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Surgery.(General 2).Vascular > Arterial.7.Vasospastic Disorders and Arteritis > Flashcards

Arterial.7.Vasospastic Disorders and Arteritis Flashcards

1
Q

List Vasospastic Disorders

A
  1. Raynaud’s disease
  2. Raynaud’s phenomenon
  3. Acrocyanosis
  4. Erythromelalgia
  5. Erythrocyanosis Frigida (Bazin’s disease).
  6. Causalgia: Look Neurosurgery
  7. Sudeck’s atrophy : Look orthopedics.
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2
Q

ETIOLOGY of Raynaud’s disease

A

Not exactly known, Certain factors are suggested :

  1. Sensitivity of the small arteries and arterioles of the hands, and less commonly the feet, to cold.
  2. Increased sympathetic tone.
  3. Psychological instability.
  4. The presence of cold agglutinins in the blood which cause agglutination of RBCs on exposure to a low temperature.
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3
Q

DIAGNOSIS of Raynaud’s disease

A

History:

Examination

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4
Q

History in DIAGNOSIS of Raynaud’s disease

A
  1. The disease is bilateral and symmetrical and is much more common in young females, in both hands.
  2. The attacks are precipitated by coldness or emotional excitement and are relieved by warmth.
  3. The attack is usually accompanied by pain.
  4. The attack consists of 3 consecutive phases
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5
Q

3 consecutive phases in History in DIAGNOSIS of Raynaud’s disease

A
  • Pallor
  • Cyanosis
  • Redness
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6
Q

Pathogenesis of Pallor in 3 consecutive phases in History in DIAGNOSIS of Raynaud’s disease

A

Due to spasm of the digital arterioles.

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7
Q

Pathogenesis of Cyanosis in 3 consecutive phases in History in DIAGNOSIS of Raynaud’s disease

A

Due to sluggish circulation & extraction of 02 by the tissues.

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8
Q

Pathogenesis of Redness in 3 consecutive phases in History in DIAGNOSIS of Raynaud’s disease

A

As the attack passes off, the arterioles dilate “under the effect of metabolites” and oxygenated blood passes into the dilated
capillaries

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9
Q

Examination in DIAGNOSIS of Raynaud’s disease

A
  1. The radial and ulnar pulses are preserved.

2. No major gangrene, only minute patches of ulceration or gangrene may occur.

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10
Q

Grades of Raynaud’s disease

A
  1. First grade :
  2. Second grade :
  3. Third grade :
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11
Q

First grade in Grades of Raynaud’s disease

A

Presents only with Raynaud’s phenomena

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12
Q

Second grade in Grades of Raynaud’s disease

A

Mild trophic changes in the tips of fingers & nails

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13
Q

Third grade in Grades of Raynaud’s disease

A

Presents with gangrene of the tips of fingers.

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14
Q

TREATMENT of Raynaud’s disease

A
  1. conservative measures

2. Cervico-dorsal sympathectomy

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15
Q

conservative TREATMENT of Raynaud’s disease

A
  • Indications

* Modalities

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16
Q

Indications of conservative TREATMENT of Raynaud’s disease

A

In the early stages of Raynaud’s disease

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17
Q

Modalities of conservative TREATMENT of Raynaud’s disease

A
  • The patient is advised to avoid cold weather and to wear woolen gloves in winter time.
  • Vasodilator drugs.
  • Calcium channel antagonists
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18
Q

Cervico-dorsal sympathectomy in TREATMENT of Raynaud’s disease

A
  • Indication

* Outcomes

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19
Q

Indication of Cervico-dorsal sympathectomy in TREATMENT of Raynaud’s disease

A

In severe cases of Raynaud’s disease

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20
Q

Outcomes of Cervico-dorsal sympathectomy in TREATMENT of Raynaud’s disease

A
  • Its immediate results are good

* but usually the symptoms recur after sometime, but are at least, not severe

21
Q

Definition of Raynaud’s phenomenon

A

Colour changes similar to those of Raynaud’s disease may accompany a large group of organic diseases.

22
Q

Causes of Raynaud’s phenomenon

A
  1. Thoracic outlet syndrome.
  2. Buerger’s disease.
  3. Collagen diseases as rheumatoid arthritis, scleroderma, SLE.
  4. Cryogloubulinaemia.
  5. Drugs as chronic administration of ergot-containing drugs for migraine.
  6. Certain occupations as typists, pianists & laborers using vibrating tools.
  7. Atrophic disorders of limbs, e.g. after poliomyelitis
23
Q

Treatment of Raynaud’s phenomenon

A
  • Treatment of the cause

* Vasodilators and B-blockers are prescribed

24
Q

Difference between acrocyanosis and Raynaud’s disease

A
  1. Not paroxysmal.
  2. It affects hands, nose, ears & L.L.
  3. Initial stage of pallor is absent.

4- The attack is painless & pain occurs after the attack.

  1. Accompanied by paraesthesia.
  2. In between the attacks the hands are colder than normal & there is excessive sweating of the palms.
25
Q

Treatment of acrocyanosis

A

Sympathectomy is less effective than in Raynaud’s disease.

26
Q

Erythromelalgia

A

Precipitated by warmth rather than cold.

It affects mainly the feet.

27
Q

Main complain of Erythromelalgia

A
  • Burning pain.
  • Redness.
  • The patient often immerses his feet in cold water during the attack
28
Q

a vasospastic condition in which The patient often immerses his feet in cold water during the attack

A

Erythromelalgia

29
Q

Alternative name for Erythrocyanosis Frigida

A

Bazin’s disease

30
Q

Erythrocyanosis Frigida

A
  • Body parts affected
  • Pathogenesis
  • Morphology
  • Prognosis
31
Q

Body parts affected in Erythrocyanosis Frigida

A

L.L of obese females in winter.

32
Q

Pathogenesis of Erythrocyanosis Frigida

A

It is due to ischemic fat necrosis.

33
Q

Morphology of Erythrocyanosis Frigida

A

There are dusky red indurated areas in the calves & ankles.

34
Q

Prognosis of Erythrocyanosis Frigida

A

After repeated attacks, indolent ulcers will result.

35
Q

vasospastic condition affecting L.L of obese females in winter.

A

Erythrocyanosis Frigida

36
Q

vasospastic condition in which There are dusky red indurated areas in the calves & ankles.

A

Erythrocyanosis Frigida

37
Q

vasospastic condition Precipitated by warmth rather than cold.

A

Erythromelalgia

38
Q

vasospastic condition affects hands, nose, ears & L.L

A

acrocyanosis

39
Q

vasospastic condition in which The attack is painless & pain occurs after the attack

A

acrocyanosis

40
Q

vasospastic condition Accompanied by paraesthesia

A

acrocyanosis

41
Q

vasospastic condition in which In between the attacks the hands are colder than normal & there is excessive sweating of the palms.

A

acrocyanosis

42
Q

Vasospastic condition in which The attacks are precipitated by coldness or emotional excitement and are relived by warmth.

A

Raynaud’s disease

43
Q

Vasospastic condition in which The attack is usually accompanied by pain

A

Raynaud’s disease

44
Q

Types of Arteritis

A
  1. Buerger’s diseases.
  2. Takayasu’s diseases
  3. Arteritis of collagen origin
  4. Cranial arteritis (temporal & occipital).
  5. Erythema nodosum
45
Q

Takayasu’s diseases in Types of Arteritis

A
  • Autoimmune disease
  • Affecting thoracic & abdominal aorta & their branches.
  • Treated by cortisone.
46
Q

Arteritis of collagen origin in Types of Arteritis

A
  • Polyarteritis nodosa.
  • Scleroderrna
  • Rheumatoid
  • SLE
47
Q

Erythema nodosum in Types of Arteritis

A

Allergic vasculitis due to bacterial toxins

48
Q

Autoimmune disease Affecting thoracic & abdominal aorta & their branches.

A

Takayasu’s diseases

49
Q

Allergic vasculitis due to bacterial toxins

A

Erythema nodosum

Surgery.(General 2).Vascular (16 decks)

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