DVT/PE Flashcards
Examinations
by performing a considerate, competent medical examination which includes examining or commenting on vital signs, hydration, anaemia, nutritional problems etc. Then proceeding to observation of lower limb for swelling, inflammation, varicosities, examining for superficial /deep calf tenderness, Homans sign dorsiflexion of foot leading to pain – may indicate that this is not appropriate in case of dislodgement. Awareness that DVT could extend into pelvis and abdomen and should indicate would examine these areas. Must indicate that he/she would like to proceed to auscultation of chest and heart and major vessels and be able to nominate most signs. The candidate will be observed to perform a brief chest examination (posterior), which should be reported as normal but specify that on auscultation they are looking for tachypnoea, listening for coarse crackles, pleural rub.
Investigations
By adequately prioritizing conditions relevant to the obtained history and findings, utilizing a biopsychosocial approach, and/ or identifying relevant predisposing, precipitating perpetuating and protective factors with errors or omissions being minor and not materially adversely affecting conclusions. Makes a diagnosis of DVT and probable pulmonary embolus. Able to suggest appropriate investigations including: Ultrasound and Doppler techniques to diagnose thrombosis; Bloods should include: D-Dimer test (negative); blood gasses/ pulse oximetry,and may include polymorphic leucocytosis, raised ESR, raised LDH, Imaging: perfusion scans (V/Q); spiral CT/multidetector CT/ MRI; CT pulmonary angiogram may say not the picture of massive PE.
