Deep Venous Thrombosis

Risk Factors

100

Risk factors related to damage to veins include: 

childbirth, post op sepsis, surgery, trauma, LE fracture, varicose veins, previous hx of DVT

200

Risk factors related to stasis of blood flow include: 

prolonged bed rest, CHF/ MI, neurological disorders resulting in reduced msk activity, chronic VI, post op immobilization, prolonged air travel

300

Risk factors related to hypercoagulability include:

cancer, autoimmune d/o, increase level of coag factors (8, 11), increased hemocystiene levels

400

Risk factors related to this age, this BMI status, a h/o of this metabolic disorder.

>60, >30 BMI (obese), DM

500

Are they at risk? A 42 y/o woman with a 10 year smoking history on birth control.

Yes. Hormonal status (birth control, pregnancy, hormone replacement therapy) & cigarette smoking

Clinical Presentation

100

Common S/S include

warmth, redness, swelling, dull ache/tenderness or pain, prominence of superficial veins

200

Alongside malaise, pts with DVT may also experience one of these symptoms

chills or fever

Testing and PT Exam

100

This blood tests evaluates level of fibrin degradation

D-dimer

200

This noninvasive test requires use of trandsducer to image the vessel of interest

compression or duplex ultrasound index

300

This gold standard testing involves injecting contrast into superficial pedal vein and can be used with MRI

venography (being replaced with ultrasound)

Management

100

This type of medication prevents the thrombosis from enlarging and encourages attachment to the vessel wall

anticoagulant therapy

200

This type of treatment device to increase venous blood flow, decrease venous stasis, and reduce the swelling

compression stockings

Extra

100

DVT prevention methods

(Let's go HAAAM)

hydration, anticoag, anti-embolism exercise, ambulation, mechanical compression

200

Is DVT likely? A 34 y/o F is 7 weeks s/p TKA, with localized tenderness along deep venous system, and swelling of calf. 

Yes. (surgery w/in 12wks, tenderness deep venous system) (2 points)

300

Are they at risk? A 67 y/o M recently started palliative care for their longstanding bone cancer with met to lung with diagnosis known chronic VI with hemosiderin staining as well as with a calf swelling of 4.5 cm R vs L

Yes. (active cancer palliative care, alt dx as likely as DVT, swelling >3cm)

400

DVT risk? A 24 y/o F with previously document DVT but diagnosis of cellulitis and swelling in the RLE.

No. Alternative dx (-2), swelling is not specified