DVT- PE Flashcards Preview

PANRE 2019 > DVT- PE > Flashcards

Flashcards in DVT- PE Deck (15)
Loading flashcards...
1
Q

Causes of DVT

A
  1. Trauma
  2. Major surgery (ie THA or TKA)
  3. OCP
  4. Smoking + OCP
  5. Cancer
  6. Pregnancy/post natal
  7. Hypercoaguability (aCL, genetic, factor V)
2
Q

DVT presentation

A
  1. Skin warm, tender

2. Calf pain

3
Q

DVT most often associated with what

A

PE

4
Q

What is Homan’s sign

A

Calf pain with passive dorsiflexion of the foot (positive 8-56% of pt with DVT; also positive in 50% of symptomatic people without DVT)

5
Q

Gold standard for DVT diagnosis

A

U/S doppler

6
Q

Other options for DVT dx (rarely done)

A
  1. MRI and CT venography

2. D-dimer (lab assessing fibrin degradation products). Neg rules out DVT but if positive must do PE workup

7
Q

Treatment DVT

A
  1. Leg exercises
  2. Compression stockings
  3. Frequent ambulation
  4. anticoagulation with warfarin, lovenox, heparin
8
Q

How is superficial thrombophlebitis treated

A
  1. Aspirin (controversy NSAIDs may also cause clot exception aspirin reduces cox 1 more than cox 2 thus less clotting risk)
  2. Heat
  3. Elevation of extremity
9
Q

Recommended anticoagulant use after DVT

A

3 mo on 1st episode
Heparin
Warfarin

10
Q

Surgical treatment for DVT

A
  1. IVC filter (if concern for PE)
  2. Thrombolysis
  3. Thrombectomy
11
Q

PE risk factors

A

Virchow’s triad of venous thrombosis

  1. altered blood flow
  2. Hypercoagulable state (i.e. polycythemia)
  3. Endothelial injury
12
Q

PE presentation pt presentation

A
  1. Chest pain
  2. dyspnea
  3. Shortness of breath
  4. Hemoptysis
13
Q

PE physical exam findings

A
  1. Tachypnea
  2. Tachycardia
  3. EKG- normal, but may also have non-specific ST changes
  4. Hypoxemia
  5. CXR
    * * Westermark sign= dilation of pulmonary vessels prox to embolism with collapse distal vessels often with sharp cut off sign on cxr.
    * * Hamptom’s Hump= dome-shaped, pleural-based opacification due to lung infarct
14
Q

Gold standard for PE

A

Pulmonary CT angiography

15
Q

Treatment for PE

A
  1. Anticoagulation 6-12 months
    - Heparin immediately and then bridge to warfarin for long-term treatment
  2. Thrombolytics (controversial)
  3. IVC filter
  4. Embolectomy