Vascular

Question 1

What WELLs score denotes a DVT is ‘highly likely’

Answer 1

2 or more

Question 2

Investigations to identify the source of an embolus include:

Answer 2

ECG (e.g. to identify atrial fibrillation)
Echocardiogram
Aortic ultrasound
Popliteal and femoral artery ultrasound.

Question 3

The 2 most common causes of acute limb ischaemia is

Answer 3

acute thrombotic occlusion of a pre-existing stenotic arterial segment (60% of cases)

The second commonest cause is embolism (30%),

Question 4

The most common site for TAAs

Answer 4

Aortic arch

Question 5

In current UK clinical practice, elective surgery for AAAs is recommended if:

Answer 5

The aneurysm is symptomatic

The aneurysm is asymptomatic and larger than 5.5 cm in diameter

The aneurysm is asymptomatic and larger than 4 cm in diameter and has increased in size more than 1 cm in the past year

Question 6

If an AAA is detected as part of the UK screening program or as an incidental finding:

Answer 6

If the AAA is larger than 5.5 cm in diameter, the patient should be seen by a vascular specialist within 2 weeks.

If the AAA is smaller than 5.5 cm, the patient is usually monitored by the surveillance program.

Question 7

AAA surveillance

Answer 7

Small AAAs (3.0-4.4 cm) should undergo regular ultrasound scans every 12 months to monitor for any changes in size.

Medium AAAs (4.5-5.4 cm) require more frequent monitoring with ultrasound every 3 months to detect rapid expansion, which may necessitate earlier intervention.

Question 8

The most common cause of acute limb ischaemia is

Answer 8

acute thrombotic occlusion of a pre-existing stenotic arterial segment (60% of cases). The second commonest cause is embolism (30%),

Question 9

The most significant modifiable risk factor for the progression and rupture of abdominal aortic aneurysms (AAAs

Answer 9

Smoking