Flashcards in DVTs Deck (64)
What is a DVT?
Blood clot in the deep veins
What is the most common area for DVTs to occur?
10x more common than upper extremity
Usually starts in calf & spreads proximally
Do distal DVTs have more or less risk of clot embolizing to lungs?
Do proximal DVTs (popliteal or femoral veins) have high or low incidence of pulmonary embolism?
Are varicose veins a significant risk for DVT?
Does venous stasis promote or decrease thrombus formation?
What makes up Virchow's triad?
Does thrombosis happen before or after an event of Virchow's triad has occurred?
What increases the risk of DVT? (7)
Family history of DVT
Recent major surgery/trauma
Active cancer/ chemotherapy
Age over 60
Are individual DVT risk findings reliable?
No- you will need to use clinical prediction guidelines to predict likelihood of DVT
What are some findings when a patient has a DVT?
asymmetric calf swelling
(also includes Baker's cyst in or near popliteus)
asymmetric warmth & redness
acute cellulitis which signifies subcutaneous CT infection
exquisitely tender to touch
asymmetric edema (most likely acute onset)
If a patient has chronic edema & skin changes that include thickening and a dusky color, what is a possible diagnosis?
Chronic Venous Insufficiency
What is chronic venous insufficiency caused by?
incompetent valves in the deep veins
(can also be a DVT complication)
What could be a helpful treatment for chronic venous insufficiency?
Is chronic venous insufficiency unilateral or bilateral usually?
Can be either
What are some typical findings of chronic venous insufficiency?
medial lower leg skin changes above the ankle
there may or may not be an ulcer
calf muscle cords/ tenderness
Homan's sign (no longer considered reliable)
medial calf size greater than 3cm larger than other leg (could be from swelling for something other than a DVT as well)
What is used to predict DVT probability?
Clinical prediction guide such as Wells DVT Clinical Prediction Rules
If a patient has bilateral lower extremity pitting edema do they get a point on Wells DVT Clinical Rules?
NO- because it should be unilateral, not bilateral
How long would a patient have restricted mobility (such as bedridden for more than 3 days or major surgery) in order to give them a point on Wells DVT Clinical Rules?
How recent would an active malignancy have to be in order to give a patient a point on Wells DVT Clinical Rules?
Within the last 6 months
If the circumference of one calf over the other is 2cm how many points does the patient receive on Wells DVT Clinical Rules?
0 points- because it has to be greater than 3cm difference
- measure this 10cm below tibial tuberosity
How many points does a patient receive on Wells DVT Clinical Rules if they have varicose veins?
- 1 point is given for NON-varicose collateral superficial veins
On Wells DVT Clinical Rules what do you deduct 2 points for?
strong alternative to DVT, if there is another diagnosis that is at least as likely as DVT
On Wells DVT Clinical Rules, your patient gets 0 points, what this indicate?
Low probability (3% DVT frequency)
On Wells DVT Clinical Rules, your patient gets 1-2 points, what this indicate?
Medium probability (17% DVT frequency)
On Wells DVT Clinical Rules, your patient gets >2 points, what this indicate?
High probability (75% DVT frequency)
What do you do if you suspect a DVT?
Get an urgent ultrasound done
What do you use a D-dimer blood test for? How do you interpret it?
To test for DVT
Negative= NO DVT
Positive does NOT rule IN a DVT (imaging is required for this)
What is a potentially fatal complication of DVT?