DVT/PE

Question 1

What increases risk of DVT embolising?

Answer 1

Located above the knee

Question 2

Physical Signs of DVT?

Answer 2

Unilateral Pitting Oedema, Mild Fever, Warm/Tender to Touch

Question 3

Diagnosis of DVT?

Answer 3

1) Well’s Score
2) D-dimer if low
3) High Well’s/DD +ve = CTPA
4) Low WS, DD -ve = rule out DVT

Question 4

Management of DVT?

Answer 4

1) LMWH + Warfarin
2) Wait for INR 2-3
3) Remove Heparin
4) Warfarin 3 months

Question 5

Possible signs of PE?

Answer 5

Recent DVT, Recent surgery, Haemoptysis, Dyspnoea, Syncope, Pleuritic Chest Pain

Question 6

Diagnosis of PE?

Answer 6

1) Well’s Score
2) D-dimer (-ve = exlcusion)
3) CTPA = gold standard

Question 7

Management of PE?

Answer 7

1) DOAC (2nd line: IV LMWH/Fondaparinux)
2) Check if haemodynamically stable
2. 5) No = IV alteplase bolus (thrombolysis)
3) DOAC/Warfarin 3-6 months

Question 8

Acute Complications of PE?

Answer 8

Hypoxia, Hypotension, Tachycardia, Gallop Rhythm

Question 9

Management of PE Complications?

Answer 9

Hypoxia: 10-15L/min oxygen
Hypotension: 500ml IV fluid bolus
Pain: IV morphine 5-10mg with anti-emettic