Pathology Flashcards
What is the Buerger’s test
lie patient flat and slowly perform a straight leg raise
Point at which leg goes oale- note
Buerger’s angle- angle between leg and horizontal
What is prescribed first line to prevent progression of PAD
Clopidogrel
Signs of critical limb ischaemia
Rest pain
Pain in foot at night - relieved by handing foot outside of bed
Ulceration/gangrene
Exam- Paradoxically red foot- sunset foot.
Signs of acute limb ischaemia
Pain Pallor Pulseless Perishingly cold Paraesthesia Paralysis
Non arterial causes of ulcers
Venous Mixed arterial and venous Diabetes mellitus Vasculitis Malignancy Infection Trauma
Associated features of venous ulcers
Venous eczema
Lipodermaatosclerosis
Atrophie Blanche
Haemosiderosis
What special test can be done to identify level of venous incompetence
What do you need to be doing before this test
Trendelenburg Tourniquet Test
Pulses. If patient had critical limb ischaemia do not do Trendelenberg Test
How to perform Trendelenburg Tourniquet test
Have patient lie flat
Perform straight leg raise and rest leg on shoulder
Massage veins to expedite emptying veins
Apply tourniquet tightly in upper thigh
Have patient stand up ]Look for varicosities filling for 10-15 seconds and then release tourniquet
No filling on standing and rapid filling on release of tourniquet – isolated sapheno-femoral junction incompetence
Slow filling on standing and rapid filling on release of tourniquet – mixed
Management of venous ulcer
Graduated compression dressing
ABx for infection
