Vascular

Question 1

stages of PAD

Answer 1

intermittent claudication
night pain
rest pain/critical limb ischaemia

Question 2

Ix for PAD

Answer 2

ABPI ( <0.9 = PAD)
Duplex

Question 3

what is buergers test

Answer 3

elevate the affected leg (notice the leg turn pale); hang leg over side of bed (note Reactive Hyperaemia)

Question 4

non surgical Mx for PAD

Answer 4

exercise program
Antiplatelet (clopidogrel)
Statin

Question 5

symptomatic relief for PAD

Answer 5

naftidofuryl oxylate

Question 6

px of arterial ulcer

Answer 6

punched out, dry base, necrotic
on a hairless, red, shiny leg

Question 7

px of venous ulcer

Answer 7

wet, sloping edges, larger
found in the gaiter region

Question 8

Px of chronic venous disease

Answer 8

swollen limb
haemosiderin deposition
lipodermatosclerosis
venous eczema

Question 9

permissive hypotension
how does it work

Answer 9

Aggressive fluid resus is avoided

introducing too much fluid quickly → higher cardiac output → increased MABP → peripheral vasodilation → more blood loss

Question 10

two Mx for AAA

Answer 10

open repair

EVAR (not if they are haemodynamically unstable) shorter hospital stay

Question 11

blood pressure in aortic dissection

Answer 11

hypertensive

Question 12

Ix in aortic dissection

Answer 12

CT angiography

Question 13

surgical Mx of aortic dissection

Answer 13

TEVAR

Question 14

initial Ix for carotid artery stenosis

Answer 14

duplex ultrasound

Question 15

classifying carotid artery stenosis and respective Mx

Answer 15

• minor– 0 to 49% narrowed
• moderate– 50 to 69%narrowed
• severe – 70 to 99% blocked

moderate or severe / >50% stenosed = carotid endarterectomy / stent

choice between stent and CEA depends on patient

Question 16

medical management of carotid artery stenosis

Answer 16

aspirin/clopidogrel

statin (atorvastatin 80mg)

smoking cessation, control of HTN, diabetes