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Haematology > DVT + VTE > Flashcards

DVT + VTE Flashcards

1
Q

What are some risk factors of VTE? (9)

A

• Immobility
• Recent surgery
• Long haul travel
• Pregnancy
• Hormone therapy with oestrogen
• Malignancy
• Polycythaemia
• Systemic lupus erythematosus
• Thrombophilia

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2
Q

What are thrombophillias? What is the most common one?

A

Conditions that predispose patients to develop blood clots

Antiphospholipid syndrome

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3
Q

What is antiphospholipid syndrome associated with?

A

Recurrent miscarriage

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4
Q

What is the common VTE prophylaxis in hospital?

A

LMWH

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5
Q

What are some contraindications for LMWH prophylaxis? (2)

A

Active bleeding
Existing anticoagulation with warfarin or DOAC

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6
Q

What is the main contraindication to compression stockings?

A

Peripheral arterial disease

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7
Q

What are the presenting features of a DVT? (6)

A

Unilateral
• Calf or leg swelling
• Dilated superficial veins
• Tenderness to the calf (particularly over the site of the deep veins)
• Oedema
• Colour changes to the leg

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8
Q

What measurement is a significant increase in difference for calf circumference?

A

> 3cm

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9
Q

What is the wells score?

A

predicts the risk of a patient presenting with symptoms having a DVT or PE

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10
Q

What score predicts the risk of a patient presenting with symptoms having a DVT or PE?

A

Wells score

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11
Q

What is done if the wells score is likely for DVT?

A

Perform a leg vein ultrasound

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12
Q

What is done if the wells score is unlikely for DVT?

A

perform a d-dimer, and if positive, perform a leg vein ultrasound

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13
Q

Aside from VTE what can cause raised d-dimer? (5)

A

○ Pneumonia
○ Malignancy
○ Heart failure
○ Surgery
○ Pregnancy

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14
Q

Person has a positive d-dimer and likely wells score but leg vein ultrasound is negative. What is done?

A

Repeat leg vein ultrasound scan after 6-8 days

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15
Q

What is the initial management of DVT?

A

Treatment dose DOAC
E.g. apixaban or ribaroxaban

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16
Q

When is catheter-directed Thrombolysis indicated in DVT?

A

patients with a symptomatic iliofemoral DVT and symptoms lasting less than 14 days.

17
Q

What is the main long term anticoagulant after VTE?

A

DOACs

18
Q

What are some contraindication to DOACs? (3)

A

severe renal impairment (creatinine clearance less than 15 ml/min)
Antiphospholipid syndrome
Pregnancy

19
Q

What is the first line long term anticoagulation in those with antiphospholipid syndrome?

A

Warfarin

20
Q

What is the first line long term anticoagulant in pregnant?

A

LMWH

21
Q

How long is long term anticoagulation continued for a VTE with a reversible cause?

A

3 months

22
Q

How long is long term anticoagulation continued for a VTE in active cancer?

A

3-6 months

23
Q

How long is long term anticoagulation continued for in an unprovoked, recurrent VTE or irreversible cause?

A

> 6months

24
Q

What is an inferior vena cava filter?

A

designed to filter the blood and catch any blood clots travelling from the venous system towards the heart and lungs. They act as a sieve, allowing blood to flow through whilst stopping larger blood clots

25
Q

When are inferior vena cava filters used? (2)

A

in those unsuitable for anticoagulation
where a PE has occurred whilst already on anticoagulation.

26
Q

What is budd-chairi syndrome?

A

obstruction to the outflow of blood from the liver caused by thrombosis in the hepatic veins or inferior vena cava

27
Q

What is the classic triad of symptoms in budd-chairi syndrome?

A

• Abdominal pain
• Hepatomegaly
• Ascites

28
Q

What is the imaging of choice in budd-chiari syndrome?

A

Doppler ultrasonography

29
Q

What are the management options in budd-chiari syndrome? (4)

A

○ Anticoagulation (e.g., low molecular weight heparin and warfarin)
○ Endovascular procedures (e.g., thrombolysis or angioplasty)
○ Transjugular intrahepatic portosystemic shunt (TIPS)
○ Liver transplant

Haematology (18 decks)

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