DVT

Question 1

Risk factors for DVT

Answer 1

Age >60, active cancer, dehydration, recent orthopaedic or pelvic surgery, long distance travel, obesity, previous history of VTE, family history of VTE, thrombophilias, COCP and HRT, pregnancy

Question 2

Clinical features of DVT

Answer 2

Unilateral warm, swollen calf or thigh, pain on palpation of deep veins, distension of superficial veins, pitting oedema

Question 3

What scoring system is used to predict the liklihood of DVT

Answer 3

Wells score

Question 4

Investigations into suspected DVT

Answer 4

D dimer to exclude VTE, Doppler US, digital subtraction or CT/MR venogram

Question 5

Complications of DVT

Answer 5

PE, venous insufficiency, recurrent DVT, post-thrombotic syndrome

Question 6

Four types of management for DVT

Answer 6

Anticoagulation, percutanous mechanical thrombectomy, IVC filter and further investigations if there are other relevant symptoms

Question 7

Which anticoagulant is recommended first line

Answer 7

Apixiban or rivaroxaban - for 3 months at least

Question 8

WHen is thrombectomy used

Answer 8

In massive DVTs

Question 9

When is an IVC filter used and why

Answer 9

Used in patients when anticoagulation is contraindicated, and will reduce the chances of DVT embolising to pulmonary arteries