varicose veins

Question 1

varicose veins

Answer 1

distended superficial veins >3mm in diameter

usually affect leg

Question 2

reticular veins

Answer 2

dilated blood vessels in skin 1-3mm in diameter

Question 3

telangiectasia

Answer 3

dilated blood vessels in skin <1mm in diameter

aka spider veins, thread veins

Question 4

how to varicose veins develop

Answer 4

incompetent valves in perforating veins

blood can flow from deep veins to superficial veins, overloading them –> dilation and engorgement –> varicose veins

Question 5

chronic venous insufficiency

Answer 5

blood pools in distal veins , pressure causes veins to leak blood into tissue

• haemoglobin leaks and broken down to haemosiderin –> brown discouloriation
• inflammation so skin becomes dry + inflamed (venous eczema)
• lipodermatosclerosis

Question 6

risk factors

Answer 6

age 
FHx
female
pregnancy 
obesity 
prolonged standing
DVT

Question 7

presentation

Answer 7

engorged, dilated superficial leg veins

asymptomatic
heavy sensation 
aching 
itching 
burning 
oedema 
muscle cramps 
restless legs

Question 8

tap test

Answer 8

apple pressure to saphenofemoral junction and tap distal varicose vein

thrill suggests incompetent valves

Question 9

cough test

Answer 9

apply pressure to SFJ and get pt to cough

thrill suggests dilated vein at SFJ

Question 10

management - simple

Answer 10

weight loss
physical acitvity
keep leg elevated
compression stockings

Question 11

management - surgical options

Answer 11

endothermal ablation
scelotherapy
strippling

Question 12

complications

Answer 12

prolonged + heavy bleeding after trauma
superficial thrombophlebitis
DVT