Venous Thromboembolic Disease Flashcards
What are IVC filters used for?
patients who have frequent reoccurrence despite optimum pharmacological treatment or can’t be anti-coagulated
What is the D-Dimer?
test of exclusion - high negative predictive value - low positive predictive value
What is Virchow’s Triad?
sites of endothelial injury, turbulent blood flow and hypercoagulable blood
What are the consequences of VTE?
post-thrombotic syndrome, chronic thromboembolic pulmonary hypertension
What are low risk causes of thrombosis?
smoking, contraceptive pill, renal disease, cardiomyopathy
What is a V/Q scan?
ventilation/perfusion imaging - shows mismatched perfusion defects
What is used to treat cancer associated PEs and DVTs?
weight adjusted fragmin
What is the risk of an IVC filter?
clot can form on the filter
What is the risk with graduated compression stockings?
arterial compromise
What is an embolism?
thrombus detached - travels through vasculature - gets stuck
What are the Wells score and the Geneva score?
probability scores
What is chronic thromboembolic pulmonary hypertension?
original embolic material is replaced overtime with fibrous tissue - may occlude pulmonary artery - pulmonary artery resistance - right heart failure
What are graduated compression stockings used for?
prevent post thrombotic syndrome, worn for at least two years after diagnosis
Where is thrombosis formation favoured?
locations with Virchow’s Triad
When is a V/Q scan useful?
small peripheral PEs, pregnancy
What DVTs are scanned for and treated?
proximal DVTs - popliteal and femoral vein
What is a thrombosis?
excess intravascular coagulation, static
What characterises post-thrombotic syndrome?
pain, oedema, hyperpigmentation, eczema, varicose collateral veins, venous ulceration, venous hypertension
What are the secondary causes of thrombosis?
prolonged immobility, significant tissue injuries, MI, atrial fibrillation, cancer, chemotherapy
What are the predisposing risk factors for DVT and PE?
history of VTE, chronic heart failure, advanced age, varicose veins, obesity, immobility, paresis, pregnancy, thrombophilia, hormone therapies, renal insufficiency, cancer, inflammatory disease
What is a pulmonary embolism?
thrombus that has travelled to lungs and blocked a vessel there
What are the symptoms of chronic thromboembolic pulmonary hypertension?
initially asymptomatic, progressive dyspnoea and hypoxaemia
What are the exposing risk factors for DVT and PE?
acute medical illness, acute heart failure, acute respiratory failure, surgery, trauma, central venous catheterisation, cancer, inflammatory diseases
What is deep vein thrombosis?
formation of thrombi n the lumen of vessels that make up the deep venous system, form mainly in venous valves pockets
What is the pharmacological treatment of PEs and DVTs?
anticoagulation, thrombolysis, analgesia
What is used to treat drug use associated PEs and DVTs?
rivaroxaban or fragmin - risk of haemorrhage
What does a CXR show in PE?
usually normal, may show some pleural effusions or infarct
What is the meaning of hypoxaemia?
low blood oxygen concentration
What are the signs of a PE?
tachypnea, crackles, tachycardia, fever
