DVT LGW

Question 1

what are the differentials of DVT ?

Answer 1

cellulitis
erysipelas
hemangioma
lymphedema
ruptured bakers yst

Question 2

what is thee best investigation for DVT ?

Answer 2

duplex US

Question 3

what is the management of DVT

Answer 3

anti-coagulants is the mainstay of treatment
LMWH and warfarin are started at the same time
then LMWH is removed once INR reaches 2-3

Question 4

what are the complications associated with DVT ?

Answer 4

immediate risk of PE
post thrombotic leg
venous ulcerations
phlegmasia alba dolens
phlegmasia cerula dolens

Question 5

what is the prophylactic for DVT ?

Answer 5

active mobilization
post operative hydration
intermittent calf compression
elastic stocking
subcutaneous LMWH

Question 6

what is the significance of the trendelenburg test ?

Answer 6

determine the site of valvular incompetence in varicose

Question 7

how is the trendelenburg test done ?

Answer 7

the patient lis flat and the leg is elevated to empty the superficial veins , a tourniquet is placed around the upper thigh and the patient stands up

if the varicosities remain empty - saphenofemoral junction incompetence

if the varicies still fill up , keep lowering the tourniquet until the level of incompetence is identified

Question 8

what are the skin changes associated with varicose ?

Answer 8

venous eczema
lipodermatosclerosis

Question 9

what is the treatment for varicose veins ?

Answer 9

minor - graded compression stockings
small or medium below thee knee - sclerotherapy or superficial varicosities that are unsightly

Question 10

what are the complications of sclerotherapy ?

Answer 10

bruising
phlebitis
ulcerations

Question 11

greater saphenous vein ?

Answer 11

joins femoral vein near groin
runs medially

Question 12

what are the skin changes associated with venous ulcers ?

Answer 12

1- brawny skin - haemosedrin deposition
2- ulcers in the gaiter area ( above the medial malleous )
3- atrophy blanche

Question 13

what is the management of saphenofemoral valve incompetence ?

Answer 13

greater saphenous vein stripping

Question 14

what is the management if thee perforators are incompetent?

Answer 14

removal of perforators, stab avulsion techniques

Question 15

varicose patients should bee examined whilst ?

Answer 15

standing

Question 16

which vein is affected if there are medial thigh and calf varicosities ?

Answer 16

long saphenous vein

Question 17

which vein is affected iff there are posterolateral varicosities ?

Answer 17

short saphenous vein affection

Question 18

which vein is affected if there are varicosities in the anterolateral aspect ?

Answer 18

isolated incompetence of the proximal anterolateral long saphenous tributary

Question 19

what are the contraindications to compression stockings ?

Answer 19

DVT
peripheral artery disease

Question 20

what is the management for venous ulcers ?

Answer 20

lifestyle modifications
leg elevation
compression therapy
graduated class 1 or 2 elastic stocking ( once the ulcer has healed to prevent recurrence )

Question 21

what must the ABPI be in order to do compression stockings safely ?

Answer 21

above 0.8

Question 22

why is gaiters area associated with venous ulcers ?

Answer 22

site of medial calf perforators

Question 23

what are thee characteristic features for each type of ulcer ?

Answer 23

venous ulcer - irregular sloping white edges
arterial ulcer - well defined deep punched out
neuropathic ulcers - very thick keratinized raised edges