DVT

Question 1

What anatomical structures are affected?

Answer 1

Deep veins of the leg (femoral/ papliteal veins)

Pelvis (iliac veins)

Blockage of the vein by blood clot (thrombosis). Starts in the calf.

Question 2

What are the physiological abnormalities caused as a result of this?

Answer 2

Thrombophilla - often express itself with recurrent thrombosis.

Deficient in anticoagulation factors e.g.
Protein C/S
Antithrombin, mutations in factor V and prothrombin.

Question 3

Prior events that cause DVT?

Answer 3

Recent surgery/hospitalisation

Age/obesity

Immobilisation

Infection

Hormonal contraception

Tobacco

Family history

Question 4

Symptoms?

Answer 4

Swelling/pain in calf

Pulmonary embolisms appears suddenly

Question 5

Clinical signs

Answer 5

Swelling
Redness
Dilation if surface veins

Tenderness over veins when applying gentle pressure

Question 6

Abnormal test results?

Answer 6

Ultrasound of leg shows thrombus within vein

Test for D-dimer - this is a cross linked fibrin degradation product that shows that thrombosis is occurring. Shows that the blood clot is being dissolved by plasmin.

Question 7

How to treat?

Answer 7

Heparin/warfarin for 3-6 months.
Regular walking
Compression stockings may prevent clots in stroke patients.