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General Surgery > Claudication lower limb > Flashcards

Claudication lower limb Flashcards

1
Q

Classic risk factors for PAD

A 
Age
Smoking
DM
HPT
Hypercholesterolaemia/ homocysteinaemia/ fibrinogenaemia
Obesity
Sedentary lifestyle
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2
Q

Clinical Classification of PAD

A

Aorto-iliac
Femero-popliteal
Tibio-peroneal

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3
Q

Two stratification systems for intermittent claudication

A

Fontaine

Rutherford

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4
Q

Leriche syndrome?

A

Aorto-ileac disease
Impotence
Buttock claudication

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5
Q

Differentials of painful lower limb

A 
PAD
Spinal stenosis
Sciatica
Infection
DVT
Varicose veins
Peripheral neuropathy
Restless leg syndrome
If they ask more than that they can keep the change
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6
Q

Baseline evaluation for claudication

A 
FBC
Fasting lipids
Fasting glucose/HbA1C
Serum U&E + creatinine
Blood clotting profile
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7
Q

What to do differently in ABI of PAD

A

Resting ABI followed by post-exercise ABI

Should drop significantly

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8
Q

Imaging for intermittent claudication

A

Duplex doppler
Multi detector CT angiography
Contract enhance MR angiography
+- Peripheral angiography

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9
Q

Two prong management for PAD

A

Reduce risk factors

Relieve symptoms

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10
Q

Medical management of PAD

A

Stop smoking
Exercise
Antiplatelet (aspirin/ clopidogrel)
Statins
Cilostazol (vasodilating antiplatelet phosphodiesterase inhibitor)
Naftidrofuryl (Prevent RBC and plt aggregation)

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11
Q

Endovascular management of PAD

A 
Balloon angioplasty (focal stenosis)
Rarely stenting
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12
Q

Surgical management of PAD

A

Endarterectomy

Bypass

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13
Q

Young PAD pathologies (

A
  1. Accelerated atherosclerosis (Age:
    40 – 55 years)
  2. Precocious atherosclerosis (Age:
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14
Q

How to confirm diagnosis of critical limb ischaemia

A

Ankle pressure

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15
Q

What difference in BP between arms is significant forfuture CVS disease in PAD

A

> 20mmHg

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16
Q

Buerger’s test

A

Raised foot becomes pale. hanging foot becomes red

17
Q

Goldflam test

A

Raised foot does not become pale until the patient wiggles their toes

18
Q

How to aid smoking cessation

A

Councel
Nicotine replacement
Varenicline (partial nicotine receptor agonist)
Bupropion (antidepressant)

19
Q

Indications for surgery in PAD

A

o Severe life-style limiting claudication
o CLI with rest pain
o CLI with ischaemic foot / leg ulcers
o CLI with gangrene
o To facilitate stump salvage in a patient requiring a major amputation

General Surgery (20 decks)

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