Venous Thrombosis - Diagnosis, Prevention and Treatment of PE/DVT Flashcards
Why is DVT diagnosis difficult
Symptoms are non-specific
Symptoms of DVT
Pain, swelling
Signs of DVT
Tenderness
Swelling
Warmth
Discolouration
How does D-dimer levels help in DVT investigation
Normal = Exclude diagnosis
Positive = Potential but not confirmation
Following a D-dimer test what do we carry out for patients with suspected DVT
Ultrasound compression test on proximal vein or venogram for calf
How is DVT treated
LMW Heparin for min 5 dyas
Oral Warfarin (5mg a day), INR 2-3 for 6 months
Compression Stockings
Treat underlying cause (malignancy or thrombophilia)
Is DVT more spontaneous or provoked after first case
Spontaneous
What are the risk factors for DVT
- Surgery, Immobility, leg fracture
- OC pill, HRT, Pregnancy
- Long flights and travel
- Inherited thrombophilia (familial inheritance)
How can we mechanically prevent DVT
Hydration, early mobilisation
Compression stockings
Foot Pumps
Chemical prevention of DVT
LMW Heparin
What is the risk of thromboprophylaxis at <40 years
Low
How do we treat low risk thromboprophylaxis
Early mobilisation, hydration (no chemical intervention) and a 30 min surgery
What factors can result in high risk thromboprophylaxis
Hip and knee surgery
Pelvis surgery
Malignancy
Prolonged Immobility
How is high risk thromboprophylaxis treated
Many surgeries
Daltrparin
What are the main components of a venous thrombi
RBC
Fibrin