peripheral vascular disease

Question 1

what is an aneurysm?

Answer 1

dilatation of vessel by more than 50% of its normal diameter

Question 2

What is the difference between true and false aneurysm?

Answer 2

• the vessel wall is intact

- there is a breach in vessel wall-surrounding structures act as vessel wall

Question 3

Morphology of aneurysm?

Answer 3

saccular
fusiform
mycotic-arises secondary to an infectious process involving all 3 layers of the artery

Question 4

Abdominal aortic aneurysm risk factors?

Answer 4

age, smoking, gender, hypertension, atherosclerosis

Question 5

What is the symptoms of AAA?

Answer 5

Pain-mimic renal colic
trashing 
rupture
sudden onset epigastric/central pain 
may radiate through to back
may mimic renal colic 
collapse

Question 6

What imaging modalities for AAA?

Answer 6

Duplex ultrasound-
CT scan-arterial phase-IV contrast
aneurysm morphology- shape, size, iliac involvement
-allows for management planning
-only imaging method to identify ruptured AAA

Question 7

Management of AAA?

Answer 7

Open repair-laparotomy

• clamp aorta + iliacs
• dacron graft
• tube vs bifurcated graft
• endovascular aneurysm repair-exclude AAA from inside the vessel
• inserted via peripheral artery
• x-ray

Question 8

What is acute limb ischaemia?

Answer 8

sudden loss of blood supply to a limb-occlusion of native artery or bypass graft

Question 9

what are the causes of sudden occlusion?

Answer 9

• embolism
• atheroembolism
• arterial dissection
• trauma
• extrinsic compression

Question 10

what are the clinical features of acute limb ischaemia?

Answer 10

pain
pallor 
pulseless 
perishingly cold 
paraesthesia
paralysis

Question 11

management of acute limb ischaemia?

Answer 11

• ABC-resuscitate and investigate
• FBC, CK, COAG, TROPONIN
• ECG-MI, dysrhthmia
• CXR-underlying malignancy

Question 12

if limb is salvageable what are the three management techniques used ?

Answer 12

embolectomy
fasciotomies
thrombolysis

Question 13

Diabetic foot sepsis?

Answer 13

diabetic foot problems encompass-diabetic neuropathy

• peripheral vascular disease
• infection

Question 14

what are the sources of diabetic foot sepsis?

Answer 14

• simple puncture wound
• infection from nail plate or inter digital space
• from neuro ischaemic ulcer

Question 15

What are the systemic clinical findings of diabetic foot ?

Answer 15

• pyrexia
• tachycardic
• tachypnoeic
• confused
• kussmauls breathing

Question 16

diabetic foot sepsis is a problem of pressure rather than ischaemia-compartment pressure, vascular compromise, necrotic tissue, limb loss..t/f

Answer 16

true