Peripheral Vascular Disease Flashcards
PVD - risk factors
- Age
- CVD
- CAD
- DM
- Hypercholesterolaemia
- Smoking
- HTN
PVD - management
- CVD risk management - HTN, Lipids, DM, Smoking
- AF - rate, rhythm control, anticoagulation
- PVD - stent if small/balloon angioplasty, fem-pop bypass if big
PVD - signs
- Absent dorsalis pedis AND posterior tibial pulse
- Atypical skin colour at extremities
- Atrophic hair loss
- Temperature change
- Increased capillary refill time
Acute limb ischemia - signs/symptoms
5Ps
- Pain
- Paresthesia
- Perishingly cold
- Pulselessness
- Paralysis
PVD - Ddx
- Lumbar spinal stenosis
- Peripheral neuropathy
- Nerve entrapment
- Fracture
- Arthritis
- DVT
- Venous insufficiency
PVD - investigations
- FBC with platelets
- Lipids
- Apolipoprotein A
- HbA1c
- Creatinine
Acute limb ischemia - management
- Analgesia - 325mg aspirin
- Anticoagulation - unfractionated heparin
Or - Percutaneous thrombectomy
Chronic limb ischemia - management
- Reduce risk factors
- Aspirin and clopidogrel
- Smoking cessation, exercise
- Phosphodiesterase inhibitor - cilostazol
- Surgery - angioplasty, stent, bypass, thrombolysis
Vessel harvest sites
- Great saphenous vein
- Radial artery
- Internal mammary artery
Venous eczema - presentation
- Erythematous plaque with fine fissures and scaling
2. Haemosiderin
Venous eczema - cause
Venous stasis related to venous insufficiency
Venous eczema - management
- Avoid itching
- Dress skin
- Topical steroids
Venous eczema - complications
- Venous stasis ulcer
- Cellulitis
- Fat necrosis
Venous ulcer - risk factors
- Obesity
- Phlebitis
- Varicose veins
- DVT
Venous ulcer - symptoms
- Aching pain at ulcer site
- Leg pain increases late in the day
- Relieved by elevating legs
Venous ulcer - Ddx
- Arterial insufficiency related ulcer
- Vasculitic ulcer
- Neuropathic foot ulcer
- Pressure ulcer
- Skin malignancy
Venous ulcer - investigations
- Biopsy - vasculitis/malignancy
- ABPI
- Duplex USS to confirm venous insufficiency
Venous ulcer - management
- Elevation of leg
- Compression stocking
- ABx
- Dressing
- Aspirin
- Skin graft
- Avoid topicals
Venous insufficiency - cause
Incompetent valves causing distal venous hypertension
Venous insufficiency - risk factors
- Obesity
- CHF
- DM
Venous insufficiency - presentation
- Varicose veins
- Haemosiderin
- Pedal oedema
- Ulceration
Venous insufficiency - complications
- Venous ulcers
- Postphlebitic syndrome - DVT, thrombophlebitis
- Eczema
- Cellulitis
Venous insufficiency - investigations
- Duplex USS to assess for venous reflux
2. ABPI to confirm no arterial insufficiency
Venous insufficiency - management
- Regular walks
- Elevate legs
- Compression stocking
- Diuretics
Vasculitis types
- Giant cell arteritis - carotid artery
- Polyarteritis Nodosa
- Kawasaki disease - coronary artery
- Small vessel vasculitis
- wegener’s granulomatosis (lungs and kidneys)
Vasculitis - associated symptoms
- Headache
- Sinusitis
- Stroke
- Haematuria
Vasculitis - presentation
- Fever
- HTN
- Weight loss
- Hepatomegaly/splenomegaly
Vasculitis - examination
- Arterial bruit
- Nodules
- Palpable purpura
- Urticarial
Vasculitis - investigations
- Biopsy
- FBC
- ESR, CRP
- Blood culture
- RFT, LFT
- ANA, ANCA, RF
- CXR, ECG, ECHO
Vasculitis - Ddx
- Antiphospholipid antibody syndrome
- Endocarditis
- Multiple myeloma
- Secondary vasculitis (RA, SLE, scleroderma)