Venous Thromboembolism

Question 1

Virchow’s Triad:

Factor V Leiden

inherited or acquired hypercoagulable state?

Answer 1

inherited

Question 2

Virchow’s triad:

Protein C and S deficiency

inherited or acquired hypercoagulable state?

Answer 2

inherited

Question 3

Virchow’s triad:

Anti-thrombin deficiency

inherited or acquired hypercoagulable state?

Answer 3

inherited

Question 4

Virchow’s triad:

Malignancy

Inherited or acquired hypercoagulable state?

Answer 4

acquired

Question 5

Virchow’s triad:

Pregnancy

Inherited or acquired hypercoagulable state?

Answer 5

acquired

Question 6

Virchow’s triad:

antiphospholipid antibodies

Inherited or acquired hypercoagulable state?

Answer 6

acquired

Question 7

Virchow’s triad:

IBS

Inherited or acquired hypercoagulable state?

Answer 7

acquired

Question 8

Virchow’s triad:

Drug therapy (estrogen containing contraceptives, estrogen replacement therapy, estrogen receptor modulators)

inherited or acquired hypercoagulable state?

Answer 8

acquired

Question 9

Virchow’s triad:

acute medical illness requiring hospitalization

hypercoagulable state, blood stasis, or vascular injury

Answer 9

blood stasis

Question 10

Virchow’s triad:

surgery (especially general anesthesia > 30 mins)

hypercoagulable state, blood stasis, or vascular injury

Answer 10

blood stasis

Question 11

Virchow’s triad:

paralysis (post stroke, spinal cord injury)

hypercoagulable state, blood stasis, or vascular injury

Answer 11

blood stasis

Question 12

Virchow’s triad:

immobility (plaster casts, long travel)

hypercoagulable state, blood stasis, or vascular injury

Answer 12

blood stasis

Question 13

Virchow’s triad:

atrial fibrillation

hypercoagulable state, blood stasis, or vascular injury

Answer 13

blood stasis

Question 14

Virchow’s triad:

obesity

hypercoagulable state, blood stasis, or vascular injury

Answer 14

blood stasis

Question 15

Virchow’s triad:

surgery

hypercoagulable state, blood stasis, or vascular injury

Answer 15

vascular injury

or blood stasis if general anesthesia > 30 mins

Question 16

Virchow’s triad:

trauma

hypercoagulable state, blood stasis, or vascular injury

Answer 16

vascular injury

Question 17

Virchow’s triad:

atherosclerosis

hypercoagulable state, blood stasis, or vascular injury

Answer 17

vascular injury

Question 18

Virchow’s triad:

chemical irritation

hypercoagulable state, blood stasis, or vascular injury

Answer 18

vascular injury

Question 19

Virchow’s triad:

indwelling venous catheters

hypercoagulable state, blood stasis, or vascular injury

Answer 19

vascular injury

Question 20

Massive PE SBP?

Answer 20

< 90 mmHg

cardiogenic shock

Question 21

RV dysfunction (EKG or echo) + biomarkers (elevated troponin, BNP)

massive, submassive, or non massive PE?

Answer 21

submassive

Question 22

Normal vital signs, no RV dysfunction, no + biomarkers

massive, submassive, or non massive PE?

Answer 22

non massive

Question 23

Wells clinical DVT score

Low score range?
% of DVT?

Answer 23

low range: 0
% of DVT: 3%

used to determine if pt is likely or unlikely to have DVT

Question 24

Wells clinical DVT score:

moderate score range?
% of DVT?

Answer 24

moderate range: 1-2
% of DVT: 17%

used to determine if pt is likely or unlikely to have DVT

Question 25

Wells clinical DVT score: high score range? % DVT?

Answer 25

high range: >= 3 % DVT: 75% used to determine if pt is likely or unlikely to have DVT

Question 26

Wells clinical PE score: low score range? % PE?

Answer 26

low range: < 2 % PE: 3-10 % d-dimer test for diagnosis

Question 27

Wells clinical PE score: moderate score range? % PE?

Answer 27

moderate range: 2-6 % PE: 15-35% d-dimer test for diagnosis

Question 28

Wells clinical PE score: high score range? % PE?

Answer 28

high range: >= 7 % PE: 70-80% imaging test for diagnosis