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Patient A.B. is a 70-year-old male who had a right total knee replacement done yesterday. His past medical history includes osteoarthritis, hypertension, high cholesterol, diabetes mellitus, and GERD. During your initial shift assessment, the patient is noted to have swelling in his right calf and reports tenderness to touch in the calf region. You ask him to dorsi/plantar flex his right foot against resistance from your hand, and he indicates that the pain in his calf worsens with flexion. You suspect the patient has a DVT.

Patient A.B. is discharged home the next day with prescriptions and instructions. A few days later, he is re-admitted to the Emergency Department with complaints of shortness of breath and chest pain when taking deep breaths.

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Answer #1

The patients is a case of pulmonary embolism

The source of the emboli is a deep vein thrombus formed during the operation.


1.Signs and symptoms of DVT

pain in legs and walking

reddish colouration of legs

2.Medications to be used are :

Heparin dose by weight

warfarin for initial days

low molecular weight heparin

Use of inferior venacaval filters during surgery

3.investigations to be done are

Duplex scan

chest xray

see for signs mosses test

4.Pathophysiology of Dvt

Dvt is a thrombus formed in the deep veins of legs.

etiolgy :: after major accident

Prolonged immobilisation

After major pelvic surgery

After trauma/road accidents

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