Breast and vascular

Question 1

Chronic PVD sites?

Answer 1

1st: superficial femoral artery
2nd: aortic and iliac artery

Question 1

What is the Fontaine classification?

Answer 1

1. asymptomatic
2. intermittent claudication: a) stop >200m, b) stop <200m
3. rest or nocturnal pain
4. necrosis/gangrene

Question 2

How do you manage varicose veins?

Answer 2

often asx, can cause aching pain worse on standing

signs of venous disease: venous ulcers, eczema, haemosiderin deposition on legs, lipoderm

Ix: doppler USS

Mx:
compression therapy
weight losss
avoid prolonged standing

simple analgesia

surgery if ulcers, pain

SFJ ligation and vein stripping, stab avulsions, laser ablation, injection of sclerosing foam

prolonged varicose veins -> chronic venous insufficiency (inflammation, venous stasis ulcers, pruritis, pain)

Question 3

What is a popliteal aneurysm?

Answer 3

A bleeding aneurysm is a surgical emergency and detailed investigations are inappropriate. A priority in such a case should be to cross-match some blood.

In the non-acute case then ultrasound or CT scan can be used to ascertain the size of the aneurysm. Conservative management of some aneurysms involves periodic ultrasound scanning to assess the size of an asymptomatic aneurysm.

may be asx
Knee pain.
Lower leg pain.
Swelling behind the knee.
Pulsing feeling behind the knee.

Do not smoke.
Eat a nutritious diet.
Get regular exercise.