DVT Flashcards
Virchow’s triad includes
Stasis
Hypercoaguable state
Endothelial injury
What is the most important risk factor for DVT
Admission into hospital for medical or surgical treatment
What is the MC congenital prothrombotic condition
Factor V (leiden mutation)
What is May Thurner syndrome
Right iliac artery, presses on the left iliac vein, and gives rise to left iliac vein thrombosis 
What is Phlegmasia Cerulea Dolens
Painful blue limb
Collaterals also thrombosed
What is Phlegmasia Alba dolens
It is painful white leg / Milk leg
Collaterals are spared
MC veins involved in DVT
Calf / Soleal vein
MC veins in which DVT gives rise to PA
Iliofemoral veins
Most constant sign in DVT is
Limb edema
What is Moses sign
When Calf is squeezed it leads to pain
What is Homan’s sign
During dorsiflexion of foot - there is resistance / stiffness ( it is not pain)
IOC for DVT
Duplex Scan
Which criteria is used for predicting DVT and carrying out imaging
Modified Wells criteria
Score to remember in modified wells criteria
IV drug abuse = 3
Alternative diagnosis more likely than DVT = (-2)
Others 1
Which lab value has negative predictor value for DVT
Negative D dimer
Management for recurring DVT
Lifelong Anticoagulants
Anticoagulation management for DVT patients
First 5 days : LMWH + warfarin
After 5 days : warfarin
What is targeted INR in warfarin therapy
2-3
Maximum value of INR at which surgery can be done without raise in excessive bleeding is
1.4
What to administer if patient is sensitive to warfarin
Fondaparinux (factor Xa inhibitors)
Biliverdin (direct thrombin inhibitor )
What are some NOAC
Rivaroxaban
Apixaban
No monitoring required
What to do if patient presents with early DVT
Direct thrombolysis can be done (streptokinase/urokinase)
Management for first episode of DVT
Warfarin for 3 months
What to administer to reduce the INR
Prothrombin factor concentrates > FFP
What is ATTRACT trial?
Thrombolysis is useful in patient with proximal DVT with moderate to severe symptoms
MC used IVC Filter is
Greenfield filter
Management of IVC blocked
IV Fluid
In PE ….. will be raised
JVP
…. Position inc the risk of PE
Sitting from lying down
Primary Upper extremity DVT is also known as
Paget Schrotter disease (Axillary vein thrombosis)
Secondary upper extremity DVT is occurs due to
Indwelling catheter
Mgt of superficial thrombophlebitis
Anti inflammatory agent
Thrombophobe ointment
Compression garment can also use
DVT IS usually Unilateral or Bilateral?
Unilateral
What is the Gold standard for DVT
Venography
What investigation is done suspected case of PE
CT angiography
Maximum value of INR at which surgery can be done without rise in Excessive bleeding is
1.4
