DVT

Question 1

What are the risk factors for DVT?

Answer 1

Virchow's triad!
previous VTE
Fam Hx
malignancy 
immobilisation 
surgery 
pregnancy 
old age

Question 2

What are the components of virchow’s triad?

Answer 2

1. Venous stasis
2. Endothelial damage (trauma/surgery)
3. Hypercoagulability

Question 3

Which conditions predispose you to hypercoagulability?

Answer 3

malignancy, pregnancy, sepsis, dehydration, obesity

Question 4

Which conditions predispose you to venous stasis?

Answer 4

immobilisation, HF, varicose veins

Question 5

What are the symptoms of DVT?

Answer 5

calf tenderness along deep veins, unilateral calf swelling

Question 6

WHat are the signs of DVT?

Answer 6

unilateral pitting oedema
dilated superficial veins
unilateral calf erythema
localised increase in temp

Question 7

What are the differential diagnoses for DVT/swollen red leg?

Answer 7

cellulitis
trauma
compartment syndrome
lymphoedema
ruptured baker's cyst

Question 8

What is the scoring system for suspected DVT? Name three components of this score

Answer 8

well’s score

• prev DVT
• active cancer
• bedridden >3days or major surgery within 12 weeks

Question 9

What are the investigations for DVT?

Answer 9

bloods- FBC, LFTs, CRP, coag, D dimer
Blood cultures/skin swab (if cellulitis suspected)
Doppler USS leg

Question 10

Well’s score of <2 and D dimer negative. Will this be DVT?

Answer 10

Wells’ <2 and D-dimer negative:
DVT unlikely, consider another diagnosis
Wells’ <2 and D-dimer positive:
treat as DVT until Doppler USS confirmation
Wells’ ≥2:
treat as DVT until Doppler USS confirmation

Question 11

What is the management of DVT?

Answer 11

give LMWH until DVT is confirmed on doppler USS

switch from LMWH to DOAC or warfarin
continue coagulation for 3 months or longer if recurrent DVT