Miscellaneous Vascular

Question 1

Thoracic outlet syndrome

Answer 1

Compression of brachial plexus, subclavian artery or vein at site of thoracic outlet

Question 2

Features of neurogenic TOS

Answer 2

Painless muscle wasting of hands, hand weakness, numbness and tingling, cold hands, blanching, swelling

Question 3

Features of vascular TOS

Answer 3

Vein- painful diffuse arm swelling with distended veins

Artery- painful arm claudication, perhaps ulceration and gangrene

Question 4

Investigations for TOS

Answer 4

Vascular and neuro exam
Rule out causes of neuropathy eg. Bloods, diabetes etc.
CXR/Cervical spine radiograph (cervical rib, Ossetian malformations etc.)
MRI venography or angiography

Question 5

Treatment of TOS

Answer 5

Conservative- education, rehabilitation, physio
Surgical- esp. if physical anomaly (decompression, removal of rib etc.)

Question 6

Surgical safety checklist

Answer 6

The checklist identifies three phases of an operation:
1) Before the induction of anaesthesia (sign in)
2) Before the incision of the skin (time out)
3) Before the patient leaves the operating room (sign out)

Before the induction of anaesthesia, the following must have been checked:
Patient has confirmed: Site, identity, procedure, consent
Site is marked
Anaesthesia safety check completed
Pulse oximeter is on patient and functioning
Does the patient have a known allergy?
Is there a difficult airway/aspiration risk?
Is there a risk of > 500ml blood loss (7ml/kg in children)?

Question 7

Sensitivity

Answer 7

the proportion of people with the condition who will have a positive result. It is defined as TP/(TP+FN)

Question 8

Specificity

Answer 8

the proportion of people without the condition who will test negative. Specificity is defined as TN/(TN+FP)