Vascular

Question 1

Who is the AAA screening programe offered to?

What should you do if AAA:

1. > 5.5cm
2. 3.0-5.4cm

Answer 1

All men 65 and over

Refer to specialist to be seen within 2 weeks
Refer to a specialist to be seen within 12 weeks

Question 2

What is the monitoring for a AAA if <5.5cm?

Answer 2

4. 5-5.4cm - every 3 months

3. 0-4.4cm - annually

Question 3

Under what circumstances would you operate on a AAA?

Answer 3

Symptomatic
>5.5cm
>4cm and has grown by >1cm in one year

Question 4

What are the 6 P’s of acute limb ischaemia?

Answer 4

Pain, pulselessness, pallor, perishingly cold
Paraesthesia
Paralysis

Question 5

How would you investigate suspected peripheral arterial disease?

Answer 5

ABPI
Doppler of pulses
Angiography

Question 6

What triad of symptoms would you expect with aorto-iliac atherosclerosis?

Answer 6

Thigh/buttock claudication
Absent femoral pulses
Male impotence

Question 7

What is the management for intermittent claudication? (4)

Answer 7

Lifestyle modifications
Supervised exercise programme - if not suitable or no improvement, consider surgery or naftidrofuryl oxalate
Medication e.g. clopidogrel 75mg, atorvastatin 80mg
Optimise diabetes or hypertension if present

Question 8

What are the 4 types of shock?

Answer 8

Hypovolaemic
Cardiogenic - intrinsic cardiac failure
Distributive - marked vasodilation e.g. sepsis, neurogenic
Obstructive - failure of circulatory flow e.g. tension pneumothorax, PE, pericardial tamponade