Vascular

Question 1

AAA rupture presentation triad

Answer 1

flank / back pain
hypotension
pulsatile + expansile abdominal mass

Question 2

AAA rupture immediate treatment

Answer 2

high flow O2
IV access
urgent bloods: FBC, U+Es, clotting, G+S, X-match for at least 6 units
Nb. do not aggressively treat hypotension - may dislodge clot formation “permissive hypotension”

Question 3

AAA rupture repair indications

Answer 3

unstable = immediate referral for open repair
stable = req CT angiogram ? appropriate for endovascular repair

Question 4

critical limb ischaemia triad

Answer 4

pain at rest (exacerbated by elevating the leg, relieved by hanging leg off the side of the bed)
wet gangrene
ulcerations

Question 5

acute limb ischaemia presentation

Answer 5

6 Ps
pallor
pulselessness
pain
perishingly cold
paraesthesia
paralysis

Question 6

treatment for pt with acute limb ischaemia + irregularly irregular pulse

Answer 6

surgical embolectomy

irreg irreg pulse is likely to be AF > embolus formation - not thrombus

Question 7

what ABPI value is diagnostic of chronic limb ischaemia

Answer 7

<0.9

Question 8

what ABPI value is diagnostic of critical limb ischaemia

Answer 8

<0.5