Deep vein thrombosis

Question 1

The condition that predisposes someone to develop blood clots, they may preset with recurrent miscarriages?

Answer 1

Antiphospholipid syndrome

Question 2

VTE prophylaxis?

Answer 2

Usually with low molecular weight heparin e.g. enoxaparin
Anti-embolic stockings

Question 3

DVT presentation?

Answer 3

Almost always unilateral

• Calf or leg swelling- measure circumference of the calf 10cm below the tibial tuberosity- more than 3cm is significant
• Dilated superficial veins
• Tenderness to the calf
• Oedema
• Colour changes to the leg

Question 4

The name of the system that predicts the risk of a patient presenting with symptoms having a DVT or PE?

Answer 4

Wells score

Question 5

Diagnosis of DVT?

Answer 5

D dimer is sensitive but not specific so helpful in exclusion of DVT

Doppler ultrsound of the leg is required to diagnose deep vein thrombosis

PE can be diagnosed with a CTPA or VQ scan

Question 6

Initial management for DVT?

Answer 6

Anticoagulation:
* Apixaban
* Rivaroxaban

Question 7

Long term anticoagulation for VTE?

Answer 7

DOAC e.g. apixaban
Warfarin
LMWH- 1st line in pregnancy

continue anticoag for:
* 3 months if cause is reversible
* Beyond 3 months id the cause i sunclear, there is recurrent VTE or there is a irreversible cause
* 3-6 months in active cancer