General Medicine

Question 1

Peripheral vascular examinations?

Answer 1

General examination
Capillary refill

Pulses: rate, volume, character
Carotid
Radial
Brachial
Femoral
Popliteal
Posterior tibial
Dorsalis pedis

Abdo exam
Buerger’s test: assessment for arterial insufficiency and looking for pallor in leg elevation 15-30 degrees for 30-60sec

Question 2

Clinical signs of peripheral vascular disease?

Answer 2

Painful legs
Pressure points
Hairless/ shiny legs
Absent distal pulses
Cold distal limbs
Poor cap refill
Erythema ab igne

Question 3

Vascular disease investigations and management?

Answer 3

Investigations:
ABPI
CT/ XRAY Angiography
Doppler ultrasound
MRA
Bloods- lipids, CRP, clotting factors, PT

Management:
Anticoagulants
BP-lowering meds
Diabetes management
Wound care
Diabetes management
Reduce cholesterol and stop smoking
Angioplasty- balloon stents to open vessel
Vascular reconstruction surgery
Amputation- last resort