Deep Vein Thrombosis

Question 1

What risk factors make up Virchow’s triad?

Answer 1

Stasis of blood flow
Endothelial injury
Hypercoagulability

Question 2

What are the risk factors for DVT? (5)

Answer 2

Age
Obesity
Surgery, immobility/ bed rest, leg fracture, plaster of Paris
High oestrogen states - combined OCP, HRT, pregnancy
Long haul flights/ travel

Question 3

What are the symptoms of a DVT? (4)

Answer 3

Calf pain
Calf swelling
Calf warmth
Redness

Question 4

What are the signs of a DVT? (2)

Answer 4

Ankle swelling

Pitting oedema

Question 5

How would you investigate a DVT? (2)

Answer 5

D-Dimer in blood: negative EXCLUDES DVT diagnosis

Ultrasound compression: if vein compresses = no clot. If vein doesn’t compress = CLOT!

Question 6

How would you treat DVT? (3)

Answer 6

LMWH (until warfarin kicks in)
Warfarin/ DOACs
Compression stockings

Question 7

How does LMWH work?

Answer 7

(Activates antithrombin III which then) Inactivates factor Xa

Question 8

How does warfarin work?

Answer 8

Antagonises vitamin K dependent clotting factors - 2, 7, 9, 10

(Blocks the liver from using vit K to make clotting factors)

Question 9

How can you prevent a DVT from occurring? (3)

Answer 9

Compression stockings
Early mobilisation
Leg elevation