peripheral vascular disease Flashcards
what is intermittent claudication (what causes it, symptoms)
insufficient blood reaching muscle during exercise caused by atherosclerosis, cramp in legs
what can intermittent claudication lead to
critical limb ischaemia (constant lack of blood and O2)
what is the ankle brachial pressure index
ankle pressure/ brachial pressure
what are normal, claudication and severe values
normal 0.9-1.2, claudication 0.4-0.85, severe 0-0.4
what non-invasive investigations can be done of ischaemia
measure ABPI and duplex ultrasound
what invasive investigations can be done of ischeamia
magnetic resonance angiography, CT angiography, catheter angiography (V invasive)
what non invasive treatment can be done (lifestyle and meds) of ischaemia
smoking cessation, diet, walking!!, antiplatelets, statins, lipid lowering
treatment of limb of limb ischaemia
stent, angioplasty, bypass
what is critical limb ischaemia
toe and leg pain, worse when lying down. can cause gangrene and ulcers. more likely in diabetics and smokers
what is the treatment for critical limb ischaemia
amputation, analgesia, angioplasty/ stenting
what is an aneurysm
dilation of a vessel by more than 50% of it’s norm
what is the difference between a true and false aneurysm
true, wall is still intact, false, wall is breached
what can cause AAA
degeneration: defect in elastin, dilation, aortic wall stress,
what are the symptoms of AAA
mainly asymptotic, pain in abdomen if ruptures
what are symptoms of ruptured AAA
sudden epigastric pain, can radiate through back, collapse, transmitted pulse and odd BP
what can you do to investigate AAA? what is gold standard and why?
ultrasound as tells if ruptured. Also duplex ultra and CT scan
what is the treatment for AAA
under 5.5cm = regular USS, over 5.5 cm = EVAR, ruptured = emergency open repair
what is acute limb ischaemia
sudden loss of blood supply to a limb with no prior claudication
what can diabetic food sepsis cause
ischaemia and limb loss from infection
how to varicose veins arise
blocked veins leading to increased pressure
what is the difference between primary and secondary varicose veins
primary = spontaneous, secondary = known cause eg DVT
what are the deep veins in lower limbs
tibials, popliteals, femorals
what are the superficial veins in the lower limbs
saphenous, perforators
what are the increasingly severe clinical features
bleeding, thrombophlebitis (inflamed vein), hemosiderin deposits, lipodermatosclerosis, ulceration
how do you investigate varicose veins
duplex scans
what non-interventional management of varicose would you do
pressure stockings - contraindicated with low ABPI
what interventional management of varicose would you do
foam sclerotherapy, mechanical laser, surgically tie it off.
