deep vein thrombosis up to date cover all things

1. DVT Deep venous thrombosis) ) By Dr- Hayam M. AL-moutary Supervised by Dr-Abdulla AL-goblain

12. Phlegmasia cerulea dolens

14. DVT

18. Score (wells score) Clinical Parameter Score +1 Active cancer (treatment ongoing, or within 6 mo or palliative) +1 Paralysis or recent plaster immobilization of the lower extremities +1 Recently bedridden for >3 d or major surgery <4 wk +1 Localized tenderness along the distribution of the deep venous system +1 Calf swelling >3 cm compared with the asymptomatic leg +1 Pitting edema (greater in the symptomatic leg) +1 Previous DVT documented +1 Collateral superficial veins (nonvaricose) -2 Alternative diagnosis (as likely or greater than that of DVT)

19. Wells score Total of Above Score > 3 High probability 1 or 2 Moderate probability < 0 Low probability

25. Duplex ultrasonography

32. Bilatral thrombosis

33. High clinical pretest probability- DVT likely Doppler ultrasound Ultrasound positive for DVT Diagnoses of DVT confirmed Begin treatment Ultrasound negative for DVT D-Dmer test (if available and reliable) Otherwise skip to repeat ultrasound D-Dimer positive Repeat ultrasound in 1 week D-Dimer negative DVT ruled out Repeat ultrasound positive for DVT Diagnoses of DVT confirmed Begin treatment Suspect DVT Low clinical pretest probability- DVT likely Consider starting with D-dimer test first (if available and reliable ) Or skip to ultrasound D-dimer positive D-Dimer negative DVT ruled out Doppler ultrasound Ultrasound positive for DVT Diagnose of DVT confirmed Begin treatment Ultrasound negative for DVT DVT ruled out (consider repeat ultrasound if D-dimer not available)