varicose veins

Question 1

what are varicose veins?

Answer 1

long twisted and diltated vessels of the lower limbs

Question 2

cause

Answer 2

atherosclerosis causing reduced blood flow

can be caused by congenital valve disease, dvt, obstruction, constipation

Question 3

rf

Answer 3

hyperlipidema, hypercholesteremia, obesity
diabetes 
smoking
hypertension
FH
Pregnancy 
the pill
prolonged standing 
crossing leggs

Question 4

symptoms

Answer 4

my legs are ugly
cramping
tingling pan
restless legs

Question 5

signs

Answer 5

odema
prominent veins 
haemorrhage
varicose ecezema 
hair loss
ulcers
phlebitis

Question 6

investigations

Answer 6

clinical examinations
ultrasound
ABPI - < 0.9 suggestive

tap test at SFJ - feel the vein and tap - if varicose should feel percussion down leg

trendbelenburg test- tornquiet on mid thigh when leg is flexed at 90 degrees -to occlude superficial (!!!) things
ask patient to stand
if they fill up - problem after SFJ junction
if they don’t fill up - problem is lower down

Perthes test- tourniquet on mid thigh walk for 2 mins and stand up and down on tip toes 10 times - testing deep veins

auscultation-Doppler

Question 7

if not treated what can lead to

Answer 7

chronic venous insufficiency and ulcers

Question 8

treatment

Answer 8

treat comorbidities
lifestyle changes
stockings 
manual massage
surgery 
injection sclerotherapy
laser coagulation