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Med Finals - Surgery > Vascular > Flashcards

Vascular Flashcards

1
Q

Define peripheral arterial disease

A

Narrowing of the arteries supplying the peripheries

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2
Q

Define intermittent claudication

A

A symptom of ischaemia in a limb, occuring during exertion and relieved by rest. Typically crampy, achy pain in calf thigh or buttock associated with waliing a certain distance.

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3
Q

Define critical limb ischaemia

A

End stage of peripheral arterial disease, where there is inadequate blood supply to a limb to allow it to function normally at rest.

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4
Q

Define acute limb ischaemia

A

Refers to rapid onset of ischaemia in a limb, typically due to a thrombus

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5
Q

Risk factors for atherosclerosis

A

Old age
FH
Male
Smoking
Alcohol
Poor diet - high sugar and fat
Low exercise
Obesity
Poor sleep
Stress
Diabetes
HTN
CKD
Inflammatory conditions - arthrits
Atypical antipsychotics

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6
Q

Clinical features of critical limb ischaemia

A

6 P’s
Pain
Pallor
Pulseless
Paralysis
Paraesthesia - pins and needles
Perishing cold

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7
Q

Features of arterial ulcers

A

Caused by ischaemia
Smaller and deeper than venous
Well defined borders
Punched out appearance
Occur peripherally - on toes
Reduced bleeding
Painful

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8
Q

Features of venous ulcers

A

Caused by pooling of blood
Are larger and more superficial than arterial
Occur after minor injury to leg
Irregular gently sloping borders
Less painful
Signs of chronic venous insufficiency 0 haemosidering, venous eczema

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9
Q

Investigations in peripheral arterial disease

A

ABPI
Duplex ultrasound - volume of blood flow
Angiography

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10
Q

Management of peripheral arterial disease

A

Lifestyle - exercise!
Statins
Clopidogrel
Surgery - angioplasty, endarterectomy, bypass

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11
Q

Management of critical limb ischaemia

A

Urgent revascularisation
?amputation

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12
Q

Define DVT

A

A thrombus that develops in the deep vascular system.

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13
Q

Risk factors for DVT

A

Immobility
Recent surgery
Long haul travel
Pregnancy
HRT - with oestrogen!
Malignancy
Polycythaemia
SLE
Thrombophilia

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14
Q

Examples of thrombophilias

A

Antiphospholipid syndrome
Factor V Leiden
Antithrombin deficiency
Protein C or S deficiency
Prothrombin gene variant
Activated protein C resistance

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15
Q

History of DVT

A

Calf/leg swelling >3cm
Dilated superficial veins
Tenderness in calf
Oedema
Colour changes

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16
Q

What scoring system is used in DVT

A

Wells score

17
Q

Define varicose veins

A

Distended superficial veins measuring more the 3mm in diameter, usually affecting the legs

18
Q

Risk factors for varicose veins

A

Old age
FH
Female
Pregnancy
Obesity
Prolonged standing
DVT

19
Q

History of varicose veins

A

Asymptomatic
Heavy dragging sensation in legs
Aching
Itching
Burning
Oedema
Muscle cramps
Restless legs

20
Q

Management of varicose veins

A

Weight loss
Exercise
Elevate legs
Compression stocking
Surgery - endothermal ablation, sclerotherapy

21
Q

Define chronic venous insufficiency

A

Occurs when blood does not drain efficiently from the legs to the heart. This often leeds to chronic pooling of blood in the legs.

22
Q

Management of chronic venous insufficiency

A

Skin hygiene
Weight loss exercise
Elevate legs
Compression stocking

23
Q

Define lymphoedema

A

Chronic condition caused by impaired lymphatic drainage of an area, tissues in this area become swollen with excess fluid.

24
Q

Management of lymphoedema

A

Massage techniques to drain
Compression
Weight loss
Skin care

25
Q

Define abdominal aortic aneurysm

A

AAA refers to the dilation of the aorta, with a diameter more than 3cm. Often leads to rupture and a high mortality rate.

26
Q

Risk factors for AAA

A

Men
Increased age
Smoking
Hypertension
FH
Existing cardivascular disease

27
Q

What is the screening programme for AAA

A

US in men age 65

28
Q

Classification of AAA

A

Normal <3cm
Small 3 - 4.4cm
Medium 4.5 - 5.4cm
Large >5.5

Yearly screening if small
3 monthly screening if medium
Elective repair if lager
Inform DVLA if >6 and stop driving if >6.5

29
Q

Define aortic dissection

A

Refers to when a break or teat forms in the inner layer of the aorta, allowing blood to flow between the layers of the wall. (between the intima and media)

30
Q

Risk factors for aortic dissection

A

HTN!
Smoking
Male
Poor diet
No exercise
High cholesterol

Bicuspid aortic valve
Coarctation
Aortic valve replacement
CABG
Ehlers-Danlos syndrome
Marfan’s Syndrome

31
Q

History of aortic dissecrriong

A

Ripping/tearing chest pain
Radiates to back
Collapse

Med Finals - Surgery (7 decks)

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