DVT Flashcards
1
Q
Sequelae of DVT?
A
- PE
- Chronic venous insufficiency
2
Q
Aetiology of DVT?
A
Virchow’s Triad: endothelial activation (i.e. injury), hypercoaguability, stasis.
3
Q
How does stasis affected DVT risk?
A
Venous stasis due to immobilisation inhibits clearance and dilution of coagulation factors.
4
Q
What are the acquired contributors to hypercoaguability?
A
- Age
- Surgery
- Trauma
- Neoplasms
- Blood dyscrasias, hyper viscosity
- Hormonal (pregnancy, OCP)
- Heart failure
5
Q
CFx DVT?
A
- Unilateral leg oedema, erythema, warmth and tenderness
- Palpable cord (thrombosed vein)
- Phlegmasia -cerulea dolens/-alba dolens with massive thrombosis
6
Q
DDx DVT?
A
- MSK: strain/tear
- Vascular: lymphangitis/obstruction; venous valvular insufficiency; arterial occlusive disease
- Ruptured popliteal cysts
- Cellulitis
7
Q
What is the purpose of VTE treatment?
A
- Prevent clot extension
- Prevent PE
- Reduce risk of recurrence
- Treat acute lower limb ischaemia/ venous gangrene
- Limit late complications (e.g. chronic venous insufficiency, chronic thromboembolic pulmonary HTN).
8
Q
Initial Rx VTE?
A
-LMWH (requires renal dosing)
9
Q
Long term Rx VTE?
A
Warfarin (initiated with heparin overlap ==> dual for 5/52. Cease once INR >2.0 for 2/7).
10
Q
Duration of anticoagulant treatment?
A
- 1st DVT + transient RFx: 3 months
- 1st DVT + ongoing RFx: consider indefinite therapy
- 1st DVT + idiopathic: 6-12 months
- Recurrent DVT: indefinite
11
Q
Alternative to anti-coagulation in DVT?
A
IVC filter: only if distal acute DVT (
