DVT

Question 1

What is a DVT?

Answer 1

When a blood clot forms in the deep vein in leg

Question 2

Examples of veins where DVT can form?

Answer 2

Popliteal vein, femoral vein

Question 3

Symptoms of DVT?

Answer 3

Calf warmth
Tenderness
Swelling
Erythema

Question 4

How to investigate DVT?

Answer 4

Wells’ score - pre-probability test

Question 5

What is in the Wells’ score?

Answer 5

All score 1 point

Active cancer/cancer that’s been treated within last 6 months
Paralyzed leg
Recently bedridden for >3 days/major surgery within last 4 weeks
Tenderness near a deep vein
Swollen leg
Swollen calf with diameter that’s >3cm larger than the other calf’s
Pitting oedema in 1 leg
Large veins in legs that aren’t varicose veins
Previous DVT
Other diagnosis more likely (-2 points)

Question 6

How is Wells’ score used?

Answer 6

If score ≥2 = DVT likely –> lower leg US

If score <2 = DVT unlikely –> D-dimer

Question 7

How is leg US used?

Answer 7

If scan positive = DVT diagnosed

If scan negative = D-dimer

Question 8

How is D-dimer used?

Answer 8

D-dimer positive = do leg US

D-dimer negative = no DVT

Question 9

What should be started if DVT is suspected?

Answer 9

Therapeutic anticoagulation

Question 10

Management of DVT?

Answer 10

DOAC e.g. rivaroxaban, apixaban

Question 11

What is used for thromboprophylaxis for DVT in hospital?

Answer 11

Mechanical - TEDs stockings

Pharmacological - LMWH/DOAC