Vascular

Question 1

What is critical limb ischaemia?

Answer 1

advanced form of chronic limb ischaemia.

ABPI less than 0.3

Question 2

ABPI

• Normal
• Mild
• Moderate
• Severe

Answer 2

• Normal= >0.9
• Mild= 0.8-0.9
• Moderate= 0.5-0.8
• Severe= <0.5

Question 3

What can an ABPI of greater than 1.2 indicate?

Answer 3

calcification

T2DM may have vessel calcification

Question 4

What is claudication?

Answer 4

a cramping-type pain in the calf, thigh, or buttock after walking a fixed distance (the ‘claudication distance’), relieved by rest within minutes.

Question 5

What does an APBI of 0.3 indicate?

Answer 5

Severe

Likely critical limb ischaemia

Question 6

What are signs of chronic venous insufficiency?

Answer 6

• Brown pigmentation
• calves appear wider at the knee than at the ankle (champagne bottle sign)
• eczema
• dry skin

Question 7

Causes of venous ulcers

Answer 7

• chronic venous insufficiency

- venous hypertension

Question 8

How do arterial ulcers present?

Answer 8

Occur on the toes and heel

painful

may be areas of gangrene

cold with no palpable pulses

Low ABPI measurements

Question 9

What ABPI would you expect in claudication?

Answer 9

less than 0.5 but greater than 0.3

Question 10

What ABPI would you expect with rest pain?

Answer 10

less than 0.5

Question 11

What screening is currently available for AAA?

Answer 11

Single abdominal ultrasound aged 65

Question 12

What are the 6 Ps that acute limb ischaemia presents with?

Answer 12

pale, pulseless, pain, paralysis, paraesthesia, perishingly cold

Question 13

What is the most appropriate management for acute limb ischaemia?

Answer 13

Surgical intervention

Question 14

Critical limb ischaemia

• clinical presentation

Answer 14

History of PAD

Critical limb ischaemia presents as pain at rest for greater than 2 weeks, often at night, not helped by analgesia