DVT Flashcards
What is a thrombus?
Solid mass formed in the circulation from the constituents of the blood during life
What are the differences between venous and arterial thrombosis?
- Venous: low pressure, fibrin rich.
- Arterial: high pressure, platelet rich
What are the 3 pillars of virchow’s triad?
- Hypercoagulability (blood)
- Vascular damage (vessel)
- Circulatory stasis (flow)
What are the risk factors for DVT?
- Recent surgery
- Immobility
- Long haul flights
- Pregnancy
- HRT/ OCP
- Polycythemia
- Thrombophilia
What is Thrombophilia?
Predisposition to developing blood clots. E.g anti- phospholipid syndrome, anti thrombin defeicinecy
What is VTE prophylaxis?
Treatment given if the patient is at risk of developing a venous thromboembolism e.g low molecular weight heparin or compression stockings
How does a DVT present?
- Unilateral
- Calf or leg swelling
- Dilated superficial veins
- Tenderness to the calf
- Oedema
- Changes in colour in the skin of the leg
- Can measure for more than a 3cm difference between the two calfs
What other things do you need to be thinking of it a patient presents with a DVT?
PE (are they having SOB, chest pains and what’s their O2 sat like)
What is the wells score?
Predicts the risk of a patient presenting with symptoms actually having a DVT or a PE. Takes into account risk factors and clinical presentation.
What is a D dimer test?
Blood test which is almost always raised when there is a DVT. Measures the amount of fibrin break down which implies clotting
Why is a D-dimer test not diagnostic of DVT?
Raised D-dimer just indicated cross linked fibrin that has been broken down. It is used for a negative exclusion test (ie if negative then NOT DVT). but if positive could be due to other things eg pregnancy, trauma, malignancy
What is the gold standard test for a DVT?
Ultrasound dobbler
What can be used to diagnose a PE?
Angiography or CT or a VQ scan
What prevention methods would you use for DVT?
- Stop OC pill 4 weeks before surgery
- Mobilize early after surgery
- LMW heparin (eg enoxaparin 20 mg/24 h s/c)
What pharmacological treatments can be used in management of a DVT?
- LMWH
- Wafarin
- DOAC
How does warfarin work?
It is a vitamin K antagonist, which is essential in developing blood clots.
What is the target INR for warfarin use?
2-3
What are DOAC?
Oral anticoagulants that are not warfarin. They don’t require monitoring in the same way that warfarin does.
What does DOAC stand for?
Direct oral anti-coagulants
What would be the first line choice of treatment for DT in pregnancy or cancer?
Long term LMWH use
What is non-pharmacological treatment for DVT?
Compression stockings
What is Budd-Chiari Syndrome?
Budd-Chiari syndrome is where a blood clot (thrombosis) develops in the hepatic vein, blocking the outflow of blood. It is associated with hyper-coagulable states. It causes an acute hepatitis.
What is the classic triad of symptoms in Budd-Chiari syndrome?
- Abdominal pain
- Hepatomegaly
- Ascites
