MSRA: VTE

Question 1

What Wells score result indicates PE likely?

Answer 1

More than 4 points

Question 2

How does the Wells score in PE influence required investigations?

Answer 2

If likely (more than 4 points) first line investigation is CTPA

If unlikely (4 points or less), first line investigation is a D-dimer

Question 3

What Wells score result indicates DVT likely?

Answer 3

2 points or more

Question 4

How does the Wells score in DVT influence required investigations?

Answer 4

If likely (2 or more points), first line investigation is proximal leg ultrasound

If unlikely (less than 2 points), first line investigation is D-dimer

Question 5

What is the anti-coagulant class of choice in suspected/confirmed VTE?

Answer 5

DOACs (first line options: Rivaroxaban, Apixaban)
Typically used for 3 months
Then discussion re continuing for a further 3 months to make 6 months treatment in total

Question 6

What is the most appropriate investigation for superficial thrombophlebitis involving the great saphenous vein?

Answer 6

Ultrasound scan

Question 7

Which scoring system is used to assess which patients with PE can be managed as an outpatient?

Answer 7

PESI
(PE severity index)