Deep Vein Thrombosis & Pulmonary Thromboembolism

Question 1

What is a thrombus?

Answer 1

Blood clotting in the wrong place- intravascular coagulation

Question 2

RECAP- what are the main components of a thrombus?

Answer 2

Fibrin
Platelets
RBCW

Question 3

What is an arterial thrombosis usually caused by?

Answer 3

Rupture of an atheromatous plaque

Question 4

What is an venous thrombosis usually caused by?

Answer 4

Combo of Virchow’s Triad- esp. stasis and hypercoagulability

Question 5

What can arterial thrombosis result in?

Answer 5

Ischaemia and infarction

Question 6

What can venous thrombosis result in?

Answer 6

Back pressure

Question 7

What causes stasis of the blood?

Answer 7

Immobility
Long haul flights

Question 8

What causes the hypercoagulability of blood?

Answer 8

Pregnancy
Cancer
Sepsis

Question 9

What can cause vessel damage and endothelial dysfunction?

Answer 9

Hypertension
Smoking
High cholesterol

Question 10

What can cause vessel damage and endothelial damage?

Answer 10

Indwelling venous catheters
Trauma
Surgery

Question 11

Which vein group tend to have valves?

Answer 11

Deep veins

Question 12

What could a DVT become?

Answer 12

An embolus

Question 13

RECAP- define embolism

Answer 13

Intravascular material that migrates from its original location to a distal vessel

Question 14

RECAP- give some examples of material which can be an embolism.

Answer 14

Blood clot, fat, air, tumour

Question 15

RECAP- what is thromboembolism?

Answer 15

Movement of blood clot along a vessel

Question 16

What are some of the symptoms of a DVT?

Answer 16

Unilateral limb swelling
Persisting discomfort
Calf tenderness
Warmth
Redness- erythema
Prominent collateral veins
Unilateral pitting oedema

Question 17

Which pretest probability score is used for DVT?

Answer 17

Wells score

Question 18

Which imaging can be used to diagnose DVT?

Answer 18

Compression Ultrasound

Question 19

What is a D-dimer?

Answer 19

Breakdown product of cross-linked fibrin

Question 20

When is d-dimer produced?

Answer 20

During fibrinolysis

Question 21

How do you test for D-dimer?

Answer 21

Using a blood test

Question 22

What are some of the symptoms of PE?

Answer 22

Pleuritic chest pain
Dyspnoea
Haemoptysis
Tachycardia
Pleural rub on auscultation - usually due to pulmonary infarction

Question 23

What are some of the symptoms of a massive PE?

Answer 23

Severe dyspnoea of sudden onset
Collapse
Blue lips and tongue - cyanosis
Tachycardia
Low blood pressure
Raised jugular venous pressure

Question 24

Name the three steps of diagnosing PE.

Answer 24

1. Wells test
2. Blood for d-dimer
3. Imaging- Isotope ventilation/perfusion scan or CT pulmonary angiogram

Question 25

Name the three steps of diagnosing PE.

Answer 25

1. Wells test
2. Blood for d-dimer
3. Compression ultrasound

Question 26

What does What is the main treatment for PE?

Answer 26

Anticoagulation drugs

Question 27

If the PE was provoked, how long will a patient be put on anticoagulants?

Answer 27

3/12 months

Question 28

If the PE was unprovoked, how long will a patient be put on anticoagulants?

Answer 28

For life

Question 29

When might you get surgery w a PE?

Answer 29

If it’s a massive PE

Question 30

What are some potential long term consequences of pulmonary embolism?

Answer 30

Post Thrombotic Syndrome
Swelling
Discomfort
Pigmentation
Ulceration in severe form

Question 31

Name some conditions caused by arterial thrombosis

Answer 31

Acute coronary syndrome
Ischaemic stroke
Limb claudication / ischaemia

Question 32

Name some conditions caused by venous thrombosis

Answer 32

DVT
Pulmonary Embolism