Vascualr

Question 1

Anatomical location of the SFJ

Answer 1

2 finger breaths below and lateral to the pubic tubercule

Question 2

Definition of a varicose vien

Answer 2

Torturous dilated vien of the superficial venous system

Question 3

Cause of varicose veins

Answer 3

Primary/idiopathic
- RF: prolanged standing, OCP, pregnancy obesity 
Secondary 5% 
- valve destruction: DVT, thrombophlebitis 
- obstruction: pelvis mass, DVT 
- Avm 
- klippel - trenaunary - weber 
- parkes - weber syndrome

Question 4

Klippel- trenaunary - weber syndrome

Answer 4

Abnormality of the deep venous syndrome causing

• varicose vein
• port wine stain
• bony and soft tissue hypetrophy of the limbs

Question 5

Parkes-weber syndrome

Answer 5

Multiple AVM with limb hypetrophy

AVM can lead to highout out heart failure

Question 6

Types of minimally invasive therapies for varicose viens

Answer 6

Injection sclerotherapy - 1% Na tetradecyl sulphate

Endovenous laser or radio frequency abalation

Question 7

Indication for minimally invasive therapy for varicose veins

Answer 7

Small below knee varicosities not involving the Great saphenous vien or short saphenous vien

Question 8

Indications for surgical management of varicose viens

Answer 8

SFJ Incompetence
Major perforator incompetence
Symptomatic: ulceration, skin changes, pain

Question 9

Surgical intervention for varicose veins

Answer 9

Trendelenburg: saphenofemoral ligation
SSV Ligation: in the popliteal fossa
LSV STRIPPING - No longer performed
Multiple adulation
Cockett’s operation: perforator ligation
SEPS: subfascial endoscopic perforator surgery

Question 10

Complications of varicose viens

Answer 10

Early: heamatoma, wound sepsis, nerve damage
Late
- superficial thrombophlebitis 
- DVT 
- reoccurrence: 10% at 15years

Question 11

Cause of chronic venous insufficiency

Answer 11

Reflux following DVT - 90%

Obstruction following DVT - 10%

Question 12

Surgical management of chronic venous insufficiency

Answer 12

Reflux
- trahere transplantation: axillary vein transplant
- kistner operation: valvuloplasty of damaged valve
Obstruction
- Palma operation

Question 13

Leriche syndrome

Answer 13

Buttock claudication and wasting
Erictile dysfunction
Absent femoral pulses

Question 14

Risk factor for peripheral vascular disease

Answer 14

Modifiable: smoking, BP, DM control, Hyperlipidemia, decreased exercise
Non-modifable: FHx, PMH, Male, increased age, ethnicity

Question 15

Fontaine classification for chronic limb ischemia

Answer 15

1. Asymptomatic - 0.8-1

2. Claudication - a (>200m) b(

Question 16

Doppler sounds

Answer 16

Normal - triphasic
Mild stenosis - biphasic
Severe stenosis - Monophasic

Question 17

Increased risk of AAA rupture

Answer 17

High BP
Smoker
Strong FH
Female

Question 18

Defintion of AAA

Answer 18

Abnormal dilatation of the abdominal aorta to >50% of its normal diameter = >3cm

Question 19

Indication for AAA operation

Answer 19

Symptomatic/evidence of complication 
Rupture 
Asymptomatic 
- greater or equal to 5.5cm 
- expanding greater than 1cm a year

Question 20

Complication of AAA

Answer 20

Death 
MI 
Renal failure 
Spinal or mesenteric ischemia 
Distal trash from thromboembolism 
Anastomotic leak 
Graft infection 
Aortoenteric fistula

Question 21

Signs of chronic venous insufficiency

Answer 21

HAS LEGS 
haemosiderosis 
Atrophie Blanche 
Swelling 
Lipodermatosclerosis 
Eczema 
Gaiters ulcers 
Stars - venous