Test your knowledge on venous thromboembolism

Read the article on diagnosing venous thromboembolism then answer these three questions to check your understanding. You may want to document your answers and any learning points to save in your CPD folder along with the article.

Read our clinical feature on how to diagnose venous thromboembolism

Question 1
Question: D-dimer can be used to exclude venous thromboembolism in any patient suspected of having the disease.  True or false?

Answer: False.  A normal D-dimer will only exclude DVT or PE in patients who score a low clinical probability of the disease.

Question 2
Question: Is the Wells score the only way to assess clinical probability of PE?
Answer: No Clinical probability can be assessed empirically by the doctor giving their estimation of the likelihood that the patient has PE.  There are also several other scores such as the Charlotte score, the Geneva score and the PISA-PED score.
Question 3
Question: If a patient has had a normal ultrasound scan of the leg, DVT has been excluded as a cause of their symptoms.  True or False?
Answer: False. It depends whether the ultrasound scan was a full leg scan (examining all veins in the leg, including the calf veins) or a thigh scan which examined the veins between the groin and popliteal fossa.  If the patient had a thigh scan, they require a second thigh scan in a week’s time to exclude DVT.

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