Other vascular

Question 1

Raynaud’s disease pathophysiology

Answer 1

Digital ischaemia caused by paroxysmal vasospasm

Question 2

Raynaud’s phenomenon

Answer 2

pale (ischaemia) -> blue (deoxy) -> red (reactive hyperaemia)

Question 3

Raynaud’s rx in mild disease

Answer 3

Keep warm

Stop smoking

Meds: Nifedipine, sildenafil

Primrose oil

Question 4

Raynauds rx in severe (gangrenous) disease

Answer 4

Prostacyclin

Digital or lumbar sympathectomy

Question 5

Carotid endarterectomy indication

Answer 5

Symptomatic + ipsilateral obstruction ≥70%

(no point in doing it for a fully blocked vessel)

Question 6

How soon after presentation should the carotid endarterectomy be carried out

Answer 6

within 2 wks

Question 7

Main complications of endarterectomy

Answer 7

Stroke/death

hypoglossal n injury

Question 8

Post-phlebitic syndrome aka

Answer 8

post-thrombotic syndrome

Question 9

Cause of post phlebitic syndrome

Answer 9

long term complication of DVT

Question 10

Post phlebitic pathogenesis

Answer 10

Clot/damage to valve -> venous HTN

Rupture of superficial valves

-> bleed/swelling/pain

Question 11

Trendelenberg’s test procedure

Answer 11

1. Supine patient, raise leg, tourniquet the thigh (to occlude superficial vessels).
2. Stand up the patient, time how long it takes for blood to return
3. If no refill after 20 s at all, release turniquet and time how long it takes for blood to return

Question 12

Trendelenberg’s interpretation

Answer 12

Step 2 normally takes around 30-35 s

If no refill, but step 3 happens rapidly, shows the deep veins are competent and it’s a superficial vein problem