venous thromboemb Flashcards
risk factors for venous thromboembolism
previous thromboembolism obesity pregnancy postpartum period malignancy inherited thrmbophilias OCP use exogenous estrogen therapy
virchow triad
stasis
vascular damage
hypercoagulability
common presenting complaints in primary care practice for a venous thromboembo
leg pain
swelling
most common symptoms of PE
dyspnea pleuritic pain cough tachypnea rales tachycardia
chronic causes of leg pain and swelling
chronic venous insufficiency posphlebitic syndrome congestive heart failure pretibial myxedema hypoalbuminemia
differential of leg pain and swelling
superficial thrombophlebitis-very common chronic venous insufficiency-very common congestive heart failure-common DVT-uncommon postphlebitic syndrome-uncommon lymphedema-uncommon
cellulitis-very common
dermatitis-very common
hypoalbuminemia-rare
fracture, muscle tear, hematoma-very common
red flags in suspected DVT
dyspnea, tachypnea–PE, CHF, dysrhythmia
chest pain–PE, CHF, dysrhythmia
syncope—PE, dysrhythmia
hypotension, pulmonary edema, cyanosis—PE, CHF, dysrhythmia
fever—PE, systemic infection
key elements of history and PE for leg pain and swelling
immobilization venous dilatation recent surgery swelling temperature diff edema calf pain local tenderness erythema
Wells clinical decision rule to evaluate probability of DVT-what risk factors are considered
active cancer
paralysis, paresis, immobilization
bedridden >3 days or major surgery within last month
localized tenderness along deep venous system
entire leg swelling
calf swelling by >3cm when compared w asymptomatic leg
pitting edema
collateral superficial veins
testing for DVT
duplex venous US, MRI, helical CT, D-dimer, contrast venography (XR dye)
duplex venous US is most widely used for those w suspected DVT
