dvt pe

Question 1

Contrast venography

pro and con

Answer 1

• pro
  
  • 1.Anatomic and luminal evaluation
  • 2.Flow physiology (collaterals)
• con
  
  • 1.Requires contrast (allergies, AKI)
  • 2. Painful
  • 3. Invasive

Question 2

Doppler venography

Answer 2

Doppler venography

• pro
  
  • 1. Inexpensive
  • 2. Easy
  • 3.No radiation
  • 4.Flow physiology
• Con
  
  • 1.Tech. dependent
  • 2.Increased false positives/negatives

Question 3

Ventilation/Perfusion scan

Answer 3

Ventilation/Perfusion scan

Pro

• 1. High sensitivity
• 2. Inexpensive

Con

• 1. Low specificity
• 2. May not demonstrate small sub-segmental defects.

Question 4

CT Pulmonary Arteriography (CT Angio)

Answer 4

CT Pulmonary Arteriography (CT Angio)

Pro

• 1. High sensitivity and specificity
• 2. Accurate anatomy assessment centrally
• 3. Often considered “gold standard” in intermediate risk cases

Con

• 1.Requires contrast (allergies, AKI)
• 2. Expensive
• 3.Radiation exposure
• 4.May miss small peripheral clots.
• *

Question 5

D-dimer

Answer 5

D-dimer

Pro

• 1. Negative test makes DVT unlikely
• 2. Simple to perform

Con

• 1. A positive test is not diagnostic of DVT
• 2.Other conditions can elevate the D-dimer

Question 6

Pain in calf or popliteal area on dorsiflexion of the foot

Answer 6

homan’s

Question 7

Pain typically caused with compression of the calf against the tibia but not when squeezing the calf itself. what this test sensitive/specific for?

Answer 7

moses test: not sen/sp for anything

Question 8

pain with percussion of the anteromedial tibia; not sensitive or specific for DVT

Answer 8

lisker sign: not sen/spec for dvt

Question 9

BP cuff applied to mid-calf and pain elicited with inflation to 80 mmHg

Answer 9

not sensitive or specific for DVT

Lowenberg’s sign

Question 10

Modified Wells criteria Criterion Score

Clinical signs or symptoms of DVT

Answer 10

3 pts

Question 11

Clinical signs or symptoms of DVT: Alternative diagnosis less likely than PE

Answer 11

3 pts

Question 12

Wells Criteria: Heart rate 100 beats per minute

Answer 12

1.5 pts

Question 13

wells criteria: Immobilization (>3 days) or surgery in last 4 weeks

Answer 13

1.5 pts

Question 14

wells c: Previous history of DVT or PE

Answer 14

1.5 pts

Question 15

wells c: Hemoptysis

Answer 15

1 pt

Question 16

wells c: active cancer

Answer 16

1 pt

Question 18

bancroft’s sign

Answer 18

is just homen’s sign