Illness script - week 2

Question 1

Peripheral vascular disease

Describes a variety of conditions affecting the _____, _____, _____ and _____ in areas such as the _____, _____, and _____

Answer 1

Peripheral vascular disease

Describes a variety of conditions affecting the aorta, arteries, veins and lymphatics in areas such as the neck, abdomen and extremities

Question 2

Arterial wall

1) _____: single layer of endothelial cells
2) _____: Elastin, collagen and muscular layer
3) _____: collagen layer

Answer 2

Arterial wall

1) Intima: single layer of endothelial cells
2) Media: Elastin, collagen and muscular layer
3) Adventitia: collagen later

Question 3

Aneurysm

Abnormal _____ or _____ in the wall of a blood vessel such as an _____

Answer 3

Aneurysm

Abnormal swelling or bulge in the wall of a blood vessel such as an artery

Question 4

Arterial disease

_____ condition in which a narrowed blood vessel reduces blood flow to the _____

Answer 4

Arterial disease

Circulatory condition in which a narrowed blood vessel reduces blood flow to the limbs

Question 5

Thrombi

A blood _____ that forms in a blood vessel and _____ there

Answer 5

Thrombi

A blood clot that forms in a blood vessel and remains there

Question 6

True aneurysm

Involves all 3 layers of the _____ wall
E.g. _____ disease and _____

Answer 6

True aneurysm

Involves all 3 layers of the arterial wall
E.g. Marfan’s disease and atherosclerosis

Question 7

False aneurysm

Not an aneurysm but a _____ _____ which has developed from a disruption to __-__ layers of the arterial wall

Answer 7

False aneurysm

Not an aneurysm but a pulsatile haematoma which has developed from a disruption to 1-2 layers of the arterial wall

Question 8

Atherosclerotic aneurysm

Commonly affects the _____ _____ below the _____ _____

Answer 8

Atherosclerotic aneurysm

Common affects the abdominal aorta below renal arteries

Question 9

Fusiform

_____ shaped, circumference of artery, usually the _____ _____ _____ (AAA)

Answer 9

Fusiform

Spindle shaped, circumference of artery, usually the abdominal aortic aneurysm (AAA)

Question 10

Saccular

_____ out to _____ side

Answer 10

Saccular

Ballooning out to one side

Question 11

Medical management of Aneurysms

1) IV cannula
2) _____ cross match, _____, _____, _____ and _____
3) Oxygen
4) _____ (ECG)
5) _____ catheter

Answer 11

Medical management of Aneurysms

1) IV cannula
2) Blood cross match, haemoglobin, coagulation, electrolytes and creatine
3) Oxygen
4) Electrocardiograph (ECG)
5) Urinary catheter

Question 12

Surgical intervention of Aneurysms

Incision in the mid line of the _____ and along the _____ length, a _____ is inserted to the un-involved proximal and distal ends of the _____, the wall is closed to prevent the _____ making direct contact with the _____

Answer 12

Surgical intervention of Aneurysms

Incision in the mid line of the abdominal and along the aneurysm length, a graft is inserted to the un-involved proximal and distal ends of the aorta, the wall is closed to prevent the graft making direct contact with the duodenum

Question 13

Complications of Aneurysm surgery

1) Arrythmias
2) _____ _____ _____ (AMI)
3) Pulmonary _____
4) _____ and _____ failure
5) Haemorrhage
6) Graft _____
7) _____ _____ and _____ ischaemia
8) Infection

Answer 13

Complications of Aneurysm surgery

1) Arrythmias
2) Acute myocardial infarction (AMI)
3) Pulmonary oedema
4) Renal and respiratory failure
5) Haemorrhage
6) Graft occlusion
7) Spinal cord and mesenteric ischaemia
8) Infection

Question 14

Peripheral arterial occulsive diesease

Acute caused by _____ which is a _____ from the heart of aneurysm, aggregate of fat which is commonly found in the _____ or _____

Answer 14

Peripheral arterial occulsive disease

Acute caused by emboli which is a thrombus from the heart or aneurysm which is aggregate of fat commonly found in the lungs or brains

Question 15

Vascular trauma

Can be caused from a _____ _____ accident, _____ wound, _____ instruments, _____ injuries and _____

Answer 15

Vascular trauma

Can be caused from a motor vehicle accident, gunshot wound, sharp instruments, crush injuries and fractures

Question 16

Classic presentations of arterial occlusive disease - 6Ps

1) _____
2) _____
3) _____
4) _____
5) _____
6) _____

Answer 16

Classic presentations of arterial occlusive disease - 6Ps

1) Pain
2) Pallor
3) Pulselessnesss
4) Parasthesia
5) Paralysis
6) Poikilothermia

Question 17

Diagnosing of arterial occlusion

1) _____/_____ scan
2) _____ _____ _____: used as a screen only

Answer 17

Diagnosing of arterial occlusion

1) Dupplex/doppler scan
2) Arterial brachial pressure: used as a screen only

Question 18

Medical management of arterial occlusion

1) IV _____
2) _____/_____
3) _____ agent: _____, _____ _____ _____ activator (r-TPA)
4) Bed rest
5) Oral _____ for long-term therapy: _____

Answer 18

Medical management of arterial occlusion

1) IV heparin
2) Embolectomy/thrombectomy
3) Thrombolytic agent: streptokinase, recombinant tissue plasminogen activator (r-TPA)
4) Bed rest
5) Oral anticoagulants for long-term therapy: Warfarin

Question 19

Ankle brachial pressure index

<0.5:          \_\_\_\_\_ ulcer
0.5 - 0.7:    \_\_\_\_\_ \_\_\_\_\_ ulcer
0.7 - 0.8:    \_\_\_\_\_ ulcer
>0.9:          \_\_\_\_\_ ulcer
>1.2:           \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

Answer 19

Ankle brachial pressure index

<0.5:           arterial ulcer
0.5 - 0.7:     mixed arterial ulcer
0.7 - 0.8:     venous ulcer
>0.9:           venous ulcer
>1.2:            possible calcified vessels

Question 20

Chronic causes of arterial occlusion

1) Progressive _____, _____ and _____ of arteries in the extremities which affect the _____, _____, _____, _____ and _____ vessels
2) Smoking
3) _____ and _____ are the main risk factors
4) _____, _____ and _____ history
5) Common __ - __ year old _____ above the knees, _____ is below the knees

Answer 20

Chronic causes of arterial occlusion

1) Progressive narrowing, degeneration and obstruction of arteries in the extremities which affect the aortoiliac, fermoral, popiteal, tibial and peroneal vessels
2) Smoking
3) Hyperlipidaemia and hypertension are the main risk factors
4) Diaetes, obesity and family history
5) Commonly 60 - 80 year old males above the knees, diabetes is below the knees

Question 21

Management of Arterial occlusion

1) Health promotion: _____, _____, _____ and _____
2) _____, _____, _____ and _____ (CWMS)
3) _____ pulses
4) _____ care
5) _____ _____ care and mobilsation

Answer 21

Management of arterial occlusion

1) Health promotion: Diet, lifestyle, exercise and footcare
2) Colour, warmth, movements and sensations (CWMS)
3) Peripheral pulses
4) Wound care
5) Pressure area care and mobilsation

Question 22

Virchow’s triad

_____ stasis, _____ damage and hyper-_____ of _____

Answer 22

Virchow’s triad

Venous stasis, endothelial damage and hyper-coagulability of blood

Question 23

_____, _____, _____, and _____ from a thrombus, it forms a tail behind the clot

If attached to the _____, the _____ process stops and _____ occurs and becomes an _____

Answer 23

RBCs, WBCs, platelets and fibrin form a thrombus, it forms a tail behind the clot

If attached to the lumen, the thrombotic process stops and lysis occurs and becomes an emboli

Question 24

Superficial thrombophlebitis

Palpable, firm, _____ cord-like vein, area is tender to touch and has _____ and _____ skin

Answer 24

Superficial thombophlebitis

Palpable, firm, subcutaneous cord-like vein, area is tender to touch and has red and warm skin

Question 25

Deep vein thrombophlebitis

May or may not have unilateral leg _____, _____, _____ skin and calf _____

Answer 25

Deep vein thrombophlebitis

May or may not have unilateral leg oedema, pain, warm skin and calf tenderness

Question 26

Chronic venous insufficiency

Common complication that has valvular _____, _____, _____, secondary _____, _____ and limb _____

Answer 26

Chronic venous insufficiency

Common complication that has valvular destruction, oedema, pigmentation, secondary varicosities, ulceration and limb cyanosis

Question 27

Management of thrombophlebitis

1) Mild _____ (_____) and NSAIDs (_____)
2) IV _____ and oral _____: to treat _____ _____
3) _____ _____ _____ time (APPT) and _____ _____ _____ (INR) for clotting profile
4) _____

Answer 27

Management of thrombophlebitis

1) Mild analgesics (aspirin) and NSAIDs (ibuprofen)
2) IV heparin, and oral warfarin: to treat DVT
3) Activated partial prothrombin time (APPT) and international normalised ration (INR) for clotting profile
4) Embolectomy

Question 28

Pulmonary embolism

A blood clot in an artery which stops blood flow to part of the _____, commonly originates from the right _____, up to the right _____ and into the right _____

__% originates as a _____ from _____ and _____ _____ veins

Can also be caused by _____ _____

Answer 28

Pulmonary embolism

A blood clot in an artery which stops blood flow to part of the lung, commonly originates from the right leg, up to the right heart and into the right lung

95% originates as a thrombi from calf and deep thigh veins

Can also be caused by arterial fibrillation

Question 29

Diagnosing pulmonary embolism

1) _____ X-ray
2) _____ (ECG)
3) __ and __ changes
4) _____ _____ _____ test (ABG)
5) _____ _____/_____ lung scan

Answer 29

diagnosing pulmonary embolism

1) Chest X-ray
2) Electrocardiograph (ECG)
3) ST and T changes
4) Arterial blood gas test (ABG)
5) Radionuclide ventilation/perfusion lung scan

Question 30

Symptoms of pulmonary embolism

1) _____
2) _____
3) _____
4) _____
5) _____
6) _____

Answer 30

Symptoms of pulmonary embolism

1) Pain
2) Dyspnea
3) Apprehension
4) Cough
5) Haemoptysis
6) Sweats

Question 31

Signs of pulmonary embolism

1) _____
2) Accentuated pulmonic S__ and/or _____ rhythm
3) _____
4) Fever and/or _____
5) _____
6) _____ _____

Answer 31

signs of pulmonary embolism

1) Tachypnea
2) Accentuated pulmonic S2 and/or gallop rhythm
3) Tachycardia
4) Fever and/or diaphoresis (sweating)
5) DVT
6) Peripheral oedema

Question 32

Complications of pulmonary embolism

1) _____ _____
2) _____ _____

Answer 32

complications of pulmonary embolism

1) Pulmonary infarction
2) Pulmonary hypertension

Question 33

Comorbidities of pulmonary embolism

1) _____
2) _____ _____
3) _____ _____ _____ _____

Answer 33

Comorbidities of pulmonary embolism

1) Immobility
2) Venous damage
3) Chronic obstructive pulmonary disease (COPD)

Question 34

Management of pulmonary embolism

1) IV _____
2) Oral _____
3) _____ agents: _____, _____ _____ _____ _____ (r-TPA)
4) _____ _____: _____ _____ _____ _____ (APPT) and _____ _____ _____ (INR)

Answer 34

management of pulmonary embolism

1) IV herparin
2) Oral warfarin
3) Thrombolytic agents: streptokinase, recombinant tissue plasminogen activator (r-TPA)
4) Clotting profiles: Activated partial prothrombin time APPT and International nationalised ration INR

Question 35

Chronic venous insufficiency

Insufficient blood _____ to the _____ due to _____, _____ dysfunction or _____ retention

This can lead to _____ hypertension within the veins and causing an _____ response

Answer 35

Chronic venous insufficiency

Insufficient blood return to the heart due to obstruction, valvular dysfunction or fluid retention

This can lead to venous hypertension within the veins and causing an inflammatory response

Question 36

Ulcer types

1) Venous: located from _____ _____ to _____, _____ in colour, highly _____, irregular shape, oedema, _____ edges
2) Arterial: located from _____ and _____, punched out look, painful, shiny, _____ legs, atrophy, blanching, _____ pen woud
3) Diabetes: located from the _____ and _____, mostly _____ in aetiology, _____ _____ or new diagnosis of diabetes

Answer 36

Ulcer types

1) Venous: located from lower leg to ankle, dusky in colour, highly exudating, irregular shape, oedema, macerated edges
2) Arterial: located from foot and ankle, punched out look, painful, shiny, hairless legs, atrophy, blanching, erythmic pen wound
3) Diabetes: Located from the foot and ankle, mostly arterial in aetiology, patient history or new diagnosis of diabetes