Question

A 58-year-old woman attends the GP with a 2-day history of a painful swollen calf after a long-haul flight. She is otherwise well. Wells score suggests ‘DVT likely’. According to NICE guidance, what is the most appropriate immediate step in primary or ambulatory care?

Accepted Answer

Arrange a proximal leg vein ultrasound scan within 4 hours and offer interim anticoagulation if scan is delayed

Answer

Request a D-dimer test alone and await the result before any treatment

Answer

Reassure her and review in 1 week

Answer

Prescribe aspirin alone and no imaging

Answer

Refer for routine outpatient ultrasound in 6 weeks

Practice question

A 58-year-old woman attends the GP with a 2-day history of a painful swollen calf after a long-haul flight. She is otherwise well. Wells score suggests ‘DVT likely’. According to NICE guidance, what is the most appropriate immediate step in primary or ambulatory care?