DVT and PE

Question 1

Define DVT

Answer 1

• Deep Venous Thrombosis

- a thrombus formed in the deep venous circulation

Question 2

Define PE

Answer 2

• Pulmonary Embolism

- a thrombus that has embolised and lodged in pulmonary circulation

Question 3

VTE stands for what?

Answer 3

• Venous thromboembolic disease

Question 4

DVT can be ____ or ____

Answer 4

• proximal (more likely to embolise)

- distal (calves)

Question 5

What is Virchow’s Triad?

Answer 5

• endothelial injury
• circulatory stasis
• hypercoagulable state

Question 6

What are the symptoms of a DVT?

Answer 6

• painful
• hot
• swollen limb
• tendreness along vein

Question 7

What are the symptoms of a PE?

Answer 7

• Sudden SOB
• Sudden collapse
• tachycardia
• low BP
• central cyanosis
• haemoptysis

Question 8

Name a PE scoring system?

Answer 8

• Well’s score

Question 9

What is D-dimer

Answer 9

• breakdown product of cross linked fibrin

- first line screening test for VTE with low Wells score

Question 10

High chance of VTE, first line investigation?

Answer 10

• Scan

- CTPA / US (Doppler)

Question 11

Low chance of VTE, first line?

Answer 11

• D-dimer
• high d-dimer = scan
• normal d-dimer = no scan required

Question 12

Characteristics of Post thrombotic syndrome

Answer 12

• pain
• oedema
• eczema
• hyperpigmentation
• varicose collateral veins
• venous ulceration

Question 13

What is the long term consequences of VTE?

Answer 13

• 1/3 will develope post thrombotic syndrome within 5 years

Question 14

First line treatment for DVT?

Answer 14

• Oral anticoagulant
• apixaban
• rivoxiban

Question 15

First line treatment for a PE?

Answer 15

• Thromboylsis (high risk)

- then oral anticoagulation