DVT

Question 1

risk factors

Answer 1

immobility 
recent surgery 
long haul travel 
pregnancy 
hormone Rx w oestrogen 
malignancy 
polycythemia 
SLE
thrombophilia

Question 2

conditions predisposing to thrombophilia

Answer 2

antiphospholipid syndrome
factor V leiden 
antithrombin deficiency 
protein C or S def
acitvated protein C resistance

Question 3

VTE prophylaxis

Answer 3

LMWH - enoxaparin

anti-embolic compression stockings

Question 4

LMWH contraindications

Answer 4

active bleeding

existing anticoagulation with warfarin or DOAC

Question 5

compression stocking contraindications

Answer 5

PAD

Question 6

DVT presentation

Answer 6

unilateral symptoms

calf swelling
dilated veins 
tenderness
oedema 
colour changes

Question 7

how to examine for leg swelling

Answer 7

measure circumference of calf 10cm below tibial tuberosity

> 3cm difference between calves is significant

Question 8

scoring system

Answer 8

WELLs

Question 9

what can caused raised D-dimer

Answer 9

VTE
pneumonia 
malignancy 
heart failure
surgery 
pregnancy

Question 10

Ix

Answer 10

d-dimer
doppler USS
CTPA, V/Q scan

Question 11

initial management

Answer 11

anticoagulation - treatment dose apixiban or rivaroxaban

Question 12

long term anticoagulation

Answer 12

DOAC - apixaban, rivaroxaban

Question 13

long term anticoagulation if antiphospholipid syndrome

Answer 13

warfarin

Question 14

long term anticoagulation if pregnancy

Answer 14

LMWH

Question 15

how long to continue anticoagulation for?1

Answer 15

• 3mo if reversible cause
• > 3mo if cause unclear, recurrent VTE or irreversible underlying cause
• 3-6mo if active cancer

Question 16

inferior vena cava filter

Answer 16

device inserted into IVC to filter blood and catch any clots traveling from venous system

act as a seive

if unusual case of recurrent PE or unsuitable for anticoagulatoin