Trigger - PVD Flashcards
characterized by ankle edema and chronic skin induration/fibrosis
Chronic venous insufficiency
also with brownish skin pigmentation
when is duplex sonography used
Varicose veins - for surgical planning
chronic venous insufficiency - surgical planning and looking for obstruction
can be treated with sclerotherapy or laser therapy
varicose veins (also varicose veins present in chronic venous insufficiency)
also treated qwith radiofrequency ablation
treated with radiofrequency ablation
varicose veins that are significant w signs of insufficiency or long variscosities
when is vein stripping used as a treatment
varicose veins (last resort)
usually presents with history of DVT or leg injury
chornic venous insufficiency
presents with distal extremity ulcers
cornic venous insufficiency
star shaped atrophic plaque with red dot in the middle
atrophie blanch - chronic venous insufficiency
Bowling pin shaped leg with reddness and skin induration
lipodermatosclerosis caused by chronic venous insufficiency
brownish skiin pigmentation caused by increased erythrocyte breakdown
hemosiderin stain due to chronic venous insufficiency
primary symptom is pitting edema of lower leg
chronic venous insufficiency
may also see itchiing, discomfort, ulcers, discoloration, ect
abnormally dilated veins around the ankle
corona phlebetaticia seen in chronic venous insufficiency
when do you use MDCT venography or MR venography
as backup imaging for chronic venous insufficiency when duplex US is not working
when do you use pneumatic compression
refractory chronic venous insufficiency
paste gauze compression that is changed weekly. provides compression and topical therapy
when is this used and what is it called
unna boot used in ulcers resulting from chronic venous insufficiency
redness and pain along a superficial vein with possible marked swelling
superficial venous thrombopglebitis
usually occuring at site of recent IV line (staph)
can result in a lingering palpable cord
superficial venous thrombophlebitis
when is venous doppler ultrasound indicated
in superficial venous thrombophlebitis that occurs in the PROXIMAL lower extremity
treat with NSAIDS if mild but use massive hot compress with leg elevation if larger/more painful
superficial venous thrombophlebitis
treated with apixiban, LMWH or xarelto for 45+ days
superficial venous thrombophlebitis that is >5+ cm
treat with vanc+rocephin+(LMWH or atrixtra)
superficial venous thrombophlebitis induced sepsis
red streaking from a wound or cellulitis towards regional lymph nodes
can present with chills, fever, malaise
lymphangitis
MCC is cutaneous inoculation of hemolytic strrep or staph
lymphangitis
caused by mosquito bite which injects the bacteria wuchereria bancrofti into the bite
lymphatic filariasis
MCC of lymphangitis worldwide previously
Painful or painless nodular subcutaneous swelling along lymphatic channel.
nodular lymphangitis
ALWAYS CONSIDER MALIGNANCY
must obtain CBC w diff, blood cultures and wound cultures for Dx
lymphangitis
also do an I&D and if there are anatomic abnormalities get imaging
What imaging may be indicated for lymphangitis?
Lymphangiography and lymphoscintigraphy
GABHS coverage: Dicloxacillin, Cephalexin, Cefazolin, Cefuroxime, Ceftriaxone, Clinda, Nafcillin, Trimethoprim, Bactrim
empiric ABX choices for lymphangitis
what kind of tx is typically used in nodular lymphangitis
surgical intervention
Painless, persistent edema of one or both legs, usually young women.
lymphedema
no ulcerations, variscosities or stasis pigmentation
buuuutttt lymphangitis and cellulitis may be present
managed with massages, wound care, compression stockings, good hygiene and possible amputation if needcded
lymphedema
