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Questions and Answers
What characteristic sign is associated with DVT during physical examination?
Which of the following conditions is NOT a differential diagnosis for Deep Vein Thrombosis?
Which statement correctly describes the mechanism behind Factor V Leiden?
In the context of venous thrombosis, how is 'Post-phlebetic syndrome' best characterized?
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What is the recommended initial treatment for suspected Deep Vein Thrombosis?
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What is a key characteristic specifically associated with arterial thromboembolic disorders?
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Which diagnostic tool is primarily used for assessing arterial thromboembolic disorders?
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What is the primary treatment option for arterial thromboembolic disorders if addressed within the first 6 to 8 hours?
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Which of the following is a prominent clinical manifestation of venous thromboembolism?
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Which finding would be least expected in a patient presenting with arterial thromboembolic disorder?
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What type of DVT is most likely to lead to pulmonary embolism?
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What is the term for the lack of pulse that can indicate an arterial thromboembolic disorder?
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What surgical procedure may be performed during the critical time frame for treating an arterial thromboembolic event?
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Which of the following symptoms is not part of the '6 P' sign associated with acute limb ischemia?
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Which statement about thromboembolic disorders is correct?
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What is a commonly accepted risk factor for deep venous thrombosis?
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Which of the following statements about the treatment of acute limb ischemia is incorrect?
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Which statement regarding the complications of deep venous thrombosis is true?
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Which mechanism does not contribute to the formation of thrombosis?
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What is the primary difference between arterial and venous thromboembolic disorders?
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Which of the following is true regarding the types of thromboembolic disorders?
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Study Notes
Thromboembolic Disorders
- Thrombosis is the blockage of a vein or artery by a clot.
- Thromboembolic disorders are categorized as either arterial or venous.
- Arterial thromboembolic disorders are caused by a blockage in an artery.
- Venous Thromboembolic disorders are caused by a blockage in a vein.
Arterial Thromboembolic Disorders
- Can be acute or chronic.
- Acute arterial emboli can originate from the heart (atrial fibrillation, mitral stenosis, intracardiac thrombi, endocarditis) or from noncardiac causes like an abdominal aortic aneurysm (AAA) or atherosclerosis.
- Manifestations of arterial thromboembolic disorders can involve the extremities, brain (stroke), heart (myocardial infarction), gastrointestinal system (mesenteric ischemia), lungs (pulmonary emboli), or other organs.
- The 6Ps are signs of arterial thromboembolic disorders, not venous thromboembolic disorders:
- Pain
- Numbness and Tingling (Paresthesias)
- Pale color
- Pulselessness (Absence or decreased Pulse)
- Decreased temperature (Palor)
- Weakness and eventual Paralysis
- Diagnosis can be made with physical exam, Doppler ultrasonography, DS or CT-MRI angiography.
- Treatment involves surgery within the first 6-8 hours, often with embolectomy or bypass, and medical treatment with anticoagulation using heparin and antiplatelet agents like aspirin.
Deep Vein Thrombosis (DVT)
- A thrombus in one or more deep veins, most commonly affecting the legs rather than the arms.
- Can occur in the portal, mesenteric, splenic, cerebral, or renal veins.
- Proximal DVT occurs in veins from the popliteal to the iliac veins and leads to 90% of pulmonary embolisms.
- Distal or calf DVT occurs distal to the popliteal vein and is often asymptomatic, rarely leading to pulmonary emboli.
- Superficial thrombosis is not DVT, does not lead to pulmonary emboli.
- Physical exam can reveal swelling, prominent superficial veins, and Homans’ sign (pain on dorsiflexion of the foot).
- Diagnosis can be made with Doppler ultrasonography, Venography, or MRI.
- Treatment involves heparin and warfarin.
- Post-phlebetic syndrome occurs in 10-30% of DVT patients, resulting from loss of deep venous valvular function leading to pain, edema, skin discoloration, and ulceration.
Pulmonary Embolism (PE)
- Untreated DVT results in PE in 30-50% of cases.
- PE is a life-threatening complication of deep vein thrombosis but not arterial thrombosis.
Other Important Information
- Buerger's disease and Atherosclerosis obliterans are mentioned as differential diagnoses for arterial thromboembolic disorders.
- Factor V Leiden, a common cause of venous thrombophilia, is associated with a higher risk of recurrent venous thrombosis and is characterized by resistance to activated protein C.
- The treatment for acute limb ischemia includes anticoagulation, surgical embolectomy, and bypass surgery.
- IVC filters are used to prevent pulmonary emboli in high-risk patients.
- D-dimer is a blood test that can be used to help rule out deep vein thrombosis, but it is not a definitive diagnostic test.
- The text highlights the importance of early diagnosis and treatment of thromboembolic disorders.
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Description
Test your knowledge on thromboembolic disorders, focusing on the differences between arterial and venous types. This quiz covers the causes, manifestations, and signs related to these important medical conditions. Challenge yourself with questions on acute and chronic arterial emboli and their effects on various organs.
