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Finals > Vascular > Flashcards

Vascular Flashcards

1
Q

Normal aorta size

A

<3cm

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2
Q

Small aortic aneurysm

A

3-4.4cm

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3
Q

Medium aortic aneurysm

A

4.5-5.4cm

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4
Q

Large aortic aneurysm

A

> 5.5cm

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5
Q

What are the modifiable risk factors for an aortic aneurym?

A

*Smoking
*Diet
*Exercise level
*Hypertension
*Diabetes
*Hyperlipidaemia

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6
Q

What is the screening programme for aortic aneurysm?

A

Abdominal USS for males aged 65+

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7
Q

Screening outcome: small aneurysm

A

Rescan every 12 months

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8
Q

Screening outcome: medium aneurysm

A

rescan every 3 months

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9
Q

Screening outcome: large aneurysm

A

Refer within 2 weeks to vascular surgery for probable intervention

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10
Q

Management of asymptomatic aneurysm, less than 5.5 cm

A

Abdominal USS surveillance and optimise cardiovascular risk factors

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11
Q

Management of ≥5.5cm, or rapidly growing , or symptomatic aneurysm

A

Refer within 2 weeks with elective endovascular repair (EVAR) or open repair

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12
Q

What counts as a rapidly growing aneurysm?

A

> 1cm a year

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13
Q

What is EVAR?

A

Stenting via the common femoral artery

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14
Q

What are the three patterns of peripheral arterial disease?

A
  1. intermittent claudication
  2. critical limb ischaemia
  3. Acute limb threatening ischaemia
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15
Q

Presentation of critical limb ischaemia

A
  • Rest pain in foot for >2 weeks
  • Ulceration
  • Gangrene
  • ABPI of <0.5
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16
Q

Management of critical limb ischaemia

A
  • refer to vascualr specialist
  • aspirin
  • risk factor modification: stop smoking, increase exercise, decrease salt
17
Q

What is the presentation of acute limb ischaemia

A
  • 6Ps: pallor, pulselessness, paraesthesia, paralysis, pain, paralysis
  • onset of symptoms rapidly over 2 weeks
18
Q

What points towards an embolic cause of acute limb ischaemia?

A
  • sudden onset
  • less severe than thrombotic
  • cardiac history of AF or recent MI
  • unlikely to have history of PAD
  • cold; soft tender artery
19
Q

What points towards a thrombotic cause of acute limb ischaemia?

A
  • gradual/vague onset
  • severe
  • no cardiac history
  • history of PAD
  • hard artery; less cold than embolic; cyanotic
20
Q

What is the management of acute limb ischaemia?

A
  • endovascular thrombolysis
  • endovascular thrombectomy or surgical embolectomy
  • bypass surgery
  • amputation if unable to restore the blood flow
  • ABCDE, IV opioids, vascular review
21
Q

What are the complications of peripheral arterial disease?

A
  • leg/foot ulcers
  • gangrene
  • permanent limb weakness/numbness/pain
22
Q

What is the presentation of a ruptured abdominal aortic aneurysm?

A
  • Severe abdominal pain radiating to the back or groin
  • HAemodynamic instability
  • pulsatile and expansile mass in the abdomen
  • collapse
  • loss of consciousness
23
Q

What is the management of ruptured abdominal aortic aneurysm?

A
  • surgical embolectomy
  • if they are haemodynamically stable you can use CT angiography to diagnose/exclude
24
Q

What is carotid artery disease?

A

Narrowing of the carotid arteries in the neck secondary to atherosclerosis

25
Q

What is the presentation of carotid artery disease?

A
  • asymptomatic
  • cervical bruit
  • focal neurological deficit - stroke or TIA
26
Q

What is the investigation for carotid artery disease?

A
  • duplex ultrasonography
  • CT angiography of the head, neck, and chest
27
Q

Classification of carotid artery disease

A
  • mild <50% reduction in diameter
  • moderate 50-69% reduction in diameter
  • severe 70%+ reduction in diameter
28
Q

Conservative management of carotid artery disease

A
  • diet and exercise
  • stop smoking
  • anti-platelet
  • lipid lowering medication
29
Q

Surgical management of carotid artery disease

A

carotid endartectomy or angioplasty and stenting

30
Q

What are the main complications of carotid artery disease?

A

Thromboembolism -> ischaemic stroke or TIA

31
Q

Medical management of intermittent claudication

A
  • Atorvastatin 80mg
  • Clopidogrel 75mg once daily (aspirin if clopidogrel is unsuitable)
  • Naftidrofuryl oxalate (5-HT2 receptor antagonist that acts as a peripheral vasodilator)
32
Q

What is ABPI?

A

ratio of systolic blood pressure (SBP) in the ankle (around the lower calf) compared with the systolic blood pressure in the arm

33
Q

Explain the results of ABPI

A
  • 0.9 – 1.3 is normal
  • 0.6 – 0.9 indicates mild peripheral arterial disease
  • 0.3 – 0.6 indicates moderate to severe peripheral arterial disease
  • Less than 0.3 indicates severe disease to critical ischaemic
34
Q

What are the signs in a history of a venous ulcer?

A
  • DVT or venous disease previously
  • obesity
  • pregnancy
  • immobility
  • pro-thrombotic tendency
35
Q

What are the signs on examination of a venous ulcer?

A
  • gaiter area
  • shallow
  • palpable pulses
  • normal CRT
  • varicosities
  • haemosiderin deposition
  • venous eczema

Finals (37 decks)

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