20 Questions
What is the main consideration for deciding inpatient versus outpatient management in patients with DVT?
Concurrent symptomatic pulmonary embolism (PE)
Which anticoagulant therapy is recommended for the treatment of DVT in most situations?
LMWH or heparin
What is the current role of thrombolytics in the management of DVT?
Rarely indicated
In the evaluation and work-up of suspected DVT, what is the recommended approach for acute isolated distal DVT without severe symptoms or risk factors?
Perform serial imaging of deep veins for 2 weeks
What is the impact of LMWH on clinically significant VTED according to the current literature?
It significantly reduces the rate of clinically significant VTED
Which statement accurately reflects the risk factors associated with developing VTE?
Risk is lower in the foot and ankle population compared to the hip and knee population
Which exam is the preferred initial imaging study for suspected DVT?
Venous duplex ultrasound
What is the recommended pharmacological intervention for patients with suspected DVT?
Lovenox
Which laboratory value is particularly useful in the work-up of suspected DVT?
D-dimer
What factors should be considered when discussing anticoagulation plans for a patient with risk factors for DVT?
Type of surgery being performed
Which of the following medications is commonly used for pre-operative prophylaxis against DVT?
Xarelto 10mg PO once daily
What should be done based on the need for NWB postoperatively in addition to risk factors for DVT?
Discuss plans for anticoagulation
What is the most appropriate prophylactic strategy for preventing VTE in foot and ankle surgery patients?
Mechanical prophylaxis only
Which anticoagulant has a shorter half-life and can be reversed with protamine sulfate?
Unfractionated Heparin (UFH)
What is the recommended therapy duration if considering LMWH following a foot or ankle surgery?
Begin therapy when immobilization starts and continue for the duration of immobilization
Which of the following anticoagulants requires routine INR monitoring?
Warfarin
When is the use of IVC filters considered for VTE prophylaxis in foot and ankle surgery patients?
If there are contraindications to chemical prophylaxis
Which prophylactic strategy is generally reserved for patients who have developed a DVT or PE?
Full anticoagulation with LMWH
What is the recommended dosage for Lovenox (enoxaparin) for subcutaneous injection once daily?
40mg
Which factor enhances the inhibition of thrombin (II) and Xa, IXa, XIa, XIIa by unfractionated heparin (UFH)?
Antithrombin III
Test your knowledge on deciding whether to manage patients with Deep Vein Thrombosis (DVT) in an inpatient or outpatient setting. Learn about indications for inpatient care including massive DVT, concurrent symptomatic pulmonary embolism, high risk of bleeding, and comorbid conditions.
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