Deep Vein Thrombosis Flashcards Preview

Vascular Surgery > Deep Vein Thrombosis > Flashcards

Flashcards in Deep Vein Thrombosis Deck (11)
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1
Q

What is deep vein thrombosis?

A

Formation of blood clot in the deep veins of a limb

2
Q

Pathophysiology of deep vein thrombosis

A

Virchow’s triad

Abnormal blood flow
- immobility

Abnormal blood components

  • smoking
  • sepsis
  • malignancy

Abnormal vessel wall

  • atheroma
  • inflammatory response
  • direct trauma
3
Q

What are risk factors for deep vein thrombosis?

A
Increasing age
Previous VTE
Smoking
Pregnancy
Recent surgery
Prolonged immobility
Hormone replacement
4
Q

Clinical features of DVT

A

65% asymptomatic

Unilateral leg pain
Swelling - measure 10cm below tibial tuberosity - >3cm = swollen
Mild fever
Prominent superficial veins

5
Q

What is the Wells’ score?

A

Identifies risk of DVT

Criteria

  • active cancer
  • bedridden > 3days OR major surgery in last 4 weeks
  • calf swellingn >3cm
  • collateral superficial veins present
  • entire leg swollen
  • localised tenderness alonf deep venous system
  • pitting oedema
  • paralysis/paresis or recent plaster of leg
  • previously documented DVT

Score = 1

  • DVT unlikey
  • D-dimer test to exlcude

Score >1

  • DVT clinically likely
  • confirmed via ultrasound
6
Q

Management of DVT

A

DOACs (contraindicated in pregnancy)

  • apixaban
  • rivaroxaban

LMWH

  • fondaparinux
  • enoxaparin
  • dalteparin
7
Q

Differentials for DVT

A

Muscle strain/tear
Lymphangitis
Cellulitis

8
Q

What is phlegmasia cerulea dolens?

A

Painful blue leg swelling

When DVT compresses arterial supply

9
Q

What investigations are done for potential DVT?

A

Bloods

  • FBCs
  • U+Es (treatments are renally cleared)
  • LFTs
  • INR
  • aPTT

Doppler venous flow
D-dimer

10
Q

What does a D-dimer show?

A

Low = definitely not DVT

High = requires further investigations

11
Q

What can cause a high D-dimer?

A

MI
DIC
Stroke
Pregnancy