VENOUS THROMBOSIS & PULMONARY EMBOLISM

Question 1

WHAT ARE THE HIGH RISK GROUP?

Answer 1

•Old people

•Cardiovascular Disease

•Bedridden patient

•Patients undergoing hip arthroplasty

Question 2

WHAT WE CAN SEE IN DVT?

Answer 2

•Pain the calf or thigh

•Soft tissue tenderness

•Sudden slight increase in temperature

•Sudden increase in pulse rate

Question 3

HOW TO DIAGNOSE DVT?

Answer 3

•Ascending venography (bilaterally)

• US scanning (detecting prox DVT)

•Radioactive iodine labelled fibrinogen(clot)

•Doppler technique (measure blood flow)

Question 4

HOW ABOUT DIAGNOSIS OF PULMONARY EMBOLISM?

Answer 4

•Difficult to diagnose =only minority have symptoms (chest pain, dyspnoe, heamoptysis)

•So high risk patients should be examine for pulmonary consolidation

•X-ray

•Pulmonary angiography

Question 5

WHAT IS THE TREATMENT of DVT ?

Answer 5

•Localized DVT
•Elastic stockings
•Low dose subcut. heparin (5000 unit)

More extensive DVT
•Bed rest
•Elastic stockings
•Full anticoagulation
•Heparin IV (10000 units 6 hourly)
•Continue for 5-7/7 with last 2/7 warfarin introduce

Question 6

HOW TO TREAT PULMONARY EMBOLISM?

Answer 6

Cardiorespiratory resuscitation

•Oxygen

•Large dose heparin (15 000 units)

•Streptokinase (dissolve clot)

•Antibiotics (prevent lung infection)