DVT Prevention

Question 2

What is DVT?

Answer 2

Deep vein thrombosis occurs when a blood clot forms in the deep veins of the leg.

Question 3

Where does DVT most commonly occur?

Answer 3

In the lower extremities: femoral, popliteal, iliac veins.

Question 4

What can happen if DVT is left untreated?

Answer 4

The clot can travel and lodge in the pulmonary artery, leading to an embolism.

Question 5

What is the most common cause of pulmonary embolism (PE)?

Answer 5

DVT.

Question 6

What are the components of Virchow’s Triad?

Answer 6

• Stasis (immobilization and hospitalization)
• Endothelial Injury (trauma and surgery)
• Hypercoagulability (cancer, OCP, pregnancy, etc.)

Question 7

List some risk factors for DVT.

Answer 7

• Immobility
• Bedrest > 3 days
• Recent surgery
• Cancer
• Pregnancy
• Hormonal therapy (OCPs, HRT)
• Prior DVT or PE
• Inherited thrombophilias (Factor V Leiden, Protein C/S deficiency)

Question 8

What are common symptoms of DVT?

Answer 8

• Unilateral leg swelling
• Pain and tenderness
• Warmth and erythema
• Positive Homan’s sign

Question 9

What indicates a progression from DVT to pulmonary embolism?

Answer 9

Respiratory symptoms such as pleuritic chest pain, sudden onset SOB, tachypnea, tachycardia.

Question 10

What criteria is used for diagnosing DVT?

Answer 10

Wells Criteria.

Question 11

What is the role of D-dimer in DVT diagnosis?

Answer 11

It is highly sensitive and useful for ruling out DVT in low-moderate risk patients.

Question 12

What is the first line confirmatory test for high risk patients suspected of having DVT?

Answer 12

Doppler Ultrasound.

Question 13

What are common complications of DVT?

Answer 13

• Pulmonary embolism
• Post thrombotic syndrome
• Recurrent DVT
• Venous insufficiency

Question 14

Why is DVT prevention important?

Answer 14

60% of hospitalized patients developed DVT without prophylaxis due to immobilization.

Question 15

What can PE cause in hospitalized patients?

Answer 15

Up to 10% of hospital deaths worldwide.

Question 16

What are some methods of DVT prevention?

Answer 16

• Early ambulation
• Hydration
• Compression stockings and other mechanical methods
• Pharmacologic prophylaxis (LMWH, direct oral anticoagulants, UFH)

Question 17

When should pharmacologic prophylaxis be started?

Answer 17

In any patient with moderate to high DVT risk.

Question 18

What are absolute contraindications of pharmacological prophylaxis?

Answer 18

• Active major bleeding
• Severe thrombocytopenia
• Coagulopathy (elevated INR in liver disease)
• Upcoming high-bleeding risk surgery
• Current or recent intracranial hemorrhage
• Uncontrolled hypertension
• History of heparin induced thrombocytopenia
• Spinal or epidural anesthesia planned

Question 19

Fill in the blank: Therapeutic LMWH requires a _______ interval between the last dose and epidural placement.

Answer 19

24-hour

Question 20

What should be done if urgent delivery is expected in a pregnant woman on therapeutic LMWH?

Answer 20

Switch to UFH in the final days of pregnancy for easier reversal.