week 12 Understanding DVTs and Pulmonary Embolism

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Questions and Answers

What is a significant complication of DVTs?

Pulmonary embolism (PE)

What is one of the three elements of Virchow's Triad?

Stasis

What is a condition that increases the risk of DVTs?

Pregnancy

What is a type of pharmaceutical that can be used to prevent DVTs?

Low molecular weight heparin (e.g., enoxaparin) Signup and view all the answers

What is the difference between a thrombus and an embolus?

A thrombus is a stationary blood clot, while an embolus is a clot that has broken loose and is moving through the bloodstream. Signup and view all the answers

What imaging techniques are used to diagnose VTE?

Doppler ultrasound, chest imaging (CTPA or V/Q scan) Signup and view all the answers

What blood tests are conducted to investigate VTE?

FBC, coagulation studies, liver and kidney function, electrolytes, D-dimer Signup and view all the answers

What are the common anticoagulation medications used to treat VTE?

Low molecular weight heparin, intravenous unfractionated heparin, warfarin Signup and view all the answers

Which artery supplies the stomach, duodenum, liver, pancreas, and spleen?

Celiac trunk Signup and view all the answers

What type of aneurysm is characterized by dilation of the entire circumference?

Fusiform Signup and view all the answers

Which artery supplies the pancreas, small bowel, and proximal large bowel?

Superior mesenteric artery Signup and view all the answers

What is the characteristic feature of a saccular aneurysm?

A dilated portion of the artery with a sac-like appearance. Signup and view all the answers

What is a dissecting aneurysm also known as?

A pseudoaneurysm Signup and view all the answers

What is a risk factor for developing an aortic aneurysm?

Atherosclerosis, connective tissue diseases, prior aortic dissection, infection, aortic valve disease, prior aortic surgery, diabetes, heredity, male gender, and age. Signup and view all the answers

What is a risk factor for rupture of an aortic aneurysm?

Large initial aneurysm diameter, current smoking, elevated blood pressure, higher aortic expansion rate, female sex, and presence of symptoms. Signup and view all the answers

What is the surgical threshold for abdominal aortic aneurysms in males?

5.5 cm. Signup and view all the answers

What is the surgical threshold for abdominal aortic aneurysms in females?

5.0 cm. Signup and view all the answers

What are the determining factors of the signs and symptoms of an aortic aneurysm?

Location and size of the aneurysm Signup and view all the answers

What is a common diagnostic test used to investigate an aortic aneurysm?

CT scan with contrast Signup and view all the answers

What is an important consideration in the management of an aortic aneurysm emergency?

Tight blood pressure control Signup and view all the answers

What are the characteristic symptoms of acute limb ischemia?

Pain, pallor, discoloration, mottling, non-blanching skin, paresthesia, and muscle weakness Signup and view all the answers

What diagnostic investigations are used to diagnose acute limb ischemia?

Doppler, ultrasound, angiography, and CT angiography Signup and view all the answers

What are the key components of management in acute limb ischemia?

Vasodilator therapy, identify and treat the cause, maintain limb position below heart level, analgesia, intravenous thrombolytics, anticoagulation, and surgical intervention Signup and view all the answers

Virchow's Triad

stasis: Any situation where blood is not moving properly, such as prolonged immobilization. Endothelial injury/dysfunction: Surgical procedures Hypercoagulabilit Signup and view all the answers

what assessment can help assess the probability of VTE

Simplified Wells score and PERC (Pulmonary Embolism Rule-out Criteria) Signup and view all the answers

Aortic Perfusion

Subclavian and carotid arteries supply the arms and brain. Celiac trunk supplies the stomach, duodenum, liver, pancreas, and spleen. Superior mesenteric artery supplies the pancreas, small bowel, and proximal large bowel. Renal arteries supply the kidneys. Inferior mesenteric artery supplies the distal large bowel. Signup and view all the answers

Aortic Aneurysm management

Surgical repair with graft for ruptured or high-risk aneurysms Signup and view all the answers

Study Notes

DVTs and Pulmonary Embolism

DVTs can lead to pulmonary embolism (PE), a significant cause of mortality
Stasis, endothelial injury/dysfunction, and hypercoagulability are risk factors for DVTs

Risk Factors for DVTs (Virchow's Triad)

Stasis: Prolonged immobilization
Endothelial injury/dysfunction: Surgical procedures, lipid/cholesterol plaque formation
Hypercoagulability: Pregnancy, diabetes, and other conditions

Investigations for DVTs

Bloodwork: FBC, coagulation studies, liver and kidney function, electrolytes, D-dimer
Imaging: Doppler ultrasound, chest imaging (CTPA or V/Q scan)

Treatment for DVTs

Anticoagulation: Low molecular weight heparin, intravenous unfractionated heparin, warfarin
Outpatient management is possible for acute DVT in selected patients

Aortic Anatomy and Aneurysms

Subclavian and carotid arteries supply the arms and brain
Celiac trunk supplies the stomach, duodenum, liver, pancreas, and spleen
Superior mesenteric artery supplies the pancreas, small bowel, and proximal large bowel
Renal arteries supply the kidneys
Inferior mesenteric artery supplies the distal large bowel

Types of Aortic Aneurysms

Fusiform: Dilation of the entire circumference
Saccular: A portion of the artery is dilated (sac-like appearance)
Dissecting (pseudoaneurysm): Dissection of the intimal layer creating a false channel or lumen

Risk Factors for Developing Aneurysms

Atherosclerosis, connective tissue diseases, prior aortic dissection, infection, aortic valve disease, prior aortic surgery, diabetes, heredity, male gender, and age

Risk Factors for Rupture

Large initial aneurysm diameter, current smoking, elevated blood pressure, higher aortic expansion rate, female sex, and presence of symptoms

Abdominal Aortic Aneurysms (AAA)

Rare under 50 years of age
Prevalence rates estimated at 1.3-8.9% in men and 1.0-2.2% in women
Surgical threshold is 5.5 cm for males and 5.0 cm for females

Aortic Aneurysm Symptoms

Severe pain (tearing, sharp, ripping)
Collapse, pulsatile mass, back pain, abdominal pain, cough, dyspnea, stridor, tachycardia, unilateral absence of major pulses, bilateral blood pressure differences, hypertension, hemiplegia, and ischemic limbs

Investigations for Aortic Aneurysms

Chest X-ray, MRI, CT scan with contrast, ultrasound, transesophageal echocardiogram, and angiogram

Management of Vascular Emergencies

Oxygen, large bore IV access, analgesia, tight blood pressure control, treatment of hypovolemic shock, and urine output monitoring
Damage limitation: Vasodilator therapy, identify and treat the cause, maintain limb position below heart level, analgesia, intravenous thrombolytics, anticoagulation, and surgical intervention

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Description

Learn about the dangers of Deep Vein Thrombosis (DVTs) and how they can lead to Pulmonary Embolism (PE), a life-threatening condition. This quiz covers the importance of understanding DVTs and the key differences between thrombus and embolus.