PVD

Question 1

Character of intemittent claudication pain?

Answer 1

Cramping/gripping/burning

Question 2

3 ass. diseases suggesting atherosclerotic disease elsewhere?

Answer 2

IHD, CVD, erectile dysfunction

Question 3

5 timing questions intermittent claudication

Answer 3

Intermittent, at rest, continual, nocturnal, freq increasing

Question 4

2 exacerbating factor questions intermittent claudication?

Answer 4

Exercise (hoe far? Does pain limit or is it something else eg. SOB), elevation limb

Question 5

2 relieving factor questions intermittent claudication?

Answer 5

Rest (how long before pain subsides), dependency of the limb

Question 6

SOCRATES intermittent claudication?

Answer 6

S - dep. on site of arterial occlusion
O - acute (e. arterial embolism), chronic (eg. atherosclerotic disease)
C - gripping/burning/cramping
R - none
A - IHD/CVD/ED
T - intermittent/continuous, rest, nocturnal, increasing freq
E - how far? elevating leg
A - rest, dependency
S - 1 to 10?

Question 7

6 Ps acute limb ischaemia?

Answer 7

Pale
Pulseless
Perishing cold
Paraesthesia
Paralysis
Pain

Question 8

SOCRATES AAA (SOCRS)?

Answer 8

S - upper epigastric (but can be anywhere)
O - acute (eg. mycotic because infections), chronic (often symptom free)
C - pulsating feeling (my heart’s in my stomach), tenderness, nagging ache
R - to back
S - severe on rupture

Question 9

6 DVT symptoms?

Answer 9

Pain (ache), tenderness, swelling, increased warmth to touch, altered skin colour, prominence superficial veins

Question 10

Virchow’s triad for VTE predisposition?

Answer 10

Stasis (immobility, post-op, intra-abdominal tumour causing venous compression), hypercoaguability (malignancy, clotting disorders, sepsis, oestrogen exposure - OCP/HRT), intimal change

Question 11

4 closing PVD questions?

Answer 11

Previous PVD diagnoses/treatment/response, previous vascular surgery, atheroma elsewhere (angina/MI, TIA/stroke/amaurosis fugax), risk factors (smoking, hypercholesterolaemia, family history, DM, hypertension)