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Vascular > Chronic Limb Ischemia > Flashcards

Chronic Limb Ischemia Flashcards

1
Q

Diagnosis of chronic limb threatening ischemia

A

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2
Q

What is the objective indication of poor vascular supply to lower limbs

A

ABPI <0.5
Toe pressure <0.3
TcPO2<30mmhg

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3
Q

Presentation of ischemic rest pain

A

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4
Q

Differentials for ischemic rest pain

A

Diabetic neuropathy
Peripheral sensory neuropathy
Nerve root compression

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5
Q

What is an ischemic ulcer

A

Painful ulcer arising from minor traumatic wounds with poor healing

Deep dry and punctuate, may develop cellulitis, abscess and osteomyelitis/septic arthritis

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6
Q

What is gangrene

A

Cyanotic anaesthetic tissue progressing with necrosis when arterial blood supply falls below minimal metabolic requirements

Dry or wet

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7
Q

What is the epidemiology of LEAD

A

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8
Q

What is the natural history of LEAD

A

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9
Q

What are the 3 most common types of PAD

A

Femoropopliteal - Calf
Aortoiliac - Buttock, erectile dysfunction, lost femoral pulse
Tibiofibular - foot claudication due to lack of collaterals

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10
Q

What is neurogenic claudication and how do you distinguish it from PAD

A

Pulses
Flex the spine to relieve pain
Night no pain

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11
Q

How to take history from patient with LEAD

A
  1. Age and occupation
    2, Pain SOCRATES + associated symptoms (erectile dysfunction)
  2. Rest pain - requiring opioids for more than 2 weeks is a feature
  3. Ulcer and gangrene
  4. PMH
  5. Drug history
    Social history
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12
Q

How to take history from patient with LEAD

A
  1. Age and occupation
    2, Pain SOCRATES + associated symptoms (erectile dysfunction)
  2. Rest pain - requiring opioids for more than 2 weeks is a feature
  3. Ulcer and gangrene
  4. PMH
  5. Drug history
  6. Social history
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13
Q

LEAD rutherford classification

A

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14
Q

What is the diagnostic flowchart for PAD

A

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15
Q

What is best medical therapy for PAD

A

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16
Q

What is the management of symptomatic claudication lead

A

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17
Q

What are the surgical indications of chronic limb ischemia

A

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18
Q

What are the surgeries available for patients with PAD

A

Angiography KIV stenting
Bypass
Endarterectomy

19
Q

Management of gangrenous limb

A

Infection and pain control
Revascularization to allow healing
Amputation

20
Q

What are the amputation indications

A 
4 Ds
Dead 
Damaged
Dangerous
Damn nuisance
21
Q

What are the complications of these surgeries

  1. Angiography KIV stenting
  2. Bypass
  3. Endarterectomy
  4. Amputation
A

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Vascular (10 decks)

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