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2b > Misc (varicose, peripheral vasc + thyroid) > Flashcards

Misc (varicose, peripheral vasc + thyroid) Flashcards

1
Q

What pulses should you test for in peripheral vasc exam in upper limb?

A
  • radial
  • (check for radio-radial delay)
  • brachial
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2
Q

Explain how to check the carotid pulse

A
  • ausclatate the carotid artery: ask patient to take a deep breath in and then hold it whilst you listen
  • if no bruit identified then palpate the carotid pulse
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3
Q

What does presence of bruit over carotid artery suggest

A

carotid stenosis

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4
Q

on palpation of aorta what is a normal and abnormal way for your hands to move?

A

normal: move up with each pulsation
abnormal: hands move outward - suggest presence of expansile mass (AAA)

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5
Q

Peripheral vasc exam: where do you ausclatate on abdomen

A
  • aorta
  • renal artery
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6
Q

peripheral vasc exam: what do you feel for on lower limb?

A
  • Temperature
  • Capillary refill
  • Pulses
  • Sensation
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7
Q

peripheral vasc exam lower limb: what pulses do you feel for?

A
  • Femoral
  • Popliteal
  • Posterior tibial pulse
  • Dorsalis pedis pulse
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8
Q

What special tests in peripheral vasc exam?

A

Buerger’s test

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9
Q

Describe burgers test

A
  • Patient lie supine, raise both of patients feet to (45)
  • Observe colour
  • slowly lower limb and watch for colour change
  • sit patient up and ask them to hang legs down over side of bed
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10
Q

a buergers angle of less than 20 indicates what?

A

critical limb ischaemia

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11
Q

Peripheral vasc exam: what would you do on completion?

A
  • Blood pressure measurement
  • Cardiovascular examination
  • Ankle-brachial pressure index (ABPI) measurement
  • Upper and lower limb neurological examination
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12
Q

Peripheral vasc exam: how should patient be positioned?

A

position the patient on the bed with the head of the bed at (45)

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13
Q

Which bit of stethoscope do you use to auscultate carotid pulse?

A

bell

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14
Q

Describe how you inspect leg in peripheral vasc exam

A

-patient lying down
- look at leg
- look between toes
- lift leg to look at posterior surface

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15
Q

peripheral vasc exam: what do you do after palpating femoral artery?

A

check for radio-femoral delay

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16
Q

What do you look for on leg inspection in varicose vein examination?

A
  • Surgical scars
  • venous eczema
  • saphena varix
  • arterial disease
  • varicose veins
17
Q

Where does the great saphenous vein run ?

A

all the way up the medial side of the leg (trouser seam)

18
Q

Where does the small saphenous vein run ?

A

Lateral aspect of foot and runs along posterior aspect of the leg

19
Q

What temp change is concerning for varicose veins

A

increased temp indicates inflammation (phlebitis)

20
Q

varicosity palpation: what does tender and hard varicosity indicate?

A

thrombophlebitis

21
Q

what four pulses do you feel for in lower limb?

A
  • femoral
  • popliteal
  • posterior tibial
  • dorsalis pedis
22
Q

varicose vein exam: what does percussion test test for

A

lower limb venous valve competency

23
Q

Where is the saphenofemoral junction located?

A

4cm inferior and 4cm lateral to the pubic tubercle

24
Q

What do you do on completion of varicose vein examination?

A
  • doppler ultrasound
  • venous duplex scanning
  • ABPI
  • peripheral arterial examination
25
Q

What clinical signs do you look for on general inspection in thyroid exam?

A
  • weight
  • agitation/ anxious
  • clothing
  • hoarse voice
26
Q

How do you assess for fine tremor in thyroid exam?

A

place a piece of paper on hands (palm down)

27
Q

Name a sign in the hand of hypothyroidism

A

dry skin

28
Q

name a sign in the hand of hyperthyroidism (3)

A
  • palmar erythema
  • onycholysis
  • sweating
29
Q

What is onycholysis associated with

A

hyperthyroidism

30
Q

Is irregular pulse associated with hypo or hyper thyroidism

A

irregular - AF (hyperthyroidism)

31
Q

What sign in face is sign of hyperthyroidism

A

sweating

32
Q

what sign in face is sing of hypothyroidism

A
  • dry skin
  • loss of outer 1/3 of eyebrow
33
Q

how do you assess for lid lag?

A

finger superior, ask patient to follow it, then position inferior

lid lag is when lids lag behind eye movement

34
Q

What do you look for when inspecting the neck in thyroid exam

A
  • skin changes (erythema)
  • scars (thyroidectomy)
  • massess (goitre/ lymph nodes)

2b (9 decks)

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