Deep Vein Thrombosis in the ED Case 1

  1. 1. Question

    A 37-year-old woman presents to the Emergency Department on a weekend. She has just returned from a holiday to New Zealand and is complaining of a painful swollen calf. After her holiday, she resumed her fitness regime of daily runs and thinks it could be related to this. She reports that she is normally fit and well.

    The affected calf has a 3.5cm greater circumference than the unaffected calf.

    You can perform a full risk stratification based on the two-level Wells Score using this information – True or False?

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  2. 2. Question

    On further questioning, you establish that she has no further historical risk factors for VTE. On further examination she is found to have tenderness associated with the deep venous system but, other than the difference in calf circumference, no other abnormal physical findings.

    What is her two-level Wells Score?

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  3. 3. Question

    Which would be the most appropriate next investigation for this lady?

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  4. 4. Question

    She has a duplex ultrasound and this confirms the presence of a popliteal DVT for which you recommend that she starts anticoagulation.

    Choose which of the following statements are true:

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