DVT

Question 1

humans sign

Answer 1

refers to pain in the calf on forceful dorsiflexion of the foot.

Question 2

first step in the diagnosis of a suspected DVT or PE

Answer 2

calculate the pre-test probability/ Modified Wells score/ likelihood that the patient does in fact have a blood clot.

Question 3

in patients with a low pre-test probability, a negative ____ excludes DVT

Answer 3

negative D dimer.

Question 4

Is ____ elevated or negative in patients with VTE

Answer 4

elevated in patients with VTE. Elevated in a variety of conditions, so it’s a non-specific marker.

Question 5

____ is needed as an investigation in patients who are considered likely to have DVT (high pre-test probability) or with a positive D-Dimer

Answer 5

Venous Compression Ultrasound with Doppler flow.

Question 6

limitations to CUS

Answer 6

include an operatoe-depednent accuracy and reduction of sensitivity and specificity in DVT or pelvic veins, small calf veins or in obese patients.

Question 7

if an isolated distal DVT is detected:

Answer 7

anticoagulation should be offered if severe clinical symptoms are present or if the risk of proximal extension Is high.

Question 8

risk factors for proximal extension of a distal DVT include

Answer 8

positive D dimer, calf DVT that is close to the proximal veins, absence of a reversible provoking risk factor, cancer, previous history or venous thromboembolism, lower extremity immobilization.

Question 9

treatment for superficial thrombophlebitis

Answer 9

treatment typically consists of NSAIDs, heat, compression and ambulation. if no improvement, try anticoagulation.

Question 10

physical exam findings of DVT

Answer 10

•  Edema	
•  Tenderness	to palpation	
•  Erythema/cyanosis	
•  Warmth	to	palpation	
•  Dilated	superficial veins	
•  Palpable thrombosed	vein
- hullmans sign

Question 11

Ddx for DVT

Answer 11

• musculoskeletal trauma
• hematoma
• extrinsic venous obstruction
• post thrombotic syndrome
• lymphedema
• infection/cellutis
• popliteal cyst (rupture)

Question 12

distal DVT

Answer 12

Clot in the deep veins below

the knee

Question 13

when should you treat someone with an isolated distal DVT

Answer 13

• only treat with anti-coagulants should be offered if patient has severe symptoms if clot extension is high.
• only treat distal DVT if symptomatic, or if immobilized in cast, or has obvious risk factors for extension or are unreliable.