Vasc

Question 1

What is the screening programe for AAAs?

Answer 1

Single abdo USS for men at 65

Question 2

What is marjolins ulcer?

Answer 2

SCC occuring at sites of chronic inflammation

Question 3

Which features indicate a AAA is high risk of rupturing and should therefore be managed surgically?

Answer 3

Symptomatic
>=5.5cm
>1cm growth/year

Question 4

Stenosis of which vessels is most likely to cause buttock claudication?

Answer 4

Illiac

Question 5

Stenosis of which vessels is likely to present with calf pain?

Answer 5

Femoral

Question 6

What should PVD patients be prescribed for secondary prevention of cardiovascular disease?

Answer 6

Clopi 75 and Atorva 80

Question 7

What is the management of peripheral arterial disease?

Answer 7

Quit smoking
Atorva 80
Clopi 75
Exercise training
Angioplasty
Stenting 
Bypass
(Naftidrofuryl oxalate)

Question 8

What ABPI is likely seen in a hyperaemic foot?

Answer 8

0.3-0.5

Question 9

ABPI in diabetics?

Answer 9

Aberrantly high

Question 10

What ulcer might be seen at a stoma site?

Answer 10

Pyoderma gangrenosum

Question 11

A 25-year-old junior doctor has a chest x-ray performed as part of a routine insurance medical examination. The x-ray shows evidence of rib notching. Auscultation of his chest reveals a systolic murmur which is loudest at the posterior aspect of the fourth intercostal space.

Answer 11

Aortic coarctation

Coarctation of the aorta may occur due to the remnant of the ductus arteriosus acting as a fibrous constrictive band of the aorta. Weak arm pulses may be seen, radiofemoral delay is the classical physical finding. Collateral flow through the intercostal vessels may produce notching of the ribs, if the disease is long standing.

Question 12

A 48-year-old man notices that he is becoming increasingly dizzy when he plays squash, in addition he has also developed cramping pain in his left arm. One day he is inflating his car tyre with a hand held pump, he collapses and is brought to hospital.

Answer 12

Subclavian steal syndrome

Subclavian steal syndrome is associated with a stenosis or occlusion of the subclavian artery, proximal to the origin of the vertebral artery. As a result the increased metabolic needs of the arm then cause retrograde flow and symptoms of CNS vascular insufficiency.