Deep Vein Thrombosis and Pulmonary Embolism Flashcards

1
Q

What are the three aspects of Virchow’s triad?

A

Stasis
Vessel damage
Hypercoagulability

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2
Q

Give examples of stasis

A

Bed rest, travel

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3
Q

Give examples of vessel damage

A

Atherosclerosis

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4
Q

Give examples of hypercoagulability

A

Pregnancy, trauma

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5
Q

What are venous thrombi also known as and what are they composed of?

A

Red thrombus

Fibrin and red cells

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6
Q

What principally cause venous thrombus?

A

Stasis and hypercoagulability

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7
Q

What result from venous thrombus?

A

Back pressure

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8
Q

What are arterial thrombus also known as and what are they composed of?

A

White clot

Fibrin and platelets

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9
Q

What do arterial thrombi result in?

A

Ischaemia and infarction

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10
Q

What do arterial thrombi tend to arise secondary to?

A

Atherosclerosis

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11
Q

Give examples of VTEs?

A

Limb deep vein thrombosis
PE
Visceral venous thrombosis
Intracranial venous thrombosis

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12
Q

What are the signs and symptoms of DVT?

A
Unilateral limb swelling
Persisting discomfort
Calf tenderness
Warmth
Erythema
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13
Q

How do you diagnose DVT?

A

Clinical assessment & pre-test probability score (Wells score)
D-dimer if low pre-test probability score
Imaging (compression USS) if +ve D-dimer or high test test probability

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14
Q

What are the long-term consequences of DVT?

A

Post-thrombotic syndrome (swelling, discomfort, pigmentation, ulceration if severe0

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15
Q

What are the signs and symptoms of PE?

A

Pleuritic chest pain, SoB, haemoptysis, tachycardia, pleural rub

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16
Q

What are the signs and symptoms of a massive PE?

A

Severe dyspnoea of sudden onset, collapse, cyanosis, tachycardia, low BP, raised JVP

Can cause sudden death

17
Q

How do you diagnose PE?

A

Clinical assessment and Wells/Geneva score
D-dimer if low score
Isotope VQ scan/CTPA if D-dimer +ve or high pretest score

18
Q

What is a potential consequence of PE?

A

Pulmonary hypertension

19
Q

What are the treatment options for PE?

A

Anticoagulation - UF heparin/LMWH or DOACs/warfarin

Thrombolysis reserved for massive PE

20
Q

How do we prevent VTE in hospital?

A

Early mobilisation
Anti-embolism stockings
Pharmacological thromboprophylaxis