Deep vein thrombosis

Question 1

What is DVT

Answer 1

condition where blood clot forms in a vein usually leg

Question 2

How may someone with a DVT present

Answer 2

pain, tenderness and swelling in affected leg

warmth and redness in affected leg

SOB and chest pain - suggestive of PE

on examination - swollen, tender and warm to touch leg - visible distension of veins in leg

Question 3

What scoring system is used for suspected DVT

Answer 3

two-level wells score

Question 4

What investigations may be used to diagnose DVT

Answer 4

if DVT liely >2
US of affected leg
– D-dimer if this is negatuve

if DVT unlikely <2 OR US cannot be carried out in 4 hours
– D dimer blood test
-give DOAC in meantime

if positive stop DOAC and do ultrasound again in a week

Question 5

What is the first line management of a DVT

Answer 5

APIXABAN OR RIVAROXABAN
– if unsuitable , severe renal impairment or antiphospholipid syndrome –
then LMWH followed by vit K antagonist ( warfarin)

3 months therapy for provoked VTE
6 months for unprovoked VTE