DVT

Question 1

risk factors for DVT

Answer 1

OCP use, prolonged immobilization, stroke, major surgery, orthopedic trauma, malignancy, age >40, *thrombotic disorders, previous DVT or PE, obesity, varicose veins, HF, endwelling femoral catheter

*factor 5 leiden mutation, protein C or S deficiency

Question 2

DVT & PE prophylaxis

Answer 2

low dose heparin, LMWH, compression stockings, intermittent pneumonic compression

all depends on the risk of each individual patient

Question 3

diagnosis of DVT & PE

Answer 3

DVT: compression US (lack of compression indicated thrombosis) + echogenic material within the lumen

PE: CT pulmonary angio

Question 4

treatment of DVT & PE

Answer 4

give heparin and warfarin until INR reaches theraputic level (2.5-3) then stop heparin and continue on warfarin

3-6 M: if below knee DVT
6 M: if proximal DVT
9 M: if PE

Question 5

indications of IVC filter? complications of IVC filter?

Answer 5

contraindication to anticoagulation therapy, failure of anticoagulation, complication of anticoagulation (pt developed bleeding)

complication of IVC filter: recurrent DVT, recurrent PE, IVC thrombosis, access site thrombosis

Question 6

contraindications to anticoagulation?

Answer 6

recent stroke, internal bleeding, previous hx of gastric or duodenal ulcers

Question 7

steps to take before inserting IVC filter?

Answer 7

-cavogram to image IVC
-rule out thrombosis in IVC
-define size of IVC (must be <28mm)
-define the renal veins bcz filter will be inserted in infrarenal part