Part 1

Question 1

What is a Tenckhoff catheter used for?

Answer 1

Peritoneal Dialysis

Question 2

Advantages of AV fistula over a Central Venous Catheter

Answer 2

Low infection rate
Low thrombosis rate
Low circulation rate
High blood flow seen

Question 3

Complications of AV fistula

Answer 3

Steal Syndrome
Thrombosis
Aneurysm
Infection
Venous stenosis

Question 4

How is the AV fistula used?

Answer 4

Two needles
- afferent - distally - blood -> machine
- efferent - proximally - machine -> blood

Question 5

How long does it take for an AV fistula to become patent

Answer 5

4-6w

Question 6

Why is an AV fistula needed

Answer 6

During haemodialysis, a great volume of blood needs to be removed and returned.
A normal vein cannot compensate with the load.
An artery and vein are joined - when the pressure of arterial blood entering the vein dilates it + increases the flow rate

Question 7

Clinical Features of Peripheral Arterial Disease

Answer 7

Pale
Pain
Pulselessness
Parasthesia
Paralysis
Perishingly cold

Question 8

What fistulas are found in the:
- Snuffbox
- Antecubital fossa

Answer 8

• Radiocephalic
• Brachiocephalic

there is also
- Transposed brachiobasilic
- Forearm loop AV fistula (present upper arm veins for future procedures)

Question 9

Name 2 types of Grafts

Answer 9

Synthetic: Dacron, PTFE
Autologous: Great Saphenous Vein

Question 10

What is the aim of bypass graft?

Answer 10

Increase circulation peripherally
Increase healing of ulcers
Stops intermittent claudication

Question 11

Name 5 types of amputation

Answer 11

Proximal Phalynx
Transmetatarsal
Metatarsal
Below knee
Above Knee
High Above Knee

Question 12

For which surgery to do you see a neck scar?

Answer 12

Carotid endarterectomy

Question 13

Indications for
1. Fem-pop bypass
2. Fem-PT bypass
3. Axillo-fem bypass

Answer 13

1. SFA occlusion
2. SFA + popliteal occlusion
3. Horizontal @ clavicle + oblique @ groin

Question 14

Indications for
1. Axillo bifemoral bypass
2. Popliteal distal bypass
3. Aorto bifemoral bypass

Answer 14

2. occluded knee
3. iliac disease (laparoscopic scar + groin scar)

Question 15

What do the following scars mean?
1. @groin
2. @medial aspect of knee
3. @ medial aspect of thigh
4. @ femoral to dorsalis pedis

Answer 15

1. femoral bypass
2. anterior tibial, posterior tibial, peroneal artery
3. great saphenous vein
4. posterior tibial

Question 16

What do the following scars mean?
1. no scar
2. no harvest graft
3. 2 longitudinal scars
4. 1 scar
5. 2 groin incisions + laparotomy incision at forearm

Answer 16

1. popliteal to DP
2. synthetic used instead (thrombosed easier)
3. fem-fem cross over, EVAR (oblique)
4. Angioplasty / stenting
5. Axillo bifem