benryan95's version from 2015-10-28 20:23

Section 1

Question Answer
What is a Deep Vein Thrombosis?A blood clop in a major deep vein in the leg, thigh, pelvis or abdomen.
What % of Venous Thromboembolism cases (DVT+PE) present with symptoms of both DVT and PE?5-10%
What are the components of Virchow's Triad, with regards to DVT?Vessel injury, venous stasis and activation of the clotting system
Where do most blood clots that develop in the deep venous system begin to form?Just above and behind a venous valve
Which deep vein in the leg is more prone to embolism and has no functioning valves?The soleal vein
For those with a provoked DVT, what is the recommended anticoagulation duration for secondary prevention?3 months
For those with an unprovoked DVT, what is the recommended anticoagulation duration for secondary prevention?Indefinitely
What is Homan's sign?Tenderness with dorsiflexion of the foot
What is Pratt's sign?Calf pain on palpation
What are strong risk factors for DVT?Recent hospitalisation/surgery, active cancer, lower-extremity trauma, increasing age, pregnancy, obesity, oestrogen oral contraceptives

Section 2

Question Answer
In the Well's score, what criteria relates to the leg?unilateral calf swelling, prominent superficial veins, pitting oedema, leg swelling, pain along venous system, previous history of DVT/PE
In the Well's score, what criteria doesn't relate to the leg?Active cancer, recent paralysis/cast immobilisation, recent bed rest/major surgery
What tests should be ordered for DVT?D-dimer, venous duplex ultrasound, INR, APTT, urea, creatinine, LFTs, FBC
What could a venous duplex ultrasound show in DVT?Inability to fully compress lumen of vein, reduced flow, intraluminal echoes
Why is INR indicated in DVT?Required before starting warfarin
Why is aPTT indicated in DVT?Required before starting intravenous heparin
In acute DVT with low bleeding risk/no PE, what is the treatment?Intravenous anticoagulation (e.g. enoxaparin AND warfarin), knee high-gradient elastic stocking for 2 years
What is the most significant complication of DVT?PE
What test is performed if the Well's score is less than 2?D-dimer
What test is performed if the Well's score is equal to or greater than 2?Venous duplex ultrasound

Section 3

Question Answer
Before elective surgery, how long should a patient have stopped taking oestrogen-containing contraceptive pills before surgery?4 weeks
What should be given to most patients post-surgery who are high risk of DVT?Pharmacological and mechanical prophylaxis (often LMWH + anti-embolism stockings)

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