Cardiovascular - Thrombotic Disease + Misc Flashcards
Presentation - Carotid Body Tumours
Asymptomatic neck lump
Carotid bruit
Cranial nerve palsy
Diagnosis - Carotid Body Tumours
Urinary catecholamines
Imaging - duplex, CTA/MRA
Management - Carotid Body Tumours
Surgical resection
Classification - Carotid Body Tumours
Shamblin system
Definition - Situational Syncope
A type of reflex syncope consistently and clearly caused by a trigger
Triggers - Situational Syncope
Coughing
Exertion
Micturition
Swallowing
Etc.
Diagnosis - Situational Syncope
Clinical
Management - Situational Syncope
Identify and treat the cause if possible
Advise the patient to lie down if a trigger occurs
Causes - Vasovagal Syncope
Decreased cerebral blood flow
Provoking factors e.g. pain, distress
Presentation - Vasovagal Syncope
Prodromal symptoms e.g. sweating, nausea
Syncope
Diagnosis - Vasovagal Syncope
Clinical diagnosis of exclusion
Management - Vasovagal Syncope
Avoidance of triggers
Avert syncope = horizontal gravity neutral position, leg crossing
Presentation - DVT
Dilated veins
Painful, swollen, red limb
Pitting oedema
Diagnosis - DVT
Doppler ultrasound
D-dimer
CT scan in some cases
Wells Score <1 - DVT
Perform D-Dimer
- Negative = DVT excluded
- Positive = do USS
Wells Score >2 - DVT
Do D-dimer and USS
- Both negative = excluded
- USS positive = treat
- USS negative but D-dimer positive = repeat USS in one week
Management - DVT (Suspected)
Heparin or enoxaparin or dalteparin
Management - DVT (Confirmed)
Apixaban or rivaroxaban
Management Duration - DVT
Provoked = 3 months
Unprovoked = 6 months
Causes - Post-Thrombotic Syndrome
Idiopathic DVT (develops within 5 years)
Presentation - Post-Thrombotic Syndrome
Eczema
Hyperpigmentation
Itch + pain
Oedema
Varicose veins + venous ulcers
Diagnosis - Post-Thrombotic Syndrome
Clinical diagnosis
Management - Post-Thrombotic Syndrome
Elevation
Exercise
Compression stockings
