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Cardio - mine > lower limb disease and DVT > Flashcards

lower limb disease and DVT Flashcards

1
Q

what is intermittent claudication

A

insufficient blood reaching the muscle while exercising.

muscle ischaemia

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2
Q

risk factors for intermittent claudication

A 
smoking
age
diabetes
hypertension
high cholesterol
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3
Q

what are the investigations for intermittent claudication

A

ABPI measurement
ultrasound
angiography (CT, Catheter, MRI)

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4
Q

what is ABPI?

A

ankle BP/ Brachial pressure

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5
Q

what is normal ABPI

A

0.9-1.2

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6
Q

what is an ABPI of claudication

A

0.4-0.85

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7
Q

what is the gold standard investigation for intermittent claudication

A

catheter angiography

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8
Q

what are the treatment options for intermittent claudication

A

angioplasty +/- stent
endarterectomy
bypass

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9
Q

what is critical intermittent claudication

A

insufficient blood reaching the muscle while at rest

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10
Q

what is a DVT

A

formation of thrombi within the lumen of the vessels that make up the deep venous system

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11
Q

where do DVT form

A

predominantly in venous valve pockets and other sites of stasis

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12
Q

what is a distal DVT

A

DVT of the calves

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13
Q

what is a proximal DVT

A

DVT of the popliteal vein or the femoral vein

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14
Q

what are the risk factors for DVT

A 
(virchow's triad)
LV dysfunction
immobility/paralysis
obesity
smoking
High BP and cholesterol
surgery
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15
Q

what is a “provoked DVT”

A

a VT with cause, these causes can be transient (e.g surgery or hospitalisation) or continuing (e.g cancer)

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16
Q

what is a “unprovoked DVT”

A

DVT with no identifiable cause. high recurrence rate

17
Q

complications of DVT

A

PE
recurrent DVT
chronic thromboembolic pulmonary hypertension (CTEPH)
post-thrombotic syndrome

18
Q

what is post-thrombotic syndrome

A

A complication of DVT experienced by 1/3 or patients

19
Q

what is post-thrombotic syndrome characterised by

A 
pain
oedema
hyperpigmentation
varicose collateral veins
venous ulceration
20
Q

what is chronic thromboembolic pulmonary hypertension (CTEPH)

A

serious complication of DVT experienced by 5% of patients. it is a progressive condition

the original material is replaced by fibrous tissue that is incorporated into the intimate and media of the pulmonary arteries

21
Q

what are the symptoms of chronic thromboembolic pulmonary hypertension (CTEPH)

A

initally asymptomatic followed by progressive SOB and low O2 in the blood

22
Q

what can chronic thromboembolic pulmonary hypertension (CTEPH) lead to

A

RH failure

23
Q

what are the investigations of DVT

A

D-dimer test
well’s score
Ultrasound
CTPA

24
Q

what is the gold standard for DVT

A

CTPA

25
Q

what is the first line test for DVT

A

D-dimer test

26
Q

what would a moderate or high D-dimer test result in

A

further imaging (CTPA)

27
Q

what would a low/negative D-dimer test suggest

A

patient is not suffering from PE or DVT

28
Q

what are the pharmacological treatments for DVT

A

anticoagulants

thrombolysis

29
Q

what are the mechanical interventions for DVT

A

compression stockings

IVC filters

30
Q

what should you check a patient presenting with a DVT for

A

thrombophila

cancer

31
Q

if the patient has a DVT due to drug use what drugs should be prescribed

A

rivaroxaban or fragmin

32
Q

when should thrombolysis be considered in patients with DVT

A

symptomatic ileofemoral DVT symptoms LEES than 14 days
low risk of bleeding
life expectancy above 1 year

33
Q

which patients should be given an IVC filter

A

PROXIMAL DVT

34
Q

what is the treatment for an provoked DVT

A

LMWH for 5 days

Vit K antagonist within 24hrs and continued for 3 months

35
Q

what is the treatment for unprovoked DVT

A

LMWH for 5 days
Vit K antagonist within 24hrs and continued for minimum 3 months
anticoagulation can be continued after 3 months to prevent recurrence

Cardio - mine (15 decks)

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