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General Medicine > Vascular > Flashcards

Vascular Flashcards

0
Q

What is takayasu arteritis

A

Granulomatous inflammation of the aorta and its major branches.
Causes poor peripheral blood flow and a lack of distal pulses.

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1
Q

Where is the sapheno-femoral junction?

A

4cm below and lateral to the pubic tubercle

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2
Q

Presentation of takayasu arteritis

A

Systemic illness- Malaise, fever, Weight loss
Arm claudication
Visual disturbance

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3
Q

What is Churg Strauss syndrome

A

Rare Systemic vasculitis that is associated with eosinophilia and asthma.
Prodromal period of rhinitis and allergies
Associated with pANCA

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4
Q

What is Bechets disease

A

Chronic vasculitis
Strong association with HLA-B5
Occlusive vasculitis and venulitis

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5
Q

Clinical features of Bechets disease

A

Recurrent oral or genital ulceration
Recurrent iritis
skin lesions
thrombophlebitis

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6
Q

what is polymyalgia rheumatica

A

found in 50% of patients with temporal arteritis
causes proximal muscle pain in the shoulders and hips
no weakness
syx worse in the morning

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7
Q

What is giant cell arteritis

A

Inflammatory arteritis of the cranial branches arising from the aorta
F:M 2:1
Most common >50

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8
Q

Features of giant cell arteritis

A 
Malaise, 
temple headache, 
Scalp tenderness 
Jaw claudication
Visual disturbance
Visual loss (due to ischaemic Optic neuritis)
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9
Q

giant cell arteritis findings on examination

A

Enlarged, tender, non-pulsatile temporal artery

Patchy granulomatous inflammation on biopsy

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10
Q

Management of giant cell arteritis

A

Prednisolone

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11
Q

What is wergener’s disease

A

Granulomatous necrotising vasculitis

Triad of involvement - Upper airway pathology, respiratory disease, renal disease

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12
Q

Features of wergener’s disease

A

Upper airway pathology - Epistaxis, saddle nose, rhinitis, deafness, proptosis
Spiritually disease - pulmonary nodules, pulmonary haemorrhage
Renal Disease- glomerulonephritis
c ANCA

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13
Q

What is polyarteritis nodosa

A

Necrotising vasculitis of small and medium vessels

Associated microaneurysm formation

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14
Q

What is microscopic polyangiitis

A

Necrotising focal sentimental glomerulo-nephritis
Renal features of haematuria and proteinuria
cANCA pANCA +ve

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15
Q

What is Kawasaki’s disease

A

Acute febrile systemic vasculitis affecting children

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16
Q

Clinical features of Kawasaki’s disease

A 
Fever for 5 or more days
\+4 of:
-cervical lymphadenopathy
-oral mucosal erythema
-Conjunctivitis
-Rash
-Extremity change such as oedema and desquamation
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17
Q

Main complication Kawasaki’s disease

A

Coronary aneurysm development

Can cause heart attack and sudden death

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18
Q

Features of henoch schonlein purpura

A

Child (usually <5)
Purpuric rash over buttocks / extensor surfaces
Associated with arthralgia, abdominal pain, nephritis

19
Q

What is a fogarty catheter used for?

A

Surgical embolectomy

20
Q

Cause of thrombophlebitis migrans

A

Recurrent thrombophlebitis in different body areas

Caused by pancreatic cancer

21
Q

What is the definition of a true aneurysm

A

Abnormal dilation of an artery involving all three layers of the arterial wall

22
Q

Adverse events associated with aneurysm formation

A

Rupture
Occlusion
Distal Ischaemia
Thromboembolic disease

23
Q

Management of abdominal aortic aneurysm < 5.5 cm diameter

A

Annual abdominal ultrasound/CT scan

24
Q

Risk factors for aortic dissection

A 
Hypertension
Male
Atherosclerosis
Collagen disorder
Trauma
25
Q

What is the difference between type A and type B aortic dissections

A

Type B begin distal to the origin of the left subclavian artery - Can be managed conservatively

Type A involve be ascending aorta - Always require emergency surgical repair

26
Q

Features of an arterial ulcer

A

Deep, painful, sharply defined
Usually on shin or foot
Peripheral pulses decreased or absent

27
Q

Features of arterial disease

A 
Intermittent claudication
Cold feet
Hair loss
Toenail dystrophy
Dusky cyanosis
Ischaemic ulcers
28
Q

What is a marjolin’s ulcer

A

A squamous cell carcinoma occurring in an area of scarred or traumatised skin
E.g. Burns/chronic wounds / ulcers
Raised, fleshy, firm papule
slow-growing

29
Q

Features of neuropathic ulcers

A 
Pressure points
Painless
Punched out
\+/- infection + malodour
Warm, dry skin, good pulses. 
Reduced sensation
30
Q

What is a martorell’s ulcer

A

Ischaemic ulcer of the leg above the ankle
Painful
Occurs due to hypertension

32
Q

What is a saphena varix

A

Dilation of the long saphenous vein

Occurs due to valve incompetence at salhenofemoral junction

37
Q

Management if venous ulcers

A

Exclude arterial component
Compression bandage
Excise necrotic tissue

If this fails - split skin grafting

38
Q

Symptoms of leriche syndrome

A 
Bilateral buttock pain (claudiation)
Erectile dysfunction
(Due to aorto-iliac obstruction)
39
Q

Management of leriche syndrome

A

Risk factor symptoms
Endarterectomy
Bypass grafting

40
Q

Symptoms of critical ischaemia

A

Rest pain in foot

Hanging leg out of bed at night to get comfortable

41
Q

Signs of critical limb ischaemia

A 
Pale 
Cold
Pulseless
Skin damage over pressure sites
Slow cap refill 
Small angle on burgers test + reactive hyperaemia
APBI <0.4
42
Q

Features of Dry gangrene

A

Due to decresed blood supply

Area is cold, dry and black and will slough off

43
Q

Features of wet gangrene

A

Follows infection in the tissues - streptococci / staphylococci.
Swelling and inflammation causes blood vessels blockage.
discharges

44
Q

Symptoms of compartment syndrome

A 
Muscle necrosis 
Severe pain
Pain on passive movement
Tense muscles
Acute renal failure from rhabdomyolysis 
Volkmanns ischaemic contracture
Nerve necrosis
45
Q

Causes of compartment syndrome

A 
Arterial surgery with prolonged clamping
Crush injuries 
Haematomas
Fractures 
Tight plasters
46
Q

Wells criteria for DVT

A

Possible score −2 to 9
Active cancer : +1 point
Calf swelling ≥ 3 cm +1 point
Swollen unilateral superficial veins +1 point
Unilateral pitting oedema +1 point
Previous DVT: +1 point
Swelling of entire leg: +1 point
Localized tenderness along the deep venous system: +1 point
Paralysis, paresis, or recent cast immobilization : +1 point
Recently bedridden ≥ 3 days / major surgery in the past 12 wks +1 point
Alternative diagnosis at least as likely: −2 points

56
Q

Possible symptoms of carotid artery disease

A

TIA
Stroke
Amaurosis fugax

57
Q

Causes of unilateral clubbing

A

Upper limb artery aneurysm

Brachial AV malformation

58
Q

Investigation of a suspected AAA

A

Blood tests:
FBC, clotting screen, renal function and liver function.
ESR and/or CRP if an inflammatory cause is suspected.
ECG, CXR and possibly lung function tests.

Ultrasound
CT with contrast / MRI angiography if suspected rupture

General Medicine (25 decks)

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