venous pathology part 1

virchow triad

stasis

injury

hypercoagulability

stasis

anything that slows blood down

examples of stasis

surgery

long car/plane ride

pregnancy

bed rest

MayThurner’s syndrome

Rouleau (roll of coins) on ultrasound

so slow you can see RBCs rolling in vein

should be treated as DVT

injury can cause

excess blood clotting

often from central line

hypercoagulable definition

clotting factor too strong or

looting factors too weak

what often causes hypercoagulable state

cancer

pregnancy

COVID

polycythemia ruba vera (too many RBCs)

hereditary factors (factor V)

signs and symptoms of DVT

swelling

heaviness

tenderness

pitting edema

shortness of breath indicates

PE

Bancroft sign

pain when pushing calf against tibia

Homan sign

pain with dorsiflexion of foot

Loewenburg sign

pain with inflated BP cuff

Trousseau’s sign

migratory clot due to cancer

Well’s criteria (look at chart)

criteria to determine risk for DVT

DVT lab test

D-Dimer

negative D-Dimer test =

no DVT

positive D-Dimer =

possible DVT, infection, pregnancy, recent surgery

MayThurner syndrome aka

iliac compression syndrome

MayThurner MC in

postpartum women

MC reason for left leg DVT

MayThurner syndromer

treatment for MayThurner syndrome

stent

Phlegmasia Alba Dolens aka

milk leg

Phlegmasia Alba Dolens

totally occluded DVT

PAD often seen in what people

cancer patients

postpartum

PAD superficial system is _____

open

PAD progresses into ??

Phlegmasia Cerulea Dolens

PCD deep and superficial systems are ______

occluded

difference between PAD and PCD

PAD has an open superficial system

popliteal vein compression

pop vein diameter is reduced by 90% due to obesity

untreated DVT leads to

PE

collaterals

90% of PEs come from ____

leg

DVT treatment

anticoagulants

anticoagulants function

stop growth of clot

anticoagulant examples

Heparin - starts working immediately

Lovenox - subcutaneous - work within hours

oral medications (Coumadin/Warfin, Eliquis, Xarelto) - 3 days to work

thrombolytic agents (Streptokinase, Urokinase, TPA) - dissolve clots (usually emergency)

antiplatelets function

stop blood cells from sticking together

Aspirin

Greenfield filter/IVC filter

catch clots before it gets to the lungs

thrombectomy

surgical removal of thrombus

thrombectomy not done unless clot is

occlusive