DVT Flashcards

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1
Q

Risk factors

A

Immobility
Recent surgery
Long haul flight
Pregnancy
Hormone therapy with oestrogen
Malignancy
Polycythaemia
SLE
Thrombophilia

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2
Q

Examples of thromophilias

A

Antiphospholipid syndrome
Factor V leiden
Antithrombin deficiency
Protein S or C deficiency
Activated protein C resistance

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3
Q

VTE prophylaxis

A

Usually low molecular weight heparin (enoxaparin)

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4
Q

Contraindications to VTE prophylaxis with heparin

A

Active bleeding or existing anticoagulation with warfarin or a DOAC

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5
Q

Contraindication for compression stockings

A

Peripheral artery disease

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6
Q

DVT presentation

A

Unilateral calf or leg swelling

Dilated superficial veins

Tenderness to the calf

Oedema

Colour changes to the leg

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7
Q

Wells score

A

Predicts risk of patient presenting with symptoms having a DVT or PE

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8
Q

Diagnosis

A

D-dimer sensitive (95%) but not specific

Doppler US (repeat if negative after 6-8 days if positive D-dimer and wells score likely)

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9
Q

PE diagnosis

A

CTPA (preferred) or VQ scan

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10
Q

Other causes of raised D-dimer

A

Pneumonia

Malignancy

Heart failure

Surgery

Pregnancy

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11
Q

Initial DVT/PE management

A

Treatment dose apixaban or rivaroxaban immediately

Consider catheter directed thrombolysis in patients with symptomatic iliofemoral DVTand symptoms lasting less than 14 days

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12
Q

Long term anticoagulation

A

DOAC, warfarin or LMWH

3 months if reversible cause

> 3 months if cause unclear/ recurrent VTE or irreversible underlying cause e.g. thrombophilia

3-6 months in active cancer

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13
Q

DOACs

A

Anticoagulants that do not require monitoring

Apixaban, rivaroxaban, edoxaban, dabigatran

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14
Q

Warfarin

A

Vitamin K antagonist

(first line in patients with antiphospholipid syndrome)

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15
Q

Target INR for warfarin

A

Between 2 and 3 when treating DVTs and PEs

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16
Q

IVC filter

A

Filter blood and catch any blood clots travelling from the venous system towards the heart and lungs

Used in unusual cases of patients with recurrent PEs or those unsuitable for anticoagulation

17
Q

Investigating unprovoked DVT

A

Antiphospholipid antibodies

Hereditaroy thrombophilias

18
Q

Budd-Chiari sydrome

A

Blood clot develops in the hepatic vein blocking outflow of blood

Assocaited with hyper-coagulable states

Causes acute hepatitis

19
Q

Budd-Chiari triad

A

Abdo pain

Hepatomegaly

Ascites