What are among the most

prevalent medical conditions worldwide?

Acute and chronic venous

diseases and their complications

List the risk factors for DVT

(7 major ones)

Definition:

 Elements that are thought to indicate a tendency in an

individual toward the developement of a disease.

What surgeries have the highest incidence of DVT?

 What is the rate?

Hip or knee replacements

 50%

Pain

Swelling

Tenderness

Temperature

Color changes

Venous Ulcers

Located in the calf,

dull aching pain that may be intense,

may be relieved by elevation

Usually in the calf:

Brawny

Spongy

Pitting

Non-compressible

What is the percentage of people with silent DVT's?

T or F

 A SVT is benign and self limiting and doesn't usually progress to a DVT.

False

benign and self limiting but CAN progress to a DVT

T or F

 Inflammation, pain, tenderness are signs and symptoms of SVT or Thrombophlebitis

What is a sign or symptom of a SVT/Thrombophlebitis?

 A) Redness

B) Palpable cord

C) Pallor

D) A and B

T or F

SVT is always associated with a PE

Accurate

Reproducible

Safe (non-invasive)

T or F

For venous studies the patient should be laying flat on the table.

At what degrees should the head be elevated?

A) 30-45

B) 5-10

C) 15-20

D) 0

1. locate vein in transverse

2. Intermittent compressions w/enough pressure to coapt vein walls

3. repeat moving distally one probe width at a time

Vein walls will not coapt

May be partially or fully non-compressible

Echogenicity may or may not be present

T or F

 It is okay to do compressions of the vein in long axis.

What type of thrombus - acute or chronic - are the following associated with?

Lightly echogenic

Attached firmly

May be floating in the lumen

Contraction of the vein

Spongy texture

Collateral channels

Acute

Chronic

Acute

Chronic

Acute

Chronic

What type of thrombus - acute or chronic - are the following associated with?

Brightly echogenic

Rigid texture

Poorly attached

Vessel Dilatation

Irregular borders

Smooth borders

Chronic

Chronic

Acute

Acute

Chronic

Acute

T or F

Flow may not be spontaneous in the small veins

T or F

 During Inspiration thoracic pressure increase and venous flow decreases.

False

Abdominal pressure Increases

Thoracic pressure decreases

Venous flow decreases

 T or F

 During expiration abdominal pressure decreases and thoracic pressure increases.

What happens to venous flow?

True

Abdominal pressure decreases

Thoracic pressure increases

Venous flow increases

Opposite

Inspiration - UE venous flow increases

Expiration - UE venous flow decreases

Name the type of flow

[image]

Where is the obstruction?

Continuous,

Proximal to location of probe.

What are the different Valvular competency test methods?

T or F

 In normal veins, flow speeds up with compression and diminishes when compression is released.

What does the following image show?[image]

Mild

Moderate

Severe

Clinically significant

T or F

 A patient's respiratory variations can make a thorough venous exam difficult or even impossible.

T or F

 It is not necessary to look at a patient's chart to determine if any respiratory problems exist.

Cheyne-Stokes

Ventilators

Seizures

T or F

Significant hypoxia always occurs in patients with Cheyne-Stokes respirations.

What type of patient can you often see Cheyne-Stokes respirations?

 A. Coma

B. Athletes

C. CHF

D. Pregnant women

E. A & C

E. A & C.

CHF patients or Coma patients w/diseased nervous centers of respiration.

T or F

 In most cases, venous compression is possible between ventilator cycles

T or F

The action of the ventilator makes venous compression easier.

False,

makes venous compression nearly impossible and very difficult

What is the best way to proceed with a venous exam if the patient is having seizures?

A. Strap them down to hold them still

B. Call in some help to hold the patient

C. Do the best, possibly reschedule

T or F

 It is not necessary to document respiratory changes/conditions on the patient history and preliminary report.

For venous duplex what is the sensitivity for DVT?

 A. 40-45%

B. 15%

C. 75-81%

D. 93-97%

D. 93-97%

Very reliable

For venous duplex, what is the specificity of normal?

 A. 20-23%

B. 95-99%

C. 60-63%

D. 85-90%

What are some differential diagnosis for the signs of DVT that can be identified during the ultrasound exam?

(There are 9 in our notes)

Popliteal (Baker's cyst)

Hematoma

Post-phlebitic syndrome

Adenopathy

Lymphedema

Cellulitis

CHF

Neuromuscular Problems

Inflammation

enlargement of the synovial membrane.

Causes compression of the vein with pain and swelling.

What is an extrinsic compression on the venous system with venous distention, continuous flow that could lead to secondary DVT?

 A. Hematoma

B. Muscle

C. Insufficient valve

DVT is no longer present but the damage has been done, leading to venous reflux. What is this?

What differential diagnosis is defined as 'enlargement/swelling of the lymph nodes'?

A. Lymphedema

B. Adenopathy

C.Hematoma

D. Ascites

T or F

 In the absence of detectable lymph node enlargement, specific sonographic findings will point to lymphedema.

False.

No specific sonographic findings point to lymphedema in the absence of detectable lymph nodes.

T or F

 Sypmtoms closely mimic that of acute DVT and venous duplex is commonly ordered to differentiate.

1. Inability of the heart to pump blood (Rt heart failure) leading to back pressure in the venous system. Shows as tissue edema and leg swelling.

2. Fluid overload, from possible renal failure

What type of flow is this?

[image]

T or F

 CHF is associated with unilateral symptoms and SOB.

T or F

 Fluid accumulation associated with CHF can be visualized in the subcutaneous areas.

T or F

Venous duplex is not often ordered to rule out DVT for CHF patients.

T or F

DVTs can originate anywhere in the venous system

Where do DVT's initially originate?

A. Arteries

B. Lungs

C. Vein sinusoids (behind valve cusps)

D. Capillaries

What locations in the legs are thought to be the most common origin site for LE DVT?

A. Soleal Sinuses

B. Gastrocnemius vessels

C. GSV

D. SSV

Non-obstructive

Obstructive

Acute Venous Obstruction

Chronic Obstruction

Define Insufficiency

Relate it to venous insufficiency

The condition of being inadequate for a given purpose.

VI: an impaired or inadequate ability to move blood out of the leg.

Define Incompetence

Relate it to valvular incompetence

Inadequate ability to perform the function or action normal to an organ or part.

VI: Inadequate ability of a vein valve to perform the function of one way flow.

Define reflux

Relate it to venous reflux

A return of backward flow

VR: leakage or significant backward venous flow.

Which of the following are not related to a non-obstructive DVT?

 A. Clot resolves & causes minimal vein damage

B. Recanalization may occur to allow flow

C. May extend to become obstructive

D. Free Floater

T or F

A non-obstructive clot can become an obstructive clot.

Which is not associated with obstructive DVT?

A. Free Floater

B. Clot attaches to wall

C. Over time clot contracts pulling vein in

D. Vein valves are often destroyed and non-functional

T or F

 In Acute venous obstruction, symptoms may not appear because of sufficient collaterals.

Why might the symptoms associated with acute venous obstruction diminish with time?

1. The clot undergoes fibrinolysis

2. The clot undergoes organization and becomes smaller (clot retraction)

Venous claudication

Phlegmasia alba dolens

Phlegmasia cerulea dolens

Free floating tail embolism

What is the term for the following definition?

When a patient exercises and oxygenated blood is not available to the muscles, due to poor venous drainage, there is pain.

Where is the acute DVT usually located when a patient presents with phlegmasia alba dolens?

T or F

 Acute DVT leading to phlegmasia cerulea dolens is mild.

T or F

 Phlegmasia cerulea dolens can lead to venous induced gangrene

Systemic Arterial Hypoxemia

&

Pulmonary Embolism

T or F

 A pulmonary embolism is not life threatening.

What percentage of above knee thrombus end in Pulmonary embolisms?

 A. 5%

B. 50%

C. 70%

D. 99%

T or F

 There is a direct relationship between the size of the embolus and the percutaneous O₂ levels.

What complication of Acute DVT are the following related to?

1. Blood fails to reach the pulmonary capillary bed

2. Oxygenation is impaired

3. Decreased percutaneous O₂ levels

Which of the following is not a symptom of PE?

A. Pleuritic pain

B.Tachypnea

C. Apprehension and Anxiety

D. Fainting

E. Non-productive cough

What is the complication of a PE?

What is this due to?

Pulmonary Hypertension

Due to increased resistance in the pulonary circuit, leading to higher workload on the right heart and increased venous back pressure.

T or F

 A massive emboli may cause sudden death when the larger pulmonary arteries are involved.

Chest X-Ray

VQ Scan - Nuc Med (gas or injection)

Pulmonary Angiography - contrast + x-ray

Vein lumen is small and flow is directed toward the center,

Thrombus adheres to the wall and becomes fibroelastic.

Pattern of resolution varies.

What are the clinical manifestations of chronic DVT?

Postphlebitic Syndrome

Chronic Venous insufficiency

Swelling

Venous dilation

Leg pain

Hyperpigmentation

Venous stasis ulcers

T or F

 With progression of the venous insufficiency, the superficial veins do not change.

How is leg pain usually described with chronic DVT?

Upon standing?

Dull Ache with heaviness.

pain or leg fullness upon standing

Describe the process of hyperpigmentation.

What kind of dermatitis is this associated with?

High pressure in venous system forces RBC out of capillaries and into interstitial spaces. Dying RBC metabolize the iron ion which causes the brown discoloration.

Scaling dermatitis

Caused by postphlebitic syndrome,

high capillary pressure forces fibrinogen into interstitial tissue where it becomes fibrin.

Fibrin prevents proper nutrition and oxygenation of tissues.

Describe a venous ulcer.

Dry or wet?

Painful or not?

Regular or irregular borders?

Granulation bed?

Inflammation?

Usually weepy and bleed easily (wet)

Very painful

Irregular borders w/moist granulating base

surrounded by a zone of inflammation.

When is the D-Dimer test used?

A. When testing for anemia

B. Patients present w/positive venous signs and symptoms

C. To visualize the deep veins of the legs

D. To prove insufficiency

What are the pros of using the D-Dimer test?

A. Minimally invasive

B. Relatively inexpensive

C. Performed quickly

D. All of the above

Which of these 4 is not another name for Venography?

 A. Phlebography

B. Contrast venography

C. Ultrasound Angiography

D. Ascending venography

C.

T or F

Contrast Venography is not an invasive method to detect DVT?

T or F

 Contrast Venography was replaced by Venous Duplex due to the higher sensitivity and specificity rates and non-invasive nature.

T or F

 During contrast venography the patient stands on the affected foot while contrast media is injected into a superficial vein of the foot and progress of the dye is monitored by image intensified fluoroscopy

What images are taken with the venography table at 45-60^o?

A. Frontal poplitieal

B. Frontal Thigh

C. AP Oblique calf

D. AP lateral calf

E. Both C & D

What venography views are taken with the table tilted at 30-45^o?

A. Lateral popliteal

B. Frontal popliteal

C. Oblique popliteal

D. Frontal Thigh

E. Both B & C

What venography views are taken with the table tilted at 15-30^o?

A. Frontal Thigh

B. Frontal popliteal

C. Oblique popliteal

D. Lateral popliteal

What view is taken while the table is horizontal and the patient performs the valsalva maneuver?

A. Oblique Thigh

B. Iliocaval

C. Frontal popliteal

D. Frontal Calf

T or F

 More than one injection of contrast is possible to focus on problem areas.

T or F

Results of a contrast venography will visualize all deep and superficial veins of the leg that are in continuity with the injections site.

T or F

PFV is not visualize beyond the first competent valve in contrast venography.

T or F

The Internal Iliac Vein is not visualized.

T or F

 Normal veins appear rough and tortuous in the venous contrast images.

T or F

Veins of the calves, because they are paired, must be visualized from a variety of views when interpreting contrast venography.

Presence of a constant filling deficit demonstrable on more than one view is a  ___________ result in contrast venography of an intraluminal clot.

A. Positive

B. Negative

How does the contrast look in venography when there is a freely floating, partially attached thrombus?

A. Stops abruptly

B. Looks central or eccentric

C. Terminates as a tail extending toward the head

D. presence of collateral veins w/contrast

D. B & C

E. All of the above

How does the contrast look in venography when there is a DVT?

 A. Stops abruptly

B. Looks central or eccentric

C. Terminates as a tail extending toward the head

D. presence of collateral veins w/contrast

D. A & D

E. All of the above

If positive results of contrast venography are suggestive of a massive DVT, what is the next step?

A. Remove tourniquet to determine collateral flow

B. Surgery

C. Duplex ultrasound

D. Nothing

T or F

Contrast venography is unsurpassed in its "map" of the venous system when performed and interpreted properly and interpretation of the contrast venography always has high diagnostic accuracy.

What are the 2 pitfalls of venography?

A. Poorly mixed contrast/blood, looks like filling defect

B. Great map images of the deep venous system

C. hard on the patient

D. Inexperience and poor technique

E. Both A & D

What is descending venography used to determine?

What is the nuclear medicine test called using IV injection of ⁹⁹Technetium?

When are pictures taken for the AcuTect test?

A. 5 min after injection

B. 30 min after injection

C. 1 hour after injection

D. Several hours after injection

E. B & D

What are the AcuTect limitations?

 A. Pregnancy

B. Breast feeding

C. Chronic clot

D. All of the above

Normal Veins are not _________ ________; are able to accomodate __________ blood volume and have _______ outflow.

A. completely filled, decreased, rapid

B. ever filled, increased, slow

C. completely filled, increased, rapid

D. always empty, increased, slow

With a venous obstruction pressure is ________, volume is _________, capacitance is ______, and emptying is _________.

A. elevated, increased, maximal, slower

B. elevated, decreased, maximal, rapid

C. lowered, increased, minimal, slower

D. lowered, decreased, minimal, rapid

What are 3 methods of venous insufficiency?

Congenital

Passive Dilation

Vavle dysfunction from direct damage

Destroyed valve cusp

Perforated cusp

"Frozen" and thickened valve cusp

Adherent valve cusp w/thickening

Tricuspid vavle

Avalvular duplication conduit

duplication conduit w/refluxive valves

Duplication of the valve with an intervening septum

Duplication of the valve w/o an intervening septum

Refluxive monocuspid valve

What mechanism is described below?

Physiological changes associated with DVT in the deep veins destroying valves and allowing blood to flow downward through incompetent valves.

T or F

 Most varicose veins are of secondary cause.

T or F

 Primary varicose veins demonstrate stasis and are at risk for development of superficial thrombophlebitis.

T or F

Many cases of SVT develop on a background of secondary disease.

What vein connects the SSV and the GSV?

What is another name it is known as?

Vein of Giacomini

AKA: Intersaphenous V.

T or F

The strength of reflected signal in PPG is proportional to the amount of RBC's in circulation.

T or F

 Photoplethysmography is a true plethysmographic technique measuring volume, not reflection.

In PPG, after baseline is established, what is the patient then instructed to do?

A. Flex arms

B. Flex thighs

C. Swing legs back and forth

D. Dorsiflexion 5 times

Dorsiflexion activates the _____ and _______ the volume of blood in the patient's leg?

A. Immune response, decreases

B. calf muscle pump, increases

C. arterial flow, reduces

D. Calf muscle pump, reduces

What does the following define?

Number of seconds required for post exercise recovery curve to achieve stable baseline after dorsiflexion.

What venous recovery time indicates valve incompetence (reflux)?

A. < 23 sec

B. > 23 sec

C. < 46 sec

D. none of the above

T or F

 During a PPG test a tourniquet can be applied to distinguish between deep and superficial incompetence.

If VRT is abnormal without tourniquet but normal with it, what does this indicate?

A. Superficial valves are competent

B. Deep valves is incompetent

C. Superficial valves are incompetent

D. Superficial valves are normal

If VRT is < 23 sec w/and w/o tourniquet proves what?

A. All systems are normal

B. Deep system is normal, superficial is incompetent

C. Deep = incompetent, superficial incompetency cannot be determined

D. Deep and superficial systems are incompetent

What classification of venous insufficiency manifests as mild ache and swelling with a VRT of 20-23 sec?

 A. Grade III

B. Grade I

C. Grade II

What classification of venous insufficiency manifests as mod-severe swelling, leg heaviness, & skin pigmentatin with a VRT of 10-20 sec?

A. Grade III

B. Grade I

C. Grade II

What classification of venous insufficiency manifests as severe swelling & skin discoloration, leg pain, & ulcer with a VRT of < 10 sec?

 A. Grade III

B. Grade I

C. Grade II

What are the disadvantages of PPG?

A. Improper placement of sensor, thick skin, non-intact skin.

B. Too much patient movement

C. muscle contraction artifact

D. specific incompetent valves are identified

What type of test does the following describe?

A quantitative method of evaluating lower extremity volume changes in relation to gravity and exercise.

What are the 4 calibrated way to measure lower extremity volume changes?

Calf venous volume

Rate at which calf venous volume fills

Calf muscle pump effectiveness

Ambulatory venous pressure

What is the first position the patient is placed in for APG and what is recorded?

 A. Standing, venous baseline

B. Supine w/leg at 45^o, max venous emptying

C. Calf raises, venous volume

D. Supine w/leg straight, venous refill time

When patient is quickly brought from supine to standing position (w/weight on opposite limb) what is being recorded?

 A. Venous refill time

B. Venous outflow

C. functional venous volume

D. none of the above

What is used to get venous filling index (VFI)?

A. 90%VV/VFT90%

B. VV/VFT

C. (VV/VFT)x100%

D. None of the above

What venous filling index indicates normal valvular function?

 A. > 7 mL/sec

B. < 7 mL/sec

C. > 5 mL/sec

D. < 2 mL/sec

What venous filling index is consistent with deep and/or superficial valvular incompetence?

A. > 7 mL/sec

B. < 7 mL/sec

C. > 5 mL/sec

D. < 2 mL/sec

What do calf raises do and how is venous volume affected?

 A. activates calf muscle pump, inc VV

B. activates calf muscle pump, dec VV

C. inactivates calf muscle pump, inc VV

D. none of the above

T or F

 The ejection volume measures the decrease in venous volume achieved with one calf exercise.

What % represents normal calf muscle pump function?

A. > 35%

B. < 10%

C. > 75%

D. < 35%

What are 2 benefits of APG testing?

A. evaluate benefit of surgical intervention

B. evaluate effect of noninvasive therapeutic (support stockings) measures

C. all the above

D. none of the above

What are the disadvantages of APG?

A. Improper placement of sensor, thick skin, non-intact skin.

B. Requires extensive patient cooperation moving from one position to the next rapidly

C. muscle contraction artifact

D. specific incompetent valves cannot be identified

E. B, C, D are all disadvantages of APG

E. B, C, D are all disadvantages of APG

T or F

Venous ulcers are usually lateral near the ankle and bleed easily.

T or F

Large pulmonary obstructions usually resolve spontaneously.

Acute venous obstruction that is high in the thigh may lead to:

A. Venous claudication

B. Phlegmasia alba dolens

C. Phlegmasia cerulea dolens

D. All of the above

T or F

Post-phlebitic syndrome results from venous insufficiency

Secondary effects of pulmonary embolus may be:

A. Pulmonary Hypertension

B. Increased workload for left side of heart

C. Pulmonary edema

D. evidence of post-phlebitic syndrome

Venous hypertension MOST often results from:

A. Deep Venous reflux

B. Valvular sufficiency

C. Pulmonary Embolism

D. Systemic Arterial Hypoxemia

Symptoms of PE would include:

A. Dyspnea

B. Pleuritic Pain

C. Tachypnea

D. Hemoptysis

E. All of the above

Which of the following best describes dyspnea?

A. Fast breathing

B. Difficulty breathing

C. No breathing

D. none of the above

T or F

When a person is suspected of having a pulmonary embolism, it is not likely that a Duplex exam will be ordered.

Diagnosis of a PE can be made by:

A. VQ Scan

B. Pulmonary Angiography

C. Chest X-ray

D. AcuTect

E. All of the above EXCEPT D

Characteristics that suggest acute thrombus rather than older thrombus include all except:

A. Poorly Attached, floating in the lumen

B. Smooth borders, spongy texture

C. Bright, heterogeneous echoes within the lumen

D. Vessel dilatation

T or F

A patient can get post-phlebitic syndrome from a current DVT.

T or F

A patient cannot display valvular incompetencee unless a DVT is present.

T or F

Patients can have venous insufficiency because of valvular incompetence.

T or F

When placing a tourniquet around a limb to test for valvular incompetency the deep veins are occluded.

D-Dimer titers detect increased ________ particles.

A. Fibrinogen

B. Plasmin

C. Fibrin

D. Hemeglobin

Air plethysmography requires the patient to be placed in the _______ position.

A. Horizontal

B. Supine

C. Reverse Trendelenberg

D. None of the above

Indirect methods of venous testing ______ presence of DVT.

A. Prove

B. Show

C. Disprove

D. Indicate

T or F

If the VRT is >20 sec with & without a tourniquet you can conclude that the deep system is incompetent.

T or F

Abnormal PPG recovery time with the use of a tourniquet indicates the superficial valves are cometent.

T or F

A problem with most APG techniques is that artifacts are produced when the patient cannot perform the proper muscle contraction exercises.

Which of the following statements best describes APG testing?

A. A means to measure volume increase in the lower extremities

B. An invasive method using contrast media

C. Screening test to detect plasmin-lysed fibrin

D. Use of a light emitting diode to measure volume changes

An advantage of venous plethysmography is:

A. It is very good at detecting the location of thrombus

B. Thick skin allows for adequate penetration of infrared light.

C. Requires little assistance from the patient

D. None of the above

Venous plethysmographic testing records the calf volume findings on:

A. Paper

B. Disk

C. Film

D. Strip chart

PPG utilizes:

A. Cuff device placed around the ankle

B. tiptoe movements to test venous residual volume

C. An infrared light emitting diode

D. Reverse Trendelenberg position

Which of the following plethysmographic instrumentation might you see in use today in a vascular lab?

A. D-Dimer

B. AcuTect

C. Photo- and air plethysmography

D. MRI

T or F

PPG detects actual volume changes and does not detect the presence of red blood cells under the probe.

T or F

An elevated D-Dimer cannot be used alone to make a diagnosis.

T or F

D-Dimer testing will eventually replace Duplex exams as the venous Gold Standard

When testing with PPG to determine superficial or deep venous insufficiency with no tourniquets, abnormal results might indicate:

A. the need to utilize a tourniquet to be able to differentiate.

B. Use a pressure cuff

C. Do no further testing

D. None of the above

A short venous refill time (< 20 sec) detected on PPG exam can be a result of:

A. No problems

B. DVT

C. Thrombus

D. Venous reflux

The best definition of varicose veins would be:

A. Abnormally dilated and tortuous deep veins

B. Smooth superficial veins

C. Abnormally dilated and tortuous superficial veins

D. Veins with brightly echoing walls

Primary varicose veins could occur:

A. Secondary to a congenital deficient valve

B. Secondary to PE

C. Secondary to normal valve

D. None of the above

Which of the following is a defining characteristic of secondary varicose veins?

A. Congenitally deficient vein valves

B. Incompetent and dilated perforators

T or F

At one time contrast venography was regarded as the "Gold Standard" for the detection of DVT in the lower extremities.

T or F

Venographic characteristics of acute DVT is radically different than on Duplex.

T or F

AcuTect is performed in the vascular lab to diagnose DVT

T or F

AcuTect binds to the surfaces of activated platelets and is therefore a good indicator of chronic venous thormbosis.

T or F

Radioactive markers are placed on the patient during contrast venography

T or F

When a filling deficit is found with contrast venography, only one view is needed to verify that DVT is present.

As contrast media moves up the leg in contrast venography, a DVT will appear as:

C. A contrast filling deficit

When a contrast venography exam is performed and there is lack of contrast in the entire deep system from multiple views, this is suggestive of:

A. Massive presence of DVT

Which of the following PPG traces would be indicative of normal VRT?

[image]

A. RT = 24 sec

B. RT = 6 sec

The following PPG exam was completed on a 32 year old female patient.  The top strip recording was a result with no tourniquet application and the bottom was with tourniquet.  What can you interpret?

[image]

A. Deep vein incompetency

B. Superficial vein incompetency

C. Both A & B

T or F

Patients with Grade III venous insufficiency would present with symptoms of pain and swelling with a VRT of >20 sec.

T or F

Patients with Grade I venous insufficiency would experience VRT of <10 sec.

T or F

When performing APG, maximum venous emptying occurs after the patient has completed a series of 10 toe-ups.

T or F

APG is routinely performed in all vascular labs across the nation.

T or F

When conducting testing with APG, a VFI of greater than 7 ml/sec is desirable.

Elevation

Mechanical Pedaling

Pneumatic Devices

Elastic compression

T or F

Patients who are mobile have increased incidence of thromboembolism

Passive dorsiflexion of the foot during surgery to reduce incidences of DVT describes what type of stasis prevention?

A. Pneumatic Devices

B. Exercise

C. Mechanical Pedaling

D. Elevation

Multiple diaphragm cuff fitting the whole calf with an air pump at the foot of the bed describes what type of stasis prophylaxis?

A. Pneumatic Devices

B. Exercise

C. Mechanical Pedaling

D. Elevation

Stockings, with max compression at the foot and minimal at the thigh, used to collapse the superficial veins and increase flow in the deep system describe what type of stasis preventive measure?

A. Pneumatic Devices

B. Exercise

C. Mechanical Pedaling

D. Elastic compression

What are 4 medications used to help prevent coagulation?

ASA (aspirin)

Heparin

Warfarin (Coumadin)

Lovenox

What type of drug is aspirin?

A. anticoagulant

B. antiplatelet

T or F

A patient already being anticoagulated usually is also on ASA

What are complications of ASA use?

A. Leukocytopenia

B. Thrombocytopenia, gastrointestinal bleeds

C. anemia, hemophilia

D. lymphocytopenia

What is one of the most widely used drug for vascular patients?

A. ASA

B. Coumadin

C. Heparin

D. Lovenox

T or F

When given in adequate amounts heparin prevents formation and/or extension of thrombi.

T or F

In prophylactic measures, the loading and maintenance doses are unequal.

How long is Heparin therapy maintained for?

A. 1-2 days

B. 2 weeks

C. 3-5 days

D. 5-7 days

 T or F

The patient's anticoagulant response must be closely monitored to avoid complications during heparin therapy.

T or F

Coumadin is probably long term treatment.

T or F

Coumadin is an oral anticoagulation with Warfarin.

T or F

An effective dose of Coumadin prevents clotting without bleeding complications.

T or F

Patients with DVT/PE may require long term therapy to prevent recurrent disease.

After the first episode of DVT/PE what is the minimum treatment length?

A. 1 month

B. 7-9 months

C. 1 year

D. 3-6 months

T or F

With recurring episodes, other risk factors indicate indefinite Coumadin therapy.