Issues in thrombosis tutorial

Question 1

are D dimers useful for confirming DVT diagnosis or ruling out DVT diagnosis

Answer 1

ruling out.
sensitive but not specific.
so if it’s negative it’s very unlikely someone has a DVT

Question 2

what wells score means DVT is unlikely

Answer 2

<1

Question 3

what wells score means moderate risk of DVT

Answer 3

1 or 2

Question 4

what wells score means high risk of DVT

Answer 4

3 or higher

Question 5

when would we use V/Q over CT for PE

Answer 5

• allergic to contrast
• don’t want large doses of radiation e.g. pregnancy

Question 6

first line treatment for DVT

Answer 6

DOAC (apixaban or rivaroxaban)

Question 7

how long should we anticoagulate for in VTE

Answer 7

3 months

life long if high risk - if this is the second VTE, unprovoked, site, men,

Question 8

an unprovoked VTE - is this low or high risk for recurrence

Answer 8

high

Question 9

when would thrombophilia testing be done in patients with VTE

Answer 9

not really often. rarely influences management

maybe if strong family history and want to start cocp