Vascular Flashcards
What difference in arm BP is significant for arterial disease?
>10mmgHg
What are the features of arterial ulcers
Dorsal/between toes
More distal
Well demarcated but irregular edge
Grey granulation tissue
No blood +hair loss/pale/muscle wasting/nail dystrophy
Pain at night relieved hanging over bed
What are the features of venous ulcers?
Mid calf to malleoli
Surrounding edema
Large and shallow
Granulating base and irregular border
Surrounding by skin changes
Relieved ellevating leg
What is atrophie blanche and what does it represent?
White plaques with telengectasia surrounded by hyperpigmentation
SIgn of venous insufficiency
What are the features of neuropathic ulcers?
Punched out
Deep Sinus
On pressure points
Surrounded by inflammatory tissue
Debreiding or bleeding
Painless
What is lipodermatosclerosis?
Chronic inflammation of subcutaneous tissue, more common in fat people.
Sign of venous disease
ABPI for intermittent claudication?
<0.9
Acute Limb Ischaemia ABPI
<0.6
Pale
Pulseless
Pain
Parathesia
Perishingly Cold
Paralysis
Critical Limb Ischaemia ABPI
<0.3
What is a sign of a misleadingly high APBI?
Calcification (so can’t compress arteries) usually from diabetes
Intervention for Peripheral Arterial Disease
Exercise - improves muscle metabollism, aim to increase walking distance
Improve CV health - antiplatelets, statin, BP, DM
Endovascular treatments - angioplasty/stent
Surgical reconstruction
Amputation
What are the signs of arterial insufficiency?
Loss of pallor
Edema
Loss of hair
Thin, shiny skin
Ulcers
Muscle wasting
Reactive hyperaemia
Rest pain e.g ischaemia night pain
Malignant melanoma
A Asymmetry
B Border irregularity
C Colour variation
D Diameter over 6 mm
E Evolving (enlarging, changing)
