Vascular

Question 1

Clinical signs on upper limbs

Answer 1

Peripheral cyanosis/pallor
Tar staining
Xanthomata
Gangrene

Question 2

Causes of radio-radial delay

Answer 2

Subclavian artery stenosis (cervical rib compression)
Aortic dissection

Question 3

2 main causes of wide pulse pressure

Answer 3

Aortic dissection + aortic regurgitation

Question 4

Clinical signs in lower limbs

Answer 4

Peripheral cyanosis/pallor
Ischaemic rubour
*venous and arterial ulcers
Gangrene
Missing limbs/toes/fingers
Scars
Hair loss
Muscle wasting
Xanthomata
Paralysis (ask to wiggle toes)

Question 5

Venous vs arterial ulcer

Answer 5

Venous = large, shallow, irregular border, mildly painful, usually over medial malleolus
Arterial = small, deep, well-defined, painful, usually in most peripheral regions of a limb (digits)

Question 6

Location of femoral pulse

Answer 6

Mid-inguinal point - halfway between ASIS and pubic symphysis

Question 7

Implication of femoral bruit

Answer 7

Femoral or iliac stenosis

Question 8

Location of dorsalis pedis pulse

Answer 8

Dorsum of foot, lateral to extensor hallucinations longus tendon, over 2nd + 3rd cuneiform bones

Question 9

Implications if leg develops pallor during Buerger’s test

Answer 9

Peripheral arterial disease = Buerger’s angle (note the angle at which this develops)
Healthy people should remain pink even to 90 degrees