EXTRAS FROM CP RESOURCE SESSION

Question 1

what is the wells score?

Answer 1

A number that reflects your risk of developing deep vein thrombosis (DVT).

Question 2

what is CURB65?

Answer 2

a score for pneumonia severity
confusion
urea
resp rate over 30
bp low
65- 65 or older
score of 2 or more probably means quite severe

Question 3

what does the wells score measure?

Answer 3

clinical signs and symptoms of DVT
PE is no.1 diagnosis or equally likely
HR over 100
immobilisation at least 3 days or surgery in previous 4 weeks
previous diagnosis of DVT or PE
hemoptysis
malignancy with treatment within 6 months
score less than 1 means DVT unlikely

Question 4

describe the order of drugs you would try to reduce bp?

Answer 4

ACE inhibitor (angiotensin 2 receptor blocker if complaining of dry cough)
calcium channel blocker
diuretics
beta blockers

Question 5

whats a common side effect of calcium channel blockers?

Answer 5

swollen ankles

Question 6

what can put you in a hyper coagulable state?

Answer 6

pregnancy
medication
after surgery
cancer
deficiencies in coagulation factors

Question 7

whats the effect of atherosclerosis in carotid and cerebral arteries?

Answer 7

stroke risk, Transient ischaemic attack/mini stroke, vascular dementia

Question 8

whats the effect of atherosclerosis in renal arteries?

Answer 8

hypertension by activating RAAS, occlusion and worsening fucntion

Question 9

whats the effect of atherosclerosis in abdominal aorta?

Answer 9

abdominal aortic aneurysm

Question 10

whats the effect of atherosclerosis in coronary arteries?

Answer 10

MI, angina

Question 11

whats the effect of atherosclerosis in superior and inferior mesenteric arteries?

Answer 11

ischaemia

Question 12

whats the effect of atherosclerosis in lower limb arteries?

Answer 12

PVD, ischaemia

Question 13

what is Virchow’s triad?

Answer 13

the factors important of developing a venous thrombosis

1. stasis
2. endothelial damage
3. activation of blood coagulation

Question 14

what is an ulcer?

Answer 14

a breach in the continuity of the skin/epithelium/mucous membrane

Question 15

ARTERIAL ULCERS
what causes them?
where are they found?
what do they look/feel like?

Answer 15

ulcers caused by ischaemia
tend to be found on lower legs and feet
look punched out with regular margins, cold and painful

Question 16

VENOUS ULCERS
what causes them?
where are they found?
what do they look/feel like?

Answer 16

caused by venous stasis
mainly located in the medial gaiter region
painful, shallow, large and irregular

Question 17

VENOUS ULCERS
what causes them?
where are they found?
what do they look/feel like?

Answer 17

caused by venous stasis
mainly located in the medial gaiter region
painful, shallow, large and irregular

Question 18

NEUROPATHIC ULCERS
what causes them?
where are they found?
what do they look/feel like?

Answer 18

Caused by diabetes damaging nerves (neuropathy)
located on pressure points
punched out, hot, painless

Question 19

NEUROPATHIC ULCERS
what causes them?
where are they found?
what do they look/feel like?

Answer 19

Caused by diabetes damaging nerves (neuropathy)
located on pressure points
punched out, hot, painless

Question 20

what is healing by primary intention?

Answer 20

healing that occurs when a wound is closed (clean, narrow incision, inflammation and proliferation, minimal scarring)

Question 21

what is healing by secondary intention?

Answer 21

healing that occurs when a wound is left open rather than being closed. This may be because the wound is too large to bring the edges together or it is infected.

Question 22

what does healing by primary intention look like?

Answer 22

clean
narrow incision
minimal scarring

Question 23

what does healing by secondary intention look like?

Answer 23

Broader based wound, granulated and heals from the base, wider more visible scar

Question 24

what factors can affect wound healing?

Answer 24

the depth of the wound, lack of blood flow, infection, wound location, oedema, old age, diabetes, smoking, obesity, immunosupression, steroid use (can weaken skin in long term use), malnutrition

Question 25

what is acute limb ischaemia?

Answer 25

blockage in an artery resulting in reduced arterial supply to a limb

Question 26

what are the symptoms of acute limb ischaemia?

Answer 26

pain
paralysis
pallor
paraesthesia
pulselessness
perishing with cold

Question 27

what are the symptoms of acute limb ischaemia?

Answer 27

pain
paralysis
pallor
paraesthesia
pulselessness
perishing with cold

Question 28

how can you tell the difference between embolic and thrombotic acute limb ischaemia?

Answer 28

thrombotic ALI has a gradual onset, less severe, history of PAD symptoms, less cold leg, cyanotic leg, hard/calcified artery and absent contralateral leg pulses
embolic ALI have a sudden onset, are more severe, unlikely PAD symptoms, likely to have cardiac history issues, cold/mottled leg, soft tender artery and present contralateral leg pulses

Question 29

what is an angiogram?

Answer 29

when contrast dye is injected during x-ray to give moving images that show blood flow

Question 30

what is collateral circulation?

Answer 30

A network of tiny blood vessels that allow blood to flow around the blocked artery to another artery nearby or to the same artery past the blockage, protecting the tissue from injury.