DVT / thrombose veineuse profonde / TPP

Question 1

DVT wells criteria (10)

Answer 1

1 active cancer cancer or tx within 6 months
2 bedridden >3 jrs ou chir dernier 3 mois
8 paralysie, parésie, or recent plaster of lower extremity
3 calf swelling >3 cm
5 entire leg swollen
6 oedeme jambe affectée
7 dlr suivant le systeme veineux profond
4 superficiel veins presente
9 previous DVT
10 Alternative diagnosis as likely or more

Question 2

wells score 0
probability of DVT

Answer 2

5%

Question 3

wells 0 and d-dimers negatif
probability of DVT

Answer 3

<1%

Question 4

wells score 0 CAT

Answer 4

faire un d-dimer

Question 5

Wells score 0 + d-dimer nég CAT

Answer 5

DVT ruled out

Question 6

Wells score 0 d-dimer positive CAT

Answer 6

do an ultrasound

Question 7

If ultrasound is positive for DVT CAT

Answer 7

anticoagulate

Question 8

Wells score of 1 OR 2 risk and probability of DVT

Answer 8

risk = moderate

prob 17%

Question 9

wells score 1-2 CAT

Answer 9

d-dimers

Question 10

wells score 1-2 and d-dimer nég (high sensitivity) - if nég prob of DVT

Answer 10

<1%

Question 11

Wells score of 3 and + CAT

Answer 11

ultrasound d’emblée

Question 12

si suspision de DVT rechercher quels autres sx

Answer 12

EMBOLIE PULMONAIRE

Question 13

Ddx DVT (7)

Answer 13

• Kyste de Baker (5%)
• cellulite (5%)
• Déchirure, étirement musculaire ou ligamentaire (40%)
• Insuffisance veineuse (7%)
• lymphangite ou obstruction lymphatique (7%),
• Œdème d’un membre paralysé (9%)
• Problème de genou (2%)

Question 14

70-80% of DVT involve which vein

Answer 14

superficial femoral

popliteal

Question 15

20-30% of DVT involve which veins

Answer 15

ant tib
post tib
peroneal vein

Question 16

so wells 3+ what do you order

Answer 16

écho doppler

ultrasound doppler

pas juste écho N

Question 17

TVP superficiel début NACO?

Answer 17

dépend si extension ou pas

Question 18

QUand débuter NACO

Answer 18

si TVP proximal suspicion clinique élévée

et temps de confirmation >4h

Question 19

Quoi débuter comme tx anticoagulant

Answer 19

Héparine non fractionnée

Héparine bas poids mol (low molecular weight)

or NACO

warfarine possible as well

IF NO CONTRE INDICATIONS

Question 20

heparine non fractionnée antidote

Answer 20

protamine

Question 21

consider warfarine if

Answer 21

valvular afib IRC <30 antiphospholid syndrome

Question 22

HBPM hep bas poids mol example

Answer 22

enoxaparine

Question 23

when is enoxaparine preferred

Answer 23

in cancer and pregnancy

Question 24

quand éviter les NACO

Answer 24

femmes en age de procréer ou grossesse

IRC sévère

Question 25

durée de tx

Answer 25

Usually 3 mo and RA

selon c’était sévère comment
et
selon risque de saignememt

Question 26

DVT complication and signs

Answer 26

Signs of chronic venous insufficiency (usually 6 months) after a DVT:

extremity pain, heaviness, cramps,
paresthesias, pruritus, venous dilation, edema, pigmentation, skin changes, and venous ulcers