilst waiting
If ultrasound negative do D-dimer - 1 or less: unlikely:
Do D-dimer
If positive then manage as if DVT likely
3
Q
Management
A
LMWH
After diagnosis:
- Warfarin aiming for INR 2-3 with 5 days LMWH coverage
- For 3 months (longer if unprovoked)
4
Q
Extra things to do in an unprovoked DVT or PE
A
If over 40 over CT CAP
Offer anyone: history, exam, bloods tests (FBC, U+Es, Ca2+, LFTs, urinalysis), CXR