Venous Thromboembolism And PE

Question 1

Virchow triad of DVT causation

Answer 1

Venous stasis
Hyper coagulability
Vascular injury
Immobility

Question 2

Epidemiology of DVT

Answer 2

1/1000/annum
30%^ risk with previous DVT
30% present as sudden death

Question 3

Risks factors of DVT

Answer 3

Family history
Previous DVT
obesity
Thrombophilia
Pregnancy

Question 4

Physiology of DVT

Answer 4

most common in legs unilaterally
Cerebral mesenteric or splenic artery

Question 5

Clinical presentation

Answer 5

Asymptomatic
Lower limb: pain swelling increased temperature of limb, dilation of limb
UNILATERALLY

Question 6

Clinical presentation of PE

Answer 6

Collapse, faintness, pleuritic chest pain, difficulty breathing, haemoptysis

Question 7

Investigations of DVT

Answer 7

D-dimer as negative predictor
Venous ultrasonography of popliteal or femoral vein
Wells probability score

Question 8

Investigations of PE

Answer 8

chest x-ray
ABG
V/Q scan
CT pulmonary angiogram

Question 9

Differential diagnosis of DVT

Answer 9

Ruptured bakers cyst
Calf haematoma
Cellulitis

Question 10

Treatment of DVT and PE

Answer 10

Rapid coagulation
Oral anticoagulant to prevent future DVT

Question 11

Define atheroma

Answer 11

Plaque found in arteries

Question 12

Define atherosclerosis

Answer 12

Plaque build up in arteries causing occlusion

Question 13

Three complications of atheroma

Answer 13

Thrombus
Embolism
Infarction

Question 14

Define thrombus

Answer 14

Calcification of blood constituents in the vascular system

Question 15

Three risk factors for thrombus
Virchow triads

Answer 15

Hyper coagulation
Vascular injury
stasis- immobility

Question 16

Complications of thrombosis

Answer 16

Arterial occlusion
Embolism

Question 17

Define embolism

Answer 17

Detached solid mass
Carried through blood
Emboli are formed from thrombi

Question 18

2 main types of embolism and definition

Answer 18

Pulmonary embolism
Systemic embolism

Question 19

Consequences of PE

Answer 19

Circulatory obstruction
Small recurrent embolsim= pulmonary hypertension

Question 20

Consequences of systemic embolism

Answer 20

Aortic aneurysms
Endocarditis

Question 21

Define infarction

Answer 21

Ischemic necrosis caused by arterial occlusion

Question 22

Most common sites of infarction

Answer 22

Middle cerebral artery- TIA
Coronary artery
look at Ross’ lecture