Vascular

Question 1

Mx of AAA

Answer 1

< 3 cm Normal =
3 - 4.4 cm- Rescan every 12 months
4.5 - 5.4 cm- Rescan every 3 months
>= 5.5cm- Refer within 2 weeks to vascular surgery for probable intervention

Question 1

Takayasu Arteritis Sx

Answer 1

Malaise, headache
Unequal blood pressure in the upper limbs

Absent or weak peripheral pulses
Upper and lower limb claudication on exertion

Question 2

Intermittent claudication defintion

Answer 2

Cramping after walking certain distance

Question 3

Critical limb ischaemia

Answer 3

Pain at rest
Hang foot out of bed
ABPI <0.5

Require urgent vascular referral

Question 4

Burgers disease sx and RF

Answer 4

Heavy smoker
Inflammation in medium arteries
Peripheries- gangrene

Question 5

Burgers sign

Answer 5

Reactive hyperaemia due to deoxygenated blood in dilated capillaries

Question 6

Chronic limb ishcaemia Ix

Answer 6

Doppler
ABPI
Bloods- lipids
Walk test

Question 7

Mx of chronic limb ischaemia

Answer 7

Conservatively- stop smoking
Surgical if- short walking distance, affecting QoL, pain at rest develops
Medical- clopidogrel, statin 80mg

Question 8

Mx of ALI

Answer 8

Embolus- embolectomy
With forgarty catheter
Anticoagulate
Tx cause- AF

Thrombosis- angiography and plasty
Or thrombylysis
or Amputation - if dead gangrenous

Question 9

Critical limb Ischaemia

Answer 9

1 or more of
Pain at rest >2w
Ulcers
Gangrene

Question 10

Investigations for peripheral vascular disease

Answer 10

Handheld doppler 1st
ABPI

Question 11

Anatomy of arteries in lower limb

Answer 11

External Iliac to common femoral after inguinal ligament

CFA to superficial and profunda

Becomes popliteal
Tibio-Peroneal trunk- Anterior tibialis branch off
Split into posterior tibialis and peroneal

Question 12

Anatomy of lower limb veins

Answer 12

External iliac to femoral

Great saphernous branch off- medially

Popliteal with small saphenous branch off on lateral side

Anterior tibial branch off
Peroneal branch off
Continue as posterior tibial

Question 13

Tx of superficial thrombophlebitis

Answer 13

NSAIDs
Compression stockings

Question 14

Medication that increase VTE prevalence

Answer 14

COCP
Tamoxifen
Antipsychotics
Oestrogen therapy

Question 15

Changes seen in venous ulcers

Answer 15

Brown piigmentation- haemosiderin
Lipodermatosclerosis
Eczema

Question 16

Initial management of acute limb ischaemia

Answer 16

IV heparin
analgesia
Vascular review

Question 17

When is ABPI >1

Answer 17

Calcification in DM

Question 18

Leriche syndrome

Answer 18

Iliac atherosclerosis
Causing, buttock claudication, impotence, decrease distal pulses

Question 19

When to start DOAC for DVT before Ix

Answer 19

If >4 hours before d dimer or scan can be done

Question 20

Tx of aortic dissection

Answer 20

A- ascending- surgery

B- beta blockers IV

Question 21

Arterial vs neuropathic ulcers

Answer 21

Arterial- heel and toes- painful and cold- reduced ABPI

Neuropathic- plantar surface

Question 22

Mx of popliteal aneurysm

Answer 22

Stable- femoral distal bypass- if symp, thrombus, >2cm

Acute- embolectomy +/- bypass

Question 23

Ix for venous ulcer

Answer 23

Venous duplex US

Question 24

Tx of severe PAD or critical ischaemia

Answer 24

Endovascular- angioplasty +/- stent
used for short segment stenosis (e.g. < 10 cm)

Surgical- endarectomy/bypasss-
open surgical techniques are typically used for long segment lesions (> 10 cm),