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Systems: Cardiovascualar AB > Deep Vein Thrombosis + PTE: Presentation, Investigation and Therapy > Flashcards

Deep Vein Thrombosis + PTE: Presentation, Investigation and Therapy Flashcards

1
Q

Thrombus

A

Clot arising in the wrong place

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2
Q

Thromboembolism

A

Movement of clot along a vessel

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3
Q

What are the 3 components of Virchow’s Triad?

A
  • Stasis
  • Hypercoagulability
  • Vessel damage
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4
Q

What can causes stasis of blood?

A
  • Bed rest

- Travel

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5
Q

What can cause hypercoagulability of blood?

A
  • Pregnancy

- Trauma

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6
Q

What can cause vessel damage?

A

Athersclerosis

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7
Q

What is the prevalence of DVT?

A

1 in 1000

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8
Q

What is the prevalence of PE?

A

1 in 3000-5000

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9
Q

What is the case fatality rate?

A

1 to 5%

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10
Q

What percentage of autopsies are PEs found in?

A

20%

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11
Q

How is a venous thrombus described?

A

Red thrombus

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12
Q

What makes a venous thrombus red?

A

Fibrin and red cells

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13
Q

What does a venous thrombus result in?

A

Back pressure

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14
Q

What are venous thrombi principally due to?

A

Stasis and hypercoagulability

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15
Q

How is an arterial thrombus described?

A

White clot

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16
Q

What makes an arterial thrombus white?

A

Platelets and fibrin

17
Q

What does an arterial thrombus result in?

A

Ischaemia and infarction

18
Q

What are arterial thrombi principally due to?

A

Secondary to atherosclerosis

19
Q

Give examples of venous thromboembolisms (4)

A
  • Limb deep vein thrombosis
  • Pulmonary embolism
  • Visceral venous thrombosis
  • Intracranial venous thrombosis
20
Q

What are the signs and symptoms of DVT?

A
  • Unilateral limb swelling
  • Persisting discomfort
  • Calf tenderness
  • Warmth
  • Erythema
  • MAY BE CLINCIALLY SILENT
21
Q

How is DVT diagnosed?

A
  • Clinical assessment and pretest probability score (Wells score)
  • Blood test: D-dimer if low pre-test probability score
  • Imaging: compression ultrasound if positive D-dimer or high pre-test probability score
22
Q

What is the potential long term consequence of DVT?

A

Post thrombotic syndrome

23
Q

What is the incidence rate of post thrombotic syndrome?

A

20-60% within 2 years of DVT

24
Q

How does post thrombotic syndrome present?

A
  • Swelling
  • Discomfort
  • Pigmentation
  • Ulceration in severe form
25
Q

What are the signs and symptoms of PE?

A
  • Pleuritic chest pain
  • Dyspnoea
  • Haemoptysis
  • Tachycardia
  • Pleural rub on auscultation
26
Q

What are the signs and symptoms of a massive PE?

A
  • Severe sudden onset dyspnoea
  • Collapse
  • Cyanosis
  • Tachycardia
  • Hypotensive
  • Raise JVP
27
Q

What can a massive PE result in?

A

Sudden death

28
Q

How is PE diagnosed?

A
  • Clinical assessment and pretest probability score (Wells score or Geneva score)
  • Blood test: D-dimer if low pretest probability score
  • Imaging: if D-dimer positive or high pretest probability score
29
Q

What imaging would be carried out in the investigation of PE?

A
  • Isotope ventilation/perfusion scan

- CT pulmonary angiogram

30
Q

What are the potential long term consequences of PE?

A
  • Most recover fully

- Pulmonary hypertension

31
Q

What are the aims of treatment of VTE?

A
  • Prevent clot extension
  • Prevent clot embolization
  • Prevent recurrent clot
32
Q

What are the treatement options for VTE?

A
  • Anticoagulation is the main treatment

- Thrombolysis reserved for massive PE

33
Q

What parenteral options are there for anticoagulation?

A
  • Unfractioned heparin

- Low molecular weight heparin

34
Q

What are the enteral options for anticoagulation?

A
  • Warfarin

- Direct Oral Anticoagulants

35
Q

How can VTE be prevented in the hospital?

A
  • Early mobilisation
  • Anti-embolism stockings
  • Other mechanical methods of thromboprophylaxis
  • Pharmacological thromboprophylaxis

Systems: Cardiovascualar AB (42 decks)

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