DVT

Question 1

WHAT IS A DEEP VEIN THROMBOSIS?

Answer 1

blood clot that develops in the deep vein of the leg

Question 2

WHAT ARE THE RISK FACTORS FOR A DVT?

Answer 2

1) Age
2) Pregnancy - blood is hypercoagulable
3) synthetic oestrogen
4) trauma
5) surgery
6) immobilisation
7) obesity
8) past DVT

Question 3

WHAT ARE THE SIGNS OF A DVT?

Answer 3

1) Calf warmth
2) Calf tenderness
3) Calf swelling > 3cm
4) Calf erythema
5) Mild fever
6) Unilateral pitting oedema

Question 4

IS DVT UNILATERAL OR BILATERAL?

Answer 4

unilateral

Question 5

WHAT IS THE INVESTIGATION FOR A DVT?

Answer 5

1) ECG
2) Bloods - FBC (WCC for infection), clotting profile (INR and APTT to help with therapy), CRP (inflammation), LFTs (hepatic dysfunction can affect clotting factor synthesis), U and E’s (look at renal clearance to guide therapy and consider dose adjustments), D-dimer (exclusion but not confirmation)
3) Duplex USS of proximal leg vein
4) CT abdomen and pelvis

Question 6

HOW CAN YOU PREVENT A DVT?

Answer 6

1) Stop oral contraceptive pill 4 weeks pre-op
2) Mobilise early
3) Graduated compression stockings - TED stocking

Question 7

WHAT IS THE TREATMENT FOR DVT (FIRST LINE AND ALTERNATIVES)?

Answer 7

FIND OUT

Question 8

HOW LONG SHOULD TREATMENT LAST FOR?

Answer 8

3 months

Question 9

WHAT ARE THE COMPLICATIONS OF DVT?

Answer 9

1) Pulmonary embolism

Question 10

IN WHAT OTHER SITUATIONS IS D-DIMER RAISED?

Answer 10

• infection
• malignancy
• sepsis
• pregnancy

Question 11

WHAT SCORING SYSTEM IS USED TO ASSESS THE PROBABILITY OF DVT?

Answer 11

• two level DVT Well’s score