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Flashcards in DVT and PE Deck (41)
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1

Presentation of DVT?

Painful
Swollen limb
Redness
Heat
Tenderness along vein
Sub-acute development
No other obvious cause

2

Presentation of PE?

Sudden SOB with pleuritic pain
+- collapse +- heamoptysis +-Hypoxia and tachycardia
BP may be low

3

Scoring system for PE probability?

WELLS Score

4

What is D-Dimer?

Breakdown product of cross-linked fibrin

5

If a D Dimer has a high negative result?

->98% for VTE
No further investigations needed?

6

If there is a moderate to high probability a patient has a VTE what do they need?

Scan

7

Scan done for PE?

CT pulmonary angiogram (CTPA)

8

Severity assessment for
-DVT
-PE?

-Almost always symptomatic, clinical assessment, not very serious
-PESI score (PE severity index score) because for PEs there can be a risk of deterioration and death as PEs put strain on right heart

9

What is PTS?

Post thrombatic syndrome

10

Characteristics of PTS?

Pain
Oedema
Hyperpigmentation
Eczema
Varicose collateral veins
Venous ulceration

11

When does PTS occur?

Approx 5 years after treatment for VTE, in 1/3 of patients

12

What is thought to be associated with PTS?

DVT-induced damage to valves in the deep veins and valvular reflux leading to venous hypertension are thought to be associated with PTS.4

13

Management of DVT?

Oral anticoagulation
(highly specialised centres could consider thrombolysis)

14

PE management?

High risk
Thrombolysis
then anticoagulation
Intermediate risk=
Oral anticoagulation

15

What is thrombolysis othere name?

Fibrinolysis

16

What does thrombolysis do?

Aggressive clot destruction

17

Examples of direct anti-coagulant?

Apixaban
Rivaroxaban
1st line therapy

18

Only time warfarin hsould be used?

Metal valve
Anti-phospholipid syndrome

19

Vitamin K antagonist example?

Warfarin
- rarely used now

20

Low molecular wight heparin Injections?

Used in patients with active cancer and PE

21

Examples of anti-coagulants to treat with?

Direct oral anticoagulant
Vitamin K antagonist
Low molecular weight heparin injection

22

How long to treat provoked VTE with reversible factor for?

3-6 months

23

Duration to treat provoked VTE with irreversible factors?

3-6 months
or
Lifelong depending on patient factors

24

Duration to treat unprovoked VTE with
-Transient risk factor
-Non-major transient risk factor
-Woman with unprovoked VTE
-Man with unprovoked VTE?

-3 months
- 3 months or long term
- Long term
-Long term

25

Advice for man with unprovoked VTE?

Recommend life long anti coagulants ubless bleeding issue

26

Scoring system to see whether to keep patients on anti-coagulants?

HERDOO-2

27

Define DVT?

Deep Vein Thrombosis
Clot (thrombus)formed in the deep venous circulation (usually legs) but can be anywhere

28

Define PE?

Pulmonary Embolism
Thrombus (clot) that has embolised (travelled) and lodged in the pulmonary circulation

29

Define PTE?

Venous Thromboembolic Disease
Covers both DVT and PE

30

Where DVTs form?

Thrombi form predominately in venous valve pockets and other sites of presumed stasis