Deep vein thrombosis & pulmonary thromboembolism

Question 1

what is deep vein thrombosis

Answer 1

it is thrombosis in a vein lying deep below the skin, especially in the legs

Question 2

when does deep vein thrombosis occur

Answer 2

when a thrombus forms in one or more of the deep veins in your body, usually in your legs

Question 3

what can deep vein thrombosis cause

Answer 3

leg pain or swelling, but can also occur with no symptoms

Question 4

what can sometimes occur for no apparent reason

Answer 4

DVT

Question 5

list things that increase getting DVT

Answer 5

inactivity
staying in hospital
blood vessel damage
medical conditions
genetic conditions
pregnancy
contraceptive pills
hormone replacement therapy

Question 6

state a medical condition that can cause DVT

Answer 6

vasculitis, varicose veins

Question 7

state conditions that increase your risk of getting DVT

Answer 7

cancer
heart disease
infectious conditions
inflammatory conditions
thrombophilia
anti-phospholipid syndrome

Question 8

how can cancer increase your chance of getting DVT

Answer 8

cancer treatments such as chemotherapy and radiotherapy can increase your risk of getting DVT

Question 9

state a genetic condition that increases your risk of getting DVT

Answer 9

thrombophilia, it is a genetic condition where your blood has an increased tendency to clot

Question 10

state an immune system disorder that increases your risk of getting DVT

Answer 10

anti-phospholipid syndrome, this disorder causes an increased risk of blood clots

Question 11

state other causes of DVT

Answer 11

being overweight
being obese
smoking
dehydration
being over 60

Question 12

what is the treatment of DVT

Answer 12

medicines called anticoagulants, these drugs prevent blood clot getting bigger and can prevent an embolism

Question 13

what are anticoagulants referred to as

Answer 13

blood thinning medicines, however, they do not thin blood, they prevent clots forming so easily

Question 14

state 2 anticoagulants used to treat DVT

Answer 14

heparin

warfarin

Question 15

describe heparin treatment of DVT

Answer 15

heparin works immediately to prevent further clotting, it is injected straight into one of your veins generally

Question 16

what are the 2 forms of heparin available

Answer 16

standard heparin

low molecular weight heparin

Question 17

what are side effects of heparin

Answer 17

skin rash
bleeding
allergic reactions
weakening of the bones

Question 18

describe warfarin treatment of DVT

Answer 18

warfarin is taken as a tablet, it prevents further blood clots occurring

Question 19

what are 2 main complications of deep vein thrombosis

Answer 19

pulmonary embolism

post-thrombotic syndrome

Question 20

what is the most serious complication of DVT

Answer 20

pulmonary embolism

Question 21

When does pulmonary embolism occur as a complication of DVT

Answer 21

it happens when a piece of blood clot breaks off and travels through your bloodstream to your lungs, where it blocks one of the blood vessels

Question 22

what is post-thrombotic syndrome

Answer 22

it is the occurrence of long term symptoms after having a DVT

Question 23

what percentage of people with history of DVT does post-thrombotic syndrome affect?

Answer 23

20-40%

Question 24

what do the symptoms of post-thrombotic syndrome include

Answer 24

calf pain
swelling
a rash
ulcers on the calf

Question 25

what increases your risk of getting post-thrombotic syndrome

Answer 25

if your DVT is in your thigh vein if you are overweight if you have more than one DVT in the same leg

Question 26

what is the initial investigation of choice in nearly all patients with suspected DVT

Answer 26

duplex ultrasound

Question 27

state 4 investigations of DVT

Answer 27

ultrasound venography CT venography MRI

Question 28

what is pulmonary thromboembolism

Answer 28

it is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream

Question 29

what does pulmonary thromboembolism result from

Answer 29

usually thrombus in the leg that travels to the lung

Question 30

what is the presentation of pulmonary thromboembolism

Answer 30

``` chest pain pain of the upper back difficulty breathing coughing up of blood a developing DVT ```

Question 31

describe the management of pulmonary thromboembolism

Answer 31

injection of anticoagulant medicine in hospital, anticoagulant tablets then for 3 months

Question 32

what is the role of anticoagulants

Answer 32

they stop blood clots getting bigger and prevent new clots forming

Question 33

state investigations of pulmonary thromboembolism

Answer 33

``` routine laboratory blood tests chest x-rays ECGs ventilation/perfusion scan CT pulmonary angiogram pulmonary angiography ECHO MRI compression ultrasound scan ```

Question 34

what is a thrombus

Answer 34

a blood clot formed in situ within the vascular system of the body and impedes blood flow

Question 35

what is a blood clot

Answer 35

blood that has been converted from a liquid state to a solid state

Question 36

what is a blood clot also called

Answer 36

a thrombus

Question 37

where is a blood clot

Answer 37

it is stationary within a vessel or the heart

Question 38

what is coagulation

Answer 38

the process by which a blood clot forms

Question 39

what is a clot made up of

Answer 39

fibrin platelets red blood cells

Question 40

what is arterial thrombosis

Answer 40

a blood clot in an artery

Question 41

what is the result of arterial thrombosis

Answer 41

it can be very serious and can stop blood reaching important organs

Question 42

what is venous thrombosis

Answer 42

it is a blood clot that forms within a vein

Question 43

state a common type of venous thrombosis

Answer 43

deep vein thrombosis

Question 44

what is deep vein thrombosis

Answer 44

it is a blood clot in the deep vein of the leg

Question 45

what is thrombosis

Answer 45

it is a term for a blood clot occurring inside a blood vessel

Question 46

what is embolism

Answer 46

obstruction of an artery, typically by a blood clot or an air bubble

Question 47

what is thromboembolism

Answer 47

obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation

Question 48

state the 2 main examples of venous thromboembolism

Answer 48

limb deep vein thrombosis | pulmonary embolism

Question 49

what is pulmonary embolism

Answer 49

it is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream

Question 50

state 2 other examples of venous thromboembolism

Answer 50

visceral venous thrombosis | intracranial venous thrombosis

Question 51

what are symptoms of deep vein thrombosis

Answer 51

pain, swelling and tenderness in your leg a heavy ache in the affected area warm skin in the area of the clot red skin

Question 52

what are common tests for DVT

Answer 52

ultrasound d-dimer testing venography

Question 53

what is the most common test for diagnosing DVT

Answer 53

ultrasound, sound waves create images showing the blood flowing through the arteries and veins in the affected leg

Question 54

what are symptoms and signs of pulmonary embolism

Answer 54

``` pleuritic chest pain dyspnoea haemoptysis tachycardia pleural rub on auscultation ```

Question 55

what are symptoms and signs of massive pulmonary embolism

Answer 55

``` Severe dyspnoea (sudden onset) Collapse cyanosis Tachycardia Low blood pressure Raised JVP May cause sudden death ```

Question 56

state tests for diagnosis of pulmonary embolism

Answer 56

``` wells score geneva score blood tests d-dimer tests CT pulmonary angiogram isotope ventilation/perfusion scan ```

Question 57

what is the outcome of pulmonary embolism

Answer 57

most patient recover fully | development of pulmonary arterial hypertension

Question 58

what are the aims of treatment of venous thromboembolism

Answer 58

prevent clot extension prevent clot embolisation prevent recurrent clot

Question 59

what is the main treatment of pulmonary embolism

Answer 59

anticoagulation

Question 60

what are the parental options of anticoagulation treatment of pulmonary embolism

Answer 60

unfractionated heparin | low molecular weight heparin

Question 61

what are the enteral options of anticoagulation treatment of pulmonary embolism

Answer 61

warfarin | direct oral anticoagulants

Question 62

what is another treatment for pulmonary embolism that isn't anticoagulation treatment

Answer 62

thrombolysis thrombolysis is reserved as treatment for massive pulmonary embolism alteplase is a thrombolytic drug

Question 63

describe prevention of venous thromboembolism in hospital

Answer 63

early mobilisation anti-embolism stockings mechanical methods of thromboprophylaxis pharmacological thromboprophylaxis