Vascular conditions Flashcards
What is the triad of symptoms in Leriche syndrome (occlusion of abdominal aorta and/or both iliac arteries)
- Claudication of the buttocks and thighs
- Atrophy of the musculature of the legs
- Impotence (due to paralysis of the L1 nerve)
How to differentiate between acute limb ischaemia and DVT
DVT is red hot
Acute limb ischaemia is cold
Components of wells score for DVT
PRO-THROMBOTIC
- Active cancer
- Immobile/ major surgery within 3 months
LEG FEATURES
- Calf swelling >3cm
- Entire leg swollen
- Pitting oedema only on affected leg
- Non-varicose superficial veins
- Localised tenderness
HISTORY
8. Previous DVT
What investigations to do in a DVT with a likely Wells score (2 points or more)
Doppler within 4h
If cannot within 4h, D dimer + anticoagulant, then Doppler within 24h
If negative Doppler, do d dimer
If negative Doppler + positive d dimer, repeat Doppler 6-8 days later
What investigations to do in a DVT with an unlikely Wells score (1 point or less)
Doppler within 4h
If cannot within 4h, then Doppler within 24h
(No need to do D dimer)
What investigations to do in a PE with a likely Wells score (5 points or more)
Immediate CTPA
If cannot immediate, give anticoagulants until CTPA done
What investigations to do in a PE with an unlikely Wells score (4 points or less)
D dimer
If positive, do immediate CTPA
Contraindications for compression stockings
Peripheral arterial disease
Treatment for confirmed DVT/PE + active cancer
6 months LMWH
Treatment for confirmed DVT/PE without cancer
3 months warfarin
Treatment for unprovoked/ recurrent DVT/PE
Lifelong warfarin
At what age do men get screened for AAA
1 off USS at age 65
AAA screening: what to do if
AAA < 3 cm
No need to repeat screening
AAA screening: what to do if
AAA 3-4.4 cm
Continue USS screening every 1 year
AAA screening: what to do if
AAA 4.5-5.4 cm
Continue USS screening every 3 months
