Deep Vein Thrombosis (DVT) Flashcards

1
Q

What is DVT

A

Thrombus (clot) formed in the deep venous circulation

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2
Q

What are the 3 factors DVT may arise from

A

Hypercoagulable state
Endothelial injury
Circulators stasis

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3
Q

What are Hypercoagulable states

A

Malignancy
Pregnancy
Oestrogen therapy
IBD (inflammatory bowl disease)
Sepsis
Thrombophilia

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4
Q

What are the endothelial injuries

A

Venous disorder
Venous valvular damage
Trauma or surgery
Indwelling catheters

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5
Q

What are the Circulatory stasis

A

Left ventricular dysfunction
Immobility or paralysis
Venous insufficiency/varicose veins
Venous obstruction - tumour, obesity, pregnancy

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6
Q

Where do DVTs form

A

Venous valve pockets
Other sites of assumed stasis

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7
Q

What is Distal vein thrombosis

A

DVT of calves

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8
Q

What is proximal vein thrombosis

A

DVT of popliteal or femoral vein (more likely to embolism)

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9
Q

What are the symptoms for DVT

A

Calf - warmth, tenderness, swelling, erythema
Mild fever

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10
Q

What are signs of DVT

A

Pitting oedema

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11
Q

What are the investigations for DVT

A

D-dimer - rule out test (based on wells score)
US Doppler leg scan - diagnostic, indicates raised D-dimers or high levels of Wells score

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12
Q

What is first line testing for DVT

A

US doppler leg scan

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13
Q

What is the acute management of DVT

A

Anticoagulation - apixaban or rivaroxaban (first line)

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14
Q

What treatment is used if apixaban and rivaroxaban is not suitable

A

LMWH followed by dabigatran or
Edoxaban or LMWH followed by vitamin K antagonist

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15
Q

What is secondary treatment for DVT

A

options for long term anticoagulation are:
Warfarin
DOAC
LMWH

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16
Q

What treatment should be continued for at least 3 month

A

Provoked DVT with reversible factors
Provoked DVT with irreversible factors or unprovoked (potentially life long)