DVT

Question 1

Epidemiology of deep vein thrombosis

Answer 1

25-50% of patients

Question 2

Risk factors for DVT

Answer 2

Age

Pregnancy

Synthetic oestrogen

Trauma

Surgery (pelvic/orthopaedic)

Hx DVT

Cancer

Obesity

Immobility

Thrombophilia

Question 3

Signs of DVT

Answer 3

warm, tender, red, swollen, calph

Mild fever

Pitting oedema

Question 4

Differential diagnosis of DVT

Answer 4

Cellulitis

Ruptured baker’s cyst

Both of the above may co-exist with DVT

Question 5

How to investigate DVT

Answer 5

Well’s score

If low risk perform D-dimer

USS, if both negative but wells score is high repeat USS within one week

Look for underlying malignancy

Look for thrombophilias if recurrent DVT with no clear risk factors

Question 6

Prevention of DVT

Answer 6

Stop the pill

Mobilise early

LMWH in high risk patients

Compression stockings

fondaparinux maybe better

Compression stockings

Question 7

Medical treatment of DVT

Answer 7

LMWH or Fondaparinux

LMWH better the UH (UH in renal disease or increased risk of bleeding)

Start warfarin with LMWH and stop LMWH when INR is 2-3

Inferior vena cava filters when Rx fails

Question 8

What is the duration of treatment for DVT

Answer 8

Lifelong if recurrent DVTs or thrombophilias

6 months if no cause is found

3 Months if post-op