DVT, lympahtic and venous disease

Question 1

what % of the population do varicose veins effect

Answer 1

1/3

Question 2

what is a varicose vein

Answer 2

a vein that is dilated and twisty

often superficial

most commonly in the lower limbs

Question 3

what are the risk factors of varicose veins

Answer 3

age - older

female

pregnancies

DVT

standing for a long time (occupation)

family history

Question 4

what is the pathophysiology of varicose veins

Answer 4

damaged valves - lead to more incompetence distally and a build up of blood

Question 5

what can cause damage to the valves

Answer 5

surgical or trauma

DVT

hormonal changes - pregnancy - weaken valves

Question 6

how do you diagnose a varicose vein

Answer 6

burning
itching
heaviness
swelling
discolouration 

ulceration - in extreme circumstances

Question 7

what are some investigations that can be carried out

Answer 7

ultrasound the valves

Question 8

what is the management of varicose veins

Answer 8

1st - endovenous treatment

2nd - ultrasound guided sclerotherapy

3rd - open surgery

Question 9

what is endovenous treatment

Answer 9

when the LSV or SSV is cannulated under ultrasound

the catheter causes irritation to the venous wall and occludes the vein

Question 10

what is the LSV

Answer 10

lesser saphenous vein

Question 11

what is the SSV

Answer 11

small saphenous vein

Question 12

how are the veins occluded

Answer 12

fibrosis of the venous wall

Question 13

what is foam sclerotherapy

Answer 13

under ultrasound chemical foam is injected into the affect vein

Question 14

what dose open surgery do for varicose veins

Answer 14

the vein is striped out and removed

Question 15

what is chronic venous insufficiency

Answer 15

failure calf muscle pump

superficial/ deep venous reflux

venous obstruction

Question 16

what are the symptoms of chronic venous insufficiency

Answer 16

oedema

eczema

hypopigmentation

ulceration

Question 17

how do you treat chronic venous insufficiency

Answer 17

exclude arterial disease

wound care
elevation
compression bandaging

Question 18

what is the pathology of primary lymphedema

Answer 18

congenital

around puberty

Question 19

what is the pathology of secondary lymphedema

Answer 19

malignancy

surgery

infection

Question 20

what is the treatment of lymphedema

Answer 20

elevation

drainage

Question 21

what can cause venous obstruction

Answer 21

heart failure

portal hypertension

obesity

Question 22

what are venous ulcers

Answer 22

Breach in the skin between the knee and ankle joint, present for >4 weeks

Question 23

what is the different between arterial and venous thrombosis

Answer 23

caused by stasis and hypercoaguality

causing back pressure

Question 24

what is the definition of embolism

Answer 24

Intravascular material that migrates from its original location to a distal vessel

E.g: blood clot, fat, air, tumour

Question 25

what is the definition of thromboembolism

Answer 25

Movement of blood clot along a vessel

Question 26

what are examples of venous thromboembolisms (VTE)

Answer 26

DVT PE

Question 27

what are the risk factors of VTE

Answer 27

surgery obstetrics lower limb problems

Question 28

what are the sings of a DVT

Answer 28

unilateral limb swelling persistent discomfort calf tenderness

Question 29

how do you diagnose a DVT

Answer 29

blood test - d dimer imaging - compression ultrasound if D-dimer is positive

Question 30

what is a D Dimer

Answer 30

a chemical from the Breakdown product of cross-linked fibrin | clot

Question 31

what does the d dimer test have

Answer 31

High sensitivity for VTE Low specificity for VTE

Question 32

what are the sings/symptoms of small PEs

Answer 32

pleuritic chest pain SOB haemoptysis tachycardia

Question 33

what are the sings and symptoms of a massive PE

Answer 33

sever/ sudden onset SOB collapse central cyanosis tachycardia low BP

Question 34

how do you diagnoses a PE

Answer 34

blood test - d-dimer imaging

Question 35

what are the imaging technique for PEs

Answer 35

isotope ventilation/perfusion scan CT pulmonary angiogram

Question 36

what are the aims of treatment for VTE

Answer 36

to prevent... clot extension clot embolization recurrent clot

Question 37

what are the treatment options of VTE

Answer 37

anticoagulation thrombolysis for massive PE

Question 38

what is the drug used in thrombolysis of big PEs

Answer 38

alteplase

Question 39

how can VTEs be prevented in hospital

Answer 39

early mobilisation anti-embolism stockings

Question 40

what are the anticoagulation drugs that are used for VTE

Answer 40

LMW heparin warfarin