Acute Venous Pathology Flashcards
(110 cards)
1
Q
D-Dimer
A
blood test for clotting factors
2
Q
R/O
A
rule out
3
Q
pitting edema
A
swelling to the point where it doesn’t bounce back after being poked
4
Q
what are two really bad symptoms of a DVT
A
chest pain/difficulty breathing could = pulmonary embolism
5
Q
Venous Thromboembolism (VTE)
A
a blood clot in a superficial or deep vein or a pulmonary embolism
6
Q
Deep Venous thrombosis
A
blood clot in a deep vein
7
Q
pulmonary embolism
A
a sudden blockage in the pulmonary arteries from a blood clot that has broken off from a deep vein, typically from the legs
8
Q
what percentage of PE start from in the leg
A
80 percent
9
Q
PE mortality rate if untreated
A
30 percent
10
Q
CVI
A
chronic venous insufficiency
can be a complication from a DVT
11
Q
venous disease can be either ____ or ____ and can effect the ___ or _____ system
A
acute
chronic
deep
superficial
12
Q
can the venous system be affected by non-venous pahtologies
A
yes
13
Q
which gender is more likely to get a DVT
A
females
14
Q
races more likely to get DVT
A
african < caucasian < asian and native
15
Q
2 genetic factors (not genetic or race)
A
antithrombin deficiency
Factor V Leiden mutation
16
Q
Virchow’s triad
A
acquired factors of DVT can be categorized into this
stasis, injury, hypercoagulability
17
Q
what is the most common fact for LE DVT
A
stasis
immobility, CHF, obesity, pregnancy, surgery
18
Q
most common factor for UE DVT
A
central lines (venous catheters) (injury)
19
Q
what can increase the clotting ability of blood
A
pregnancy, cancer, estrogen intake (BCP/HRT), genetic blood factors
20
Q
5 questions to ask patient being scanned for DVT
A
previous DVT/family history
trauma
surgery
bed rest >4 days
medications (BCP/HRT)
21
Q
SOB means
A
shortness of breath
22
Q
hemoptysis
A
coughing blood
23
Q
postitive Homans sign
A
flex foot and hurts (DVT)
24
Q
d-dimer test is ___% specific to clot but not specific to ____
A
95
DVT
25
Well's score (DVT)
≤0 = low probability
1-2 = intermediate
≥ 3 = high
26
Well's score (PE)
<2 = low probability
2-6 = intermediate
>6 = high
27
thrombus usually begins in the ______ veins or at the ____ due to stasis
soleal calf
valvue cusps
28
acute stage is within the first ___ days after thrombus forms
14
29
Calf Vein DVT treated by
therapeutic anticoagulation and survellience with duplex US
30
Fem-pop DVT
more serious than isolated calf thrombus
treated by anticoagulation therapy/duplex US
31
for iliac DVT ____ signals can give indirect informartion
Doppler
32
if both CFV are continuous =
if only one continuous =
IVC
iliac
33
upper exremity DVT are usually the result of
Central venous catheters
34
3 less common causes of upper extremity DVT (not central venous catheters)
mediastinal lymphoma
previous radiation therapy
trauma or surgery to the area
35
acute thrombus is _______ to _______ and enlarges the vessel slightly
anechoic
hypoechoic
36
will there be incomplete compression of the lumen with an acute DVT
yes
37
sub-acute is __ to ___ old and can be slightly more ____ and retracts in size
1
2months
echogenic
38
partial occlusion
blood can still flow a little (doppler will show around the thrombus edges)
39
what is the gold standard to ruling out DVT
compressions in trans
40
if you see a floating thrombus what do you do
don't compress
41
when the DVT is proximal to where you scan, the waveform is ___ with a loss of _____
continuous
respirophasicity
42
when the DVT is distal to where you scan the waveform can show a _____
reduced or absent augment
43
collateralization is another sign of ____ and what is it seen as
DVT
seen as veins that aren't normally seen now are
44
May-Thurner syndrome AKA
iliac vein compression syndrome
45
what is May-Thurner syndrome (what, most common in, symptoms)
result of overriding RT CIA compressing LT CIV against the 5th lumbar vertebra
most common in 20-40 year old females
left leg pain/swelling
46
what is the gold standard to diagnosing May-Thurner syndrome
venography with pressure measurements
47
with May-Thurner syndrome you may see a _____ with a ___ at the site of stenosis or a _____ flow pattern distal
narrowing
jet
continuous
48
treatment for May-Thurner syndrome
balloon angioplasty and the insertion of a stent
49
Paget-Schroetter Syndrome (AKA, more common in, associated with)
effort thrombosis/venous thoracic outlet compression
more common in men in dominant arm
can be associated with thoracic outlet abnormalities (cervical rib/muscle)
50
what is the most common axillo-subclavian thrombosis in ambulatory cancer free populatioj
Paget-Schroetter syndrome
51
Phlegmasia Alba Dolens translates to and AKA
painful white inflamation
AKA milk leg
52
Phlegmasia Alba Dolens can affect women in the ______ or _____
3rd trimester
post partum
53
Phlegmasia Alba Dolens is a _____ of the major _____
massive occlusion
deep venous system
54
how does blood still drain in Phlegmasia Alba Dolens
via collaterals
55
symptoms of Phlegmasia Alba Dolens
extensive edema with a white discoloration
56
Phlegmasia Alba Dolens can progress to ___
cerulea dolens
57
Phlegmasia Cerulea Dolens translate to
painful blue inflammation
58
Phlegmasia Cerulea Dolens is an occlusion of the ____ and _____
major deep venous system
collaterals
59
Phlegmasia Cerulea Dolens results in ___ arterial flow
reduced
60
Phlegmasia Cerulea Dolens symptoms
massive thigh and calf swelling with blue discoloration
61
is Phlegmasia Cerulea Dolens a surgical emergency
yes
62
three categories of DVT treatment
prevention (control risk factors)
medical
surgical
63
medical treatments for DVT (2)
Anticoagulation therapy: (heparin, warfarin) 3-6 months, prevents clot propagation (doesn't dissolve thrombus)
Thormbolytic agent: (streptokinase) dissolves thrombus, used when symptoms are severe, can lead to major bleeding episodes
64
Venous thrombectomy is done for
patient with impending limb loss (phlegmasia cerulea dolens) if a thrombolytic agent does not work or is contraindicated
65
bypass grafting done for
caval occlusion
66
ballon venoplasty and stenting is done for
chronic iliofemoral DVT
May-Thurner Syndrome
67
an ______ is an option for patients who cannot be anticoagulated
IVC filter
68
approximately _____ of superficial thrombophlebitis have a concurrent DVT or PE
25%
69
Anticoagulation therapy is indicated the superficial thrombophlebitis is ___ in length or within ____ of SFJ (saphenofemoral junction), SSV, and pop anastomosis
more than 5cm
3cm
70
superficial thrombophlebitis treatment (4)
apply heat to the site
compression stockings
nonsteroidal anti-inflammatory meds
low molecular weight heparin for 45 days
71
4 other tests that can asses for VTE
venography
CT
nuclear medicine
MRI
72
VTE stands for
venous thromboembolic disease
73
venogram
x ray talen where contrast media is injected to outline the veins
74
venogram has difficulty differentiating between ____ and ____ clots
acute
chronic
75
CTPA
pulmonary angiogram (CTPA)
standard test for PE
contrast injected
76
what is the standard test for PE
CTPA
77
what is the gold standard for thrombus
venogram
78
nuclear medicine does what test
ventilation-perfusion(V/Q) scan
79
V/Q scan
Inhale radioactive gas to demonstrate PE
shows what part of lungs are getting oxygen
looks at blood flow to lungs to see if there is diminished flow from clots
80
does V/Q scan confirm diagnosis
no it gives high/moderate/low probability
81
isotope venography is a ____ test where ______ is injected to evaluate ______ and ______ veins
nuclear med
radioisotope
peripheral
pulmonary
82
isotope venography is infrequently used for _____
acute DVT
83
Bakers Cyst (what, extends, become)
dilation of bursa in the posteromedial knee
can extend into muscle planes, become hemorrhagic and rupture
84
bakers cyst common with (2)
degenerative joint disease and rheumatoid arthritis
85
bakers cyst symptoms (3)
pain, tenderness, swelling
86
bakers cyst can have a _____ shape and may not be visible with ____
tear-drop
knee extended
87
hematomas can be result of (3)
trauma
anticoagulation therapy
vigorous exercise
88
flow with be ____ with a hematoma
slow
89
soft tissue edema occurs due to _____ venous pressures (4 causes)
increased
heart failure
fluid overload
DVT
venous obstruction
90
soft tissue edema presents as
leg swelling
91
edema can cause a ______ augment
reduced/blunted
92
if the CHF is the cause, then the edema is ____ from increased _______ pressure
bilateral
hydrostatic
93
with edema the patient may present with ____ and have a ____ d-dimer
dyspnea
negative
94
with edema the waveform may be
pulsatile
95
lymphedema is an:
obstruction of lymph drainage due to malignancy, trauma, or surgery
96
lymphedema is most common in the ____ and ____
calf
upper extremity
97
____ of edema causes are unilateral
2/3
98
lymphedema demonstrates _____ edema and can have a ____ appearacne
pitting
milky (harder to penetrate to)
99
abscess
enclosed collection of pus
100
cellulitis
diffuse collection of fluid within the subcutaneous tissue
101
cellulitis can cause ___
edema
102
adenopathy
enlarged lymph nodes
103
adenopathy may be mistakne as
a thrombosed vein
104
adenopathy may cause ____ and ____
limb swelling
compression of veins
105
benign vs malignant adenopathy
ovoid, wider than tall, hypoechoic, has hilum, less than 1cm
vs
rounded shape, taller than wide, increased colour flow, lose normal architecture
106
benign tumors are called
lipomas
107
malignant tumors are called
sarcoma
lymphoma
108
tumors are usually ____ but may have areas of ______ (____)
solid
necrosis (fluid)
109
popliteal aneurysm presents with
lump or pain behind the knee
110
popliteal aneurysm has a ____ arterial wall
dilated
