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Core Conditions > Vascular > Flashcards

Vascular Flashcards

1
Q

Define acute limb Ischaemia

A

Sudden decrease in arterial perfusion due to thrombotic or embolic causes

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2
Q

What are the most common sites for atherosclerotic lesions in the upper limb ?

A
  • subclavian artery

- brachioceohalic trunk

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3
Q

Clinical features of upper limb Arterial disease

A
  • pulse less, pale, arm pain, paraesthesia, cold (5Ps)

- unequal arm pressure - more than 15 diff = possible subclavian stenosis

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4
Q

Risk factors for PVD

A
  • smoking
  • DM
  • hypertension
  • hyperlipidaemia
  • physical inactivity
  • obesity
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5
Q

Define critical limb Ischaemia

A
  • Ischaemic rest pain
  • Ischaemic lesions or gangrene
  • attributable to arterial occlusive disease
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6
Q

Where is the PVD if buttock claudication is present ?

A

Iliac disease

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7
Q

Calf claudication suggests PVD where ?

A

Femoral artery

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8
Q

Who is at risk if buerger’s disease ?

A

Young heavy smokers

  • aka thromboangitis obliterans
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9
Q

What is leriches syndrome ?

A

Form if peripheral artery disease, involves bifurcation of aorta
- buttock claudication and impotence

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10
Q

First line anti platelet for PVD ?

A

Clopidogrel

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11
Q

How is intermittent claudication managed ?.

A
  • modify risk factors
  • supervised exercise programme
  • vasodilator e.g. Naftidrofuryl oxalate (if exercise not helped and do not want surgery)
  • revascularisation: angioplasty or bypass /graft (if angioplasty unsuccessful and severely life limiting claudication)
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12
Q

What is the first line imaging technique used when revascularisation is being consider in PVD ?

A

Duplex ultrasound

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13
Q

When is percutaneous transluminal angioplasty appropriate for treatment of PVD ? What is it ?

A
  • If disease is limited to single arterial segment
  • inflate balloon in narrowed segment
  • can use stent to maintain patency
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14
Q

When is arterial reconstruction with a bypass graft appropriate to treat PVD ?.

A
  • If atheromatous disease is extensive but distal run off is good (distal arteries filled by collateral vessels)
  • autologous vein grafts superior to prosthetic grafts
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15
Q

Emboli causing acute limb Ischaemia often originate from where ?

A

Heart-AF;mural thrombosis

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16
Q

Pathogenesis of varicose veins ?

A
  • Blood from superficial veins of leg passes into deep veins via perforator veins and at sapheno-femoral and sapheno- popliteal junctions
  • valves normally stop blood passing back in to superficial veins
  • if valves incompetent, there is venous hypertension then dilatation of superficial veins can occur
17
Q

Risk factors for varicose veins ?

A
  • prolonged standing
  • obesity
  • pregnancy
  • family history
  • the pill
18
Q

Symptoms if varicose veins

A
  • pains
  • cramps
  • tingling
  • heaviness
  • restless legs

*only slightly more common than in normal population

19
Q

Signs of varicose veins

A
  • oedemal
  • eczema
  • ulcers
  • phlebitis
  • atrophie blanc
20
Q

What is the criteria for referral of patients with varicose veins to vascular service ?

A
  • Bleeding, pain, ulceration,
  • superficial vein thrombosis
  • lower limb skin changes e.g. Pigmentation, eczema (due to chronic venous insufficiency
21
Q

what method is used to confirm diagnosis of varicose veins ?

A

Duplex ultrasound

22
Q

What are the treatment options for varicose veins ?

A
  • symptomatic I.e. Analgesia, compression stockings etc
  • endothermal ablation
  • ultrasound guided foam sclerotherapy (if ablation not appropriate )
  • surgery (if neither of above suitable)
23
Q

What is saphena varix ?

A
  • Dilatation in saphenous vein at its confluence with the femoral vein (sapheno-femoral junction)
  • transmits cough impulse, may be mistaken for inguinal/fem hernia, but on closer inspection should have bluish tinge
24
Q

What is a true aneurysm ?

A

An abnormal artery dilatation >50% of original diameter, involving ALL layers of arterial wall

25
Q

What are pseudo aneurysms ?

A

Collection if blood in the outer layer of arterial wall only (adventitia), which communicates with the lumen

26
Q

Are most AAA fusiform or berry aneurysms ?

A

Fusiform

27
Q

Where in the aorta is an aneurysm most likely to occur ?

A

Infrarenal

28
Q

Complications of AAA

A
  • rupture
  • thrombosis
  • embolism
  • fistulae
  • pressure on surrounding structures
29
Q

Symptoms and signs of ruptured AAA ?

A
  • intermittent or continuous abdo pain (radiates to back, iliac fossa and groin)
  • collapse
  • expansile abdo mass
30
Q

Which patients are endo vascular repair of AAA recommended for ?

A

Unruptured infra renal AAA

Core Conditions (15 decks)

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