DVT Flashcards
how does a patient with DVT present?
- calf pain, swelling, redness, warmth.
- engorged superficial viens
- ankle oedema
- homan’s sign (pain in the calf on dorsiflexion of foot - not diagnostic)
What is homan’s sign?
Homan’s sign is pain in the calf on dorsiflexion of the foot - it may be present in DVT but is not diagnostic.
What is the sign of complete occlusion in DVT?
cyanotic discolouration of the limb and sever oedema
What location of DVT is more likely to cause a PE?
iliofemoral DVT is more likely to cause a PE than DVT below knee.
What is post phlebitis syndrome and how is it linked to DVT?
Post phlebitis syndrome is ulceration of a limb that is caused by a chronic venous obstruction (DVT) it presents with a single swollen limb.
what are the physiological risk factors of DVT?
- pregnancy
- obesity
- elderly
What are the pathological risk factors for DVT?
- immobility
- malignancy
- venous trauma
- oestrogens (OCP / HRT)
- nephrotic syndrome
- hyperviscosity syndrome
What are the inherited risk factors for DVT?
- factor V leiden mutation
- haemoglobunuria
- protein C / S deficiency
What score is used to determine the clinical probability of a DVT?
Wells Score predicts DVT by assessing the following:
- active cancer
- recent paralysis of leg
- surgery / bedridden >3d
- tenderness along deep veins
- swollen leg
- calf swelling
- pitting oedema
What invx are done for DVT?
- D-dimer (is a fibrin degradation product present in blood after clot has been broken down.)
- negative D-dimer test rules out DVT.
- Positive d dimer doesnt confirm DVT so do USS or CT.
What may cause a false positive d dimer result?
- liver disease
- high rheumatoid factor
- inflammation
- malignancy
- pregnancy
- recent surgery
- ag
What is the treatment for DVT?
- bed rest until coagulated, then mobilisation and elastic stockings.
-Low mol weight heparin
- warfain
(until INR is 2-3)
What are the differential diagnoses of DVT?
Cellulitis
Venous eczema
ruptured baker’s cyst
