OBSTRUCTIVE DISORDERS

Question 1

what are the obstructive disorders?

Answer 1

varicose veins
superficial thrombophlebitis
VTE

Question 2

these are valves of either the perforating veins or superficial veins (GSV, SSV) fail/become incompetent

backflow leads to dilated and tortuous superficial veins (varicose veins)

PE
-vascular: no varicosities

Answer 2

varicose veins

Question 3

what are the types of varicose veins?

Answer 3

primary varicosities

secondary varicosities

Question 4

inherited incompetence of valves in GSV, SSV

more in females

what is this varicose vein type?

Answer 4

primary varicosities

Question 5

what is this varicose vein type?

prior injury to vein that damaged valvular system (phlebitis, trauma)

Answer 5

secondary varicosities

Question 6

what is the predisposition to varicose veins?

Answer 6

obesity
preg
hormonal increases (estrogen)
prolonged standing (increased venous hydrostatic pressure)

Question 7

what is this obstructive disorder?

inflamed or occluded superficial vein

caused by thrombosis of the vein, venous stasis

tender to palpation

progressive and involve deep venous system

Answer 7

superficial thrombophlebitis

Question 8

what is the progression of superficial thrombophlebitis?

Answer 8

edema
dermatitis
induration
ulceration

Question 9

main tx for superficial thrombophlebitis?

Answer 9

stop the progression, very aggressive

compression, Unna boot, elevation

topical steroids for dermatitis

warming/heat for induration

wound care for ulceration

Question 10

name this obstructive disorder based on presentation?

distended superficial vein
palpable cord
diffuse pain
+/- erythema

Answer 10

superficial venous thrombosis (SVT)

Question 11

name this obstructive disorder based on presentation?

aching, muscle cramping
erosion of vein, bleeding
localized tenderness
superficail thrombophlebitis

Answer 11

deep vein thrombosis

DVT=leg, groin, arm
PE=lungs

Question 12

thrombus aka?

arterial thrombi?
venous thrombi?

physiologic thrombus?
pathologic thrombus?

Answer 12

blood clot

more platelets, paler
darker, jelly

injury
DVT, PE

Question 13

pathologic thrombus most associated with what triad?

Answer 13

DVT: Virchow’s Triad
stasis
vessel wall injury
hypercoagulability

Question 14

name the component of virchows triad based on cause below?

immobility
paralysis
venous insufficiency
H/O VTE
left ventricular dysfunction

Answer 14

stasis

Question 15

name the component of virchows triad based on cause below?

malignancy
preg
infection
thrombophiia
inflammatory disorder
nephrotic syndrome

Answer 15

hypercoagulability

Question 16

name the component of virchows triad based on cause below?

trauma
surgery
acute MI
valvular disease
catheter
atherosclerosis

Answer 16

vessel wall injury

Question 17

why is atherosclerosis important to consider in DVT of vessel wall injury?

what is the overall disease process of development of atheromas?

Answer 17

consider atheroma (unhealthy growth) developing in the arterial wall over time, not venous

atherosclerosis

Question 18

this is the most common casue of death?

what are the considerations?

Answer 18

PE

deep vs superficial
above knee vs below knee

RF: acquired (venous stasis), inherited (factor V leiden)

Question 19

DDx DVT?

Answer 19

bakers cyst
cellulitis
lymphoedema
chronic venous insufficiency
superficial thrombophlebitis
popliteal aneurysm
hematoma

Question 20

what is the clinical diagnosis of DVT?

Answer 20

subjective exam
-acute onset, last 1-2 weeks

objective exam

• unilateral swelling
• pain
• erythema
• prominent cord like vein
• febrile
• increased HR
• • homans sign
• • pratt test