vascular

Question 1

peripheral artery disease classification

Answer 1

FONTAINE

1. intermittent claudication
2. critical limb ischaemia
   - ankle artery pressure <40mmHg
   - symptoms for >2weeks
   - rest pain or tissue loss (ulceration or gangrene)
3. acute limb-threatening ischaemia

Question 1

critical limb ischaemia according to ABPI

Answer 1

<0.5

Question 2

PAD tx

Answer 2

1. conservative
2. statin + anti-platelet

critical limb ischaemia
1. angioplasty, bypass, stenting, embolectomy
2. amputation

Question 3

varicose veins tx

Answer 3

1. conservative
2. injection sclerotherapy, radiofrequency ablation
3. trendelenburg ligation, cockett’s ligation

Question 4

how are DOACs excreted

Answer 4

dabigatran > renal
rivaroxaban > liver
apixaban > GIT

Question 5

superficial vein thromophlebitis tx

Answer 5

1. compression stockings + NSAIDs
2. • DOAC
3. varicose vein surgery

Question 6

venous ulcer features

Answer 6

medial malleolus / gaiter’s area
painless
brown pigmentation/haemosiderin
eczema

Question 7

arterial ulcer features

Answer 7

painful
toe and heal
cold
pulseless

Question 8

neuropathic ulcers features and mx

Answer 8

due to pressure and loss of sensation of pain and neuropathy
e.g. over plantar surface of hallux and metartasal head
mx = cushioned shoes

Question 9

popliteal bypass mx

Answer 9

stable > femoral-distal bypass
acute > embolectomy

Question 10

AAA screening

Answer 10

all asymptomatic men over 65 are offered single USS

aorta width:
3-4.5cm = scan in 12m
4.5-5.5 = scan in 3m
>5.5 = 2ww referral to vascular

Question 11

femoral canal contents

Answer 11

efferent lymphatic vessels
LNs

Question 12

male inguinal canal contents

Answer 12

spermatic cord
ilioinguinal nerve
genital branch of genitofemoral nerve

Question 13

women inguinal canal contents

Answer 13

round ligament
ilioinguinal nerve
genital branch of genitofemoral nerve

Question 14

superior vena cava obstruction tx

Answer 14

1. dexamethasone +/- endovascular stenting
   if stridor > intubate

Question 15

SVCO symptoms

Answer 15

dyspnoea
swelling of face, neck and arms
headaches
visual disturbance