basic science
Venous Thromboembolism and Prophylaxis
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 68-year-old male is scheduled for elective total hip arthroplasty for osteoarthritis. His past medical history includes hypertension, type 2 diabetes, and a previous DVT in the contralateral leg 5 years ago following immobilization for an ankle fracture. He is on aspirin 100mg daily. BMI is 32. He asks about blood clot prevention after surgery.
Clinical image for Venous Thromboembolism and Prophylaxis
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
Describe Virchow's triad and explain how orthopaedic surgery contributes to each component.
Question 2 (5 marks)
What are the risk factors for VTE? How do you stratify patients for thromboprophylaxis?
Question 3 (6 marks)
What are the options for VTE prophylaxis? Compare mechanical and pharmacological methods.
Question 4 (5 marks)
Discuss the pharmacological agents for thromboprophylaxis. Compare their mechanisms, dosing, and evidence.
Question 5 (4 marks)
How long should prophylaxis continue? What are the current guideline recommendations?
Question 6 (4 marks)
How would you manage VTE prophylaxis in this patient? What are the considerations?