Peripheral Vascular Disease

Question 1

describe intermittent claudication

Answer 1

exertional discomfort in the calves which is relieved by rest due to arterial damage producing an inflammatory response

Question 2

what are the risk factors for developing intermittent claudication

Answer 2

smoking, obesity, hyperlipidaemia, hypertension

Question 3

what are the signs/symptoms of intermittent claudication

Answer 3

pain/ulcers
hair loss
absent peripheral pulses
dry skin

Question 4

what are the main investigations for intermittent claudication

Answer 4

ankle brachial pressure index
duplex ultrasound
MRI/CT

Question 5

how does ABPI work and what value diagnoses intermittent claudication

Answer 5

measures blood pressure ankle and the arm, ratio of the two

pressure of below 0.9 indicates claudication

Question 6

name the treatment for intermittent claudication

Answer 6

lifestyle advice, antiplatelets, surgery in extreme cases (bypass or angioplasty)

Question 7

what are the main symptoms of acute lower limb ischaemia

Answer 7

pain, pallor, pulseless, perishingly cold, paraesthesia and loss of hair

Question 8

an aneurym is defined as what

Answer 8

dilatation of a blood vessel by more than 50% of its original size

Question 9

what is the difference between a true and false aneurysm

Answer 9

true - involves all walls of the vessel

false - only the outer layers affected

Question 10

what causes the formation of an aneurysm

Answer 10

decreased collagen in the artery wall, dilatation, stress and further dilatation

Question 11

symptoms and signs of AAA

Answer 11

usually asymptomatic

possible colicky pain radiating to the back and pulsatile mass

Question 12

what is the best investigation for diagnosing an AAA

Answer 12

ultrasound - determines whether aneurysm is present or not

also CT for whether its ruptured or dopler US

Question 13

aneurysms above what size are treated with surgery

Answer 13

> 5cm

Question 14

what are the symptoms of DVT

Answer 14

hot, red, swollen and painful legs, possible loss of hair

Question 15

what investigations are carried out for DVT

Answer 15

D-dimer, Dopler US to assess turbulent blood flow, PTP scoring

Question 16

when is PTP scoring not used in DVT diagnosis

Answer 16

if someone is pregnant or has had previous DVT

Question 17

what is the main treatment for DVT

Answer 17

anticoagulants

TED compression stockings

Question 18

what three factors increase risk for diabetic foot sepsis

Answer 18

diabetic neuropathy, PVD and infection

Question 19

what causes diabetic foot sepsis to arise

Answer 19

increase pressure within the foot, infection gets trapped causing formation of pus and necrosis of foot due to poor blood flow

Question 20

what are the signs and symptoms of diabetic foot sepsis

Answer 20

erythema, swelling, ulcers and pus, necrosis, absent pulses and foot feels boggy

Question 21

what is the main treatment for diabetic foot sepsis

Answer 21

urgent vascular surgery - may require amputation

also antibiotics for infection

Question 22

what are varicose veins

Answer 22

superficial veins that have become enlarged due to increased back pressure due to incompetent valves - blood pools in lower limb veins

Question 23

what is the difference between primary and secondary varicose veins

Answer 23

secondary varicose veins have arisen due to DVT

Question 24

what is the treatment for varicose veins

Answer 24

TED compression stockings
foam sclerotherapy - seals vein closed
endovenous ablation - seals vein closed through burning