Venous Thromboembolic Disease

Question 1

What is the difference between distal vein thrombosis and proximal vein thrombosis?

Answer 1

Distal vein thrombosis is whenit is below the popliteal vein and proximal is above. Slide 4

Question 2

What are some risk factors of venous thromboembolic disease?

Answer 2

Smoking
Travel
Major surgery
Pregnancy
Protein C and S Deficiency
Maliganancy
Slide 12

Question 3

What are examples of provoked VTE disease?

Answer 3

Reversible: Surgery
Irreversible factors: Cancer
Slide 13

Question 4

What are consequences of VTE?

Answer 4

Fatal PE
Rist of a recurrent VTE
Post-thrombotic syndrome
Chronic thromboembolic pulmoanry hypertension (CTEPH) 
Slide 15

Question 5

What is post thrombotic syndrome and how does it present?

Answer 5

It is a complication of a DVT.
Presentation:
Pain
Oedema
Hyperpigmentation
Eczema
Varicose collateral veins
Venous Ulceration. Slide 16

Question 6

What are consequences of VTE?

Answer 6

Fatal PE
Rist of a recurrent VTE
Post-thrombotic syndrome
Chronic thromboembolic pulmoanry hypertension (CTEPH) 
Slide 15

Question 7

What is post thrombotic syndrome and how does it present?

Answer 7

It is a complication of a DVT.
Presentation:
Pain
Oedema
Hyperpigmentation
Eczema
Varicose collateral veins
Venous Ulceration. Slide 16

Question 8

What is CTEPH?

Answer 8

Chronic Thromboembolic Pulmonary Hypertension
Where the is an increase in pulmonary artery resisitance due to embolic matieral being replaced with fibrous tissue over time. Slide 17

Question 9

What are some pre-tests that can be done for PE?

Answer 9

D dimers: It has a high negative predictive value.
Wells score
Genevas score
Slide 19-24

Question 10

What is the treatment of DVT and PE?

Answer 10

Patient Information
Pharmacological Interventions: Anticoagulation, thrombolysis, analgesia
Mechanical: Ted stockings, IVC filters
Screening: For cancer, thrombophilia. Slide 28

Question 11

What are NOACs and which ones are used in DVT?

Answer 11

NOACs: Noval Oral Anticoagulants
e.g. Apixaban, Rivaroxaban, Dabigatran, Edoxaban.
Only Apixaban and Rivaroxaban are used in DVTs.
Slide 31

Question 12

What are other special causes of DVTs?

Answer 12

Drug use associates.
Cancer associates
Phlegmasia. Slide 39

Question 13

When would you administer thrombolysis?

Answer 13

If patients have symptomatic ileofemoral DVT symptoms and are otherwise healthy.
Patients with PE and must have haemodynamic instability. Slide 40

Question 14

What are the negatives for IVC filters?

Answer 14

They can pierce the vein walls
Can cause thrombus to form ON them
Slide 44