Question Bank – DVT (Basic)

What the sensitivity and specificity of POCUS for the diagnosis of DVT?

Does this patient have a DVT?

As you are scanning down the distal thigh towards the knee, which techniques are most helpful to be able to visualize the femoral vein as it courses deeper toward the bone?

You are seeing an uninsured patient with leg edema, faint erythema, and tenderness with a moderate pre test probability for a DVT. Above is clip of their common femoral vessels in the patient’s right inguinal area. What is the best next step for this patient?

In addition to compression, color and pulse wave doppler are necessary to rule in or out the diagnosis of lower extremity DVT.

What medications are indicated for this patient with leg swelling? (This scan is being done behind the patient’s knee)

You are unable to visualized the deep veins with a linear, high-frequency probe in a patient with a BMI of 35 who you suspect may have a DVT. The next best step to evaluate this patient would be?

Sometimes you have to exert some force with the probe to see if the vein will collapse, especially for fluffier or for more musclebound patients. How do you know how hard is hard enough to compress for either a positive or negative POCUS DVT scan?

If you have having difficulty visualizing the common femoral vessels when scanning the inguinal area, what position change can help?

What landmark is the most important to see in the inguinal area of the DVT exam? The exam of this area shown below suggests:

When you are scanning the popliteal area from behind the knee crease, which vessel is typically on top (closest to the probe)?  This scan of the popliteal region suggests what finding?

True/False.  It is adequate to scan the lower extremity venous at two points, the femoral and the popliteal veins, in order to rule out DVT.

Identify the structure highlighted below in the popliteal fossa:

Identify the structure highlighted below in the popliteal crease

Identify the structure visible below in the popliteal crease:

Identify the saphenous vein (Images obtained from the right goin):

A)

B)

C)

D)

Identify the Femoral Vein (Image obtained from below the R inguinal Ligament):

A)

B)

C)

D)

Identify the structure highlighted below (Image obtained below the Right Inguinal Ligament):

A 35 year old female presents to your clinic with unilateral leg pain and swelling.  An ultrasound of the painful leg is performed to evaluate for a deep venous thrombosis.  The highlighted image below is non compressible.

What is the appropriate next in management?

A 48 year old female presents to your clinic complaining of leg pain and swelling.  She recently returned 3 days ago after going on vacation to South Africa (a 13 hour plane ride).   You perform a bedside ultrasound that shows the following:

Right popliteal fossa

What is an appropriate next stop in management?

A 65 year old male underwent an open reduction external fixation orthopedic surgery after fracturing his right hip 2 weeks ago.  He is seen in clinic for a follow up appointment and noticed that his right leg has been more swollen than usual.

A bedside ultrasound in clinic is performed and shows the following finding from the right popliteal fossa:

What is the most appropriate next step in management?

A 57 year old male with a history of homelessness and chronic alcoholism presents complaining of pain and swelling in his legs, primarily his left leg.  He says his legs are always swollen because he has a hard time elevating them.  He has no history of shortness of breath, orthopnea, or exertional dyspnea.  You perform a bedside ultrasound of the left leg to evaluate him for a deep venous thrombosis.

Based on this ultrasound below the left inguinal canal, what is the next appropriate step in management?

A 73 year old female presents to your clinic with pain radiating from her right gluteus down her right leg. She also noticed that the leg appears slightly more swollen. On her exam, the legs appear symmetric. The patient also reports she was treated for a deep venous thrombosis over 10 years ago which she developed after having hip surgery.

You perform a bedside ultrasound that shows the following finding:

What is the most appropriate next step in management for this patient?

You are seeing a patient with unilateral leg swelling, erythema, and pain and a pre test probability of 5%. Your POCUS is negative for a DVT. What is the post test probability for a DVT in this patient?

DVT in this compression ultrasound of the right leg is?

A 24 year old male presents 10 days post-operatively from tibial plateau fracture repair. The following 2D, non-compression sweep shows?

A 33 year old patient presents with severe edema of both of her legs which are also somewhat erythematous. She has chronic stasis edema. A DVT scan is performed and is noted to be?

A 55 year old female presents with posterior knee pain and swelling after a long car trip. A DVT scan of this region is

A 75 year old female with severe knee osteoarthritis and a history of Baker’s cyst presents due to worsening posterior knee pain. She is concerned about a clot. A DVT scan of this region is

A 45 year old female 4 days post operatively from total hip replacement for avascular necrosis presents with leg swelling and pain. A DVT scan of this region is

In the popliteal region, what vessel is marked by the yellow arrow?

In the popliteal region, what vessel is marked by the yellow arrow in this clip in this patient with a high body mass index?

This clip demonstrates which of the following?

DVT in this compression ultrasound of the left leg is?

Compression ultrasound at the level of the popliteal trifurcation here is?

A compression ultrasound is performed in the groin in a patient with swelling in this area. The yellow arrow marks which of the following?