DVT- PE Flashcards
1
Q
Causes of DVT
A
- Trauma
- Major surgery (ie THA or TKA)
- OCP
- Smoking + OCP
- Cancer
- Pregnancy/post natal
- Hypercoaguability (aCL, genetic, factor V)
2
Q
DVT presentation
A
- Skin warm, tender
2. Calf pain
3
Q
DVT most often associated with what
A
PE
4
Q
What is Homan’s sign
A
Calf pain with passive dorsiflexion of the foot (positive 8-56% of pt with DVT; also positive in 50% of symptomatic people without DVT)
5
Q
Gold standard for DVT diagnosis
A
U/S doppler
6
Q
Other options for DVT dx (rarely done)
A
- MRI and CT venography
2. D-dimer (lab assessing fibrin degradation products). Neg rules out DVT but if positive must do PE workup
7
Q
Treatment DVT
A
- Leg exercises
- Compression stockings
- Frequent ambulation
- anticoagulation with warfarin, lovenox, heparin
8
Q
How is superficial thrombophlebitis treated
A
- Aspirin (controversy NSAIDs may also cause clot exception aspirin reduces cox 1 more than cox 2 thus less clotting risk)
- Heat
- Elevation of extremity
9
Q
Recommended anticoagulant use after DVT
A
3 mo on 1st episode
Heparin
Warfarin
10
Q
Surgical treatment for DVT
A
- IVC filter (if concern for PE)
- Thrombolysis
- Thrombectomy
11
Q
PE risk factors
A
Virchow’s triad of venous thrombosis
- altered blood flow
- Hypercoagulable state (i.e. polycythemia)
- Endothelial injury
12
Q
PE presentation pt presentation
A
- Chest pain
- dyspnea
- Shortness of breath
- Hemoptysis
13
Q
PE physical exam findings
A
- Tachypnea
- Tachycardia
- EKG- normal, but may also have non-specific ST changes
- Hypoxemia
- CXR
* * Westermark sign= dilation of pulmonary vessels prox to embolism with collapse distal vessels often with sharp cut off sign on cxr.
* * Hamptom’s Hump= dome-shaped, pleural-based opacification due to lung infarct
14
Q
Gold standard for PE
A
Pulmonary CT angiography
15
Q
Treatment for PE
A
- Anticoagulation 6-12 months
- Heparin immediately and then bridge to warfarin for long-term treatment - Thrombolytics (controversial)
- IVC filter
- Embolectomy
