EXTRAS FROM CP RESOURCE SESSION Flashcards
what is the wells score?
A number that reflects your risk of developing deep vein thrombosis (DVT).
what is CURB65?
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
what does the wells score measure?
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
describe the order of drugs you would try to reduce bp?
ACE inhibitor (angiotensin 2 receptor blocker if complaining of dry cough)
calcium channel blocker
diuretics
beta blockers
whats a common side effect of calcium channel blockers?
swollen ankles
what can put you in a hyper coagulable state?
pregnancy medication after surgery cancer deficiencies in coagulation factors
whats the effect of atherosclerosis in carotid and cerebral arteries?
stroke risk, Transient ischaemic attack/mini stroke, vascular dementia
whats the effect of atherosclerosis in renal arteries?
hypertension by activating RAAS, occlusion and worsening fucntion
whats the effect of atherosclerosis in abdominal aorta?
abdominal aortic aneurysm
whats the effect of atherosclerosis in coronary arteries?
MI, angina
whats the effect of atherosclerosis in superior and inferior mesenteric arteries?
ischaemia
whats the effect of atherosclerosis in lower limb arteries?
PVD, ischaemia
what is Virchow’s triad?
the factors important of developing a venous thrombosis
- stasis
- endothelial damage
- activation of blood coagulation
what is an ulcer?
a breach in the continuity of the skin/epithelium/mucous membrane
ARTERIAL ULCERS
what causes them?
where are they found?
what do they look/feel like?
ulcers caused by ischaemia
tend to be found on lower legs and feet
look punched out with regular margins, cold and painful
VENOUS ULCERS
what causes them?
where are they found?
what do they look/feel like?
caused by venous stasis
mainly located in the medial gaiter region
painful, shallow, large and irregular
VENOUS ULCERS
what causes them?
where are they found?
what do they look/feel like?
caused by venous stasis
mainly located in the medial gaiter region
painful, shallow, large and irregular
NEUROPATHIC ULCERS
what causes them?
where are they found?
what do they look/feel like?
Caused by diabetes damaging nerves (neuropathy)
located on pressure points
punched out, hot, painless
NEUROPATHIC ULCERS
what causes them?
where are they found?
what do they look/feel like?
Caused by diabetes damaging nerves (neuropathy)
located on pressure points
punched out, hot, painless
what is healing by primary intention?
healing that occurs when a wound is closed (clean, narrow incision, inflammation and proliferation, minimal scarring)
what is healing by secondary intention?
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.
what does healing by primary intention look like?
clean
narrow incision
minimal scarring
what does healing by secondary intention look like?
Broader based wound, granulated and heals from the base, wider more visible scar
what factors can affect wound healing?
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
what is acute limb ischaemia?
blockage in an artery resulting in reduced arterial supply to a limb
what are the symptoms of acute limb ischaemia?
pain paralysis pallor paraesthesia pulselessness perishing with cold
what are the symptoms of acute limb ischaemia?
pain paralysis pallor paraesthesia pulselessness perishing with cold
how can you tell the difference between embolic and thrombotic acute limb ischaemia?
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
what is an angiogram?
when contrast dye is injected during x-ray to give moving images that show blood flow
what is collateral circulation?
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.
