DVT + PE Flashcards

1
Q

What is a DVT

A

Development of a blood clot in one of major deep veins of leg or thigh

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2
Q

What is a PE

A

Consequence of DVT, embolus travelling to pulmonary vasculature

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3
Q

What is Virchow’s triad?

A
  1. Vessel injury
  2. Venous stasis
  3. Hypercoagulability/activation of clotting system.

Can lead to DVT

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4
Q

What are risk factors for DVT and PE?

A

Drugs e.g. COCP, HRT, tamoxifen, olanzapine

Active malignancy
Recent major surgery and hospitalisation
Recent trauma 
Medical illness
Age
Pregnancy 
Air travel
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5
Q

What are Sx of DVT?

A

Calf swelling, pain, warmth
Mild fever
Pitting oedema

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6
Q

What are Sx of PE

A

SOB, pleuritic chest pain, tachycardia/pnoea, may also be DVT Sx. haemoptysis

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7
Q

What Ix in DVT/PE?

A

Is suspected, calculate a Wells or Geneva score. If -ve, do a D dimer.
(If D dimer results not available in 4 hours, interim anticoagulation)

If its +ve, do a duplex US leg for DVT and CTPA for PE.

Bloods: clotting, platelets, and thrombophilia screen are important

for PE: also do an ECG (sinus tachy), echo instead of CTPA if unstable/after to look at heart, cardiac biomarkers, consider ABG

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8
Q

What is difference between provoked and unprovoked PE?

A

Provoked - has identifiable cause/risk factors in last 3 months.

Unprovoked doesn’t (look for cancer and thrombophilia)

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9
Q

What are DDx for DVT?

A

Cellulitis
ruptured Baker’s cyst
achilles tear
haematoma

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10
Q

What are DDx for PE?

A
ACS
pneumothorax
pneumonia
copd
asthma
pericarditis
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11
Q

What is Rx of DVT?

A

(Interim heparin until diagnosis made)

DOAC e.g. apixaban. 3 months or 6 months, provoked or not

IVC filters can be used if medical fails

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12
Q

What are complications of DVT

A

PE
Bleeding
HIT if heparin used
Post-thrombotic syndrome

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13
Q

What is post-thrombotic syndrome

A

Chronic obstruction of venous outflow causes venous hypertension, varicose veins, ulceration,

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14
Q

What is Rx of PE

A

MASSIVE PE - thrombolysis. Haemodynamic instability

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