Chapter 24- Venous Pathology S/S

Question 1

What are 3 of the risk factors for developing venous thrombosis?

Answer 1

1-Trauma to the vessel
2- Venous stasis ( decreased venous return)
3-Hypercoagulability

Question 2

What is Paget Schroettter Syndrome? Caused by?

Answer 2

an upper extremity thrombosis of the axillary/subclavian veins

Caused by stress or effort

Question 3

Patient’s who have Thoracic Outlet Syndrome are more at risk for developing what syndrome

Answer 3

Paget Schroetter Syndrome

If you think about the extra rib or subclavian injury that occurs with TOS and PSS having to do with the axillary/subclavian veins it makes sense why the two are connected.

Question 4

What is two examples of “trauma” induced DVT?

Answer 4

1- Paget Schroetter Syndrome

2-PICC lines

Question 5

IF you know your anatomy well, explain why a PICC line inserted into the cephalic vein can cause a DVT

Answer 5

Cephalic-subclavian - innominate-SVC. Thombosis usualaly occurs at the proximal end of the PICC line

Question 6

What is Virchow’s Triad and what does it related to?

Answer 6

The risk factors for venous thrombosis

1-Trauma-
2- Venous stasis
3-Hypercoagulability

Question 7

What are some examples of why venous stasis (decreased venous return to heart) can happen

Answer 7

Long flights, compression of vein, immobility, pregnancy, COPD or history of DVT

Question 8

A person who works out way too much can be at risk for which trauma induced- venous thrombosis?

Think of all the collaterals that form / veins popping out :)

Answer 8

Paget Schroetter Syndrome

EFFORT THROMBOSIS

Question 9

A patient who takes estrogen is at risk for hypercoagulability and DVT.

True or False

Answer 9

True

Question 10

When an acute thrombosis occurs, what other disorders/disease processes can happen after that?

Answer 10

Pulmonary Embolus, valvular incompetence, post-phlebitic syndrome, or acute outflow obstruction

Question 11

What is post-phlebitic syndrome?

Answer 11

A DVT sequelae that occurs when the deep vein are occurs, the valves and walls are scarred, resulting in poor venous return

Question 12

Venous hypertension is common to see after an acute DVT

Answer 12

Post-phlebitic syndrome

Question 13

Ultrasound is the best imaging to diagnose a Pulmonary Emboli.. True or False

Answer 13

FALSE, CT is

Question 14

When does pulmonary embolism occur?

Answer 14

when a part of the thrombosis dislodges and finds its way into the pulmonary circulation.

Question 15

What is the most life-threatening sequelae of acute DVT?

Answer 15

Pulmonary Emboli

Question 16

When a patient devlopes the Superrior Vena Cava syndrome, what should we expect to see clinically?

Answer 16

This is an obstruction in the SVC, The SVC drains the upper half of the body. You will see edema, collaterilization, patient will cough or have difficulty breathing and SOB.

Question 17

Chronic venous insufficiency is often seen more commonly in the superficial veins..true or false?

This is basically incompotent valves

Answer 17

True

Question 18

What are the main differences between primary chronic venous insufficiency versus secondary?

Answer 18

Primary, the varicose veins form due to incompetent valves in the superficial vein with a normal deep system

Secondary, varicose veins form due to deep system obstruction OR incompotent valves,

Question 19

Portal hypertension is often caused by patients with what liver

2 diseases?

Answer 19

hepatitis and cirrhosis

Question 20

What is the syndrome in which patient does have a completely formed deep veins, resulting in multiple superificial varicosities.

Answer 20

Klippel-Trenaunay

Question 21

The most common cause of a IVC tumor is…..

very important

Answer 21

Renal Cell Carcinoma-this is because the tumor invades renal vein extending into the IVC.

Question 22

Varicose veins are often seen in patients with

Answer 22

Chronic venous insufficiency.

Question 23

What are the most common findings of a patient with an acute venous thrombosis?

Answer 23

Swelling, pain, redness, and warmth

Question 24

What is phlegmasia alba dolens, what’s another word for it?

Answer 24

Milk leg :(

when the arterial inflow is compromised, the whole leg is white.

Question 25

Phlegmasia alba dolens is a MEDICAL emergency and possible leg losss

True / False

Answer 25

True

Question 26

When you see a patient with “wine stain” redness in different parts of their arm, what disorder should we immediately think of?

Answer 26

Klippel-Trenaunay

Question 27

What is Phlegmasia cerula dolens

Answer 27

blueish discoloration due to limited venous outflow, at risk for gangrene.

Question 28

What are the signs of a chronic venous obstruction?

Answer 28

swelling, tiredness, discoloration, skin changes, and varicosities.

Question 29

If we see a patient that has a “blue leg” what should we bethinking?

Answer 29

Phlegmasia cerula dolens….limited venous outflow

Question 30

If we see a patient that has a leg that is noticeably white, what should we think?

Answer 30

Phlegmasia alba dolens

Question 31

There is a classification system for venous disease. What is class 1-6?

Answer 31

Class 1- Spider veins
Class 2- Varicose Veins
Class 3- Edema
Class 4- Skin changes such as brawny skin discolor
Class 5- Healed ulceration
Class 6 - Active ulceration

Question 32

How would we know the differences between venous ulcerations and arterial ulcerations location wise?

Answer 32

Venous ulcers are in the lower leg whereas arterial is in the feet and toes.

Question 33

How would we know the differences between venous ulcerations and arterial ulcerations appearance wise?

Answer 33

Venous ulcers -Shallow and irregular

Arterial ulcerations are deeper and more regular in shape

Question 34

If we see a shallow and irregular ulcer in the mid calf, is this an arterial or venous ulcer?

Answer 34

Venous

Question 35

If we see an ulcer in the toe that is deep and regular in size, is this arterial or venous?

Answer 35

arterial

Question 36

Are brawny skin discoloration changes usually seen in VENOUS disease or ARTERIAL disease?

Answer 36

VENOUS