Vascular Disease

Question 1

Pain on walking relieved by rest

Answer 1

Peripheral artery disease =
Intermittent claudication

Question 2

Peripheral artery disease investigation

Answer 2

1. Ankle brachial pressure
2. Doppler US
3. CT angiography

Question 3

Peripheral artery disease treatment

Answer 3

Quit smoking
Treat hypertension and high cholesterol
Clopidogrel

Question 4

If peripheral artery disease is severe

Answer 4

Angioplasty

Question 5

Acute limb ischaemia

Answer 5

6P:
Pain
Pale
Pulseless
Paralysed
Paraesthetic
Perishingly cold

Usually thrombosis

Revascularisation within 4 hours

Question 6

Aortic dissection investigation

Answer 6

X-ray - wide mediastinum
Ct angiography
If unstable - transesophageal echo

Question 7

AAA screening

Answer 7

individuals at higher risk, such as men over 65, smokers, or those with a family history, can request an ultrasound scan from their doctor to screen for AAA.

Question 8

Medication to reduce thromboembolic events during hospital stay

Answer 8

Enoxaparin

Question 9

Artery embolism management

Answer 9

1. Unfractionated Heparin.
   2, emergency embolectomy

Question 10

Non-healing diabetic foot ulcer treatment

Answer 10

Revascularisation with angioplasty and stenting

Question 11

Short of breath after a loan flight and sinus tachycardia

Answer 11

Suspected pulmonary embolism

V/Q scan

Question 12

Worst sign of acute limb ischaemia

Answer 12

Paralysis

Requires immediate surgery

Question 13

How to monitor heparin effect

Answer 13

APTT from 1.5 to 2.5 times the baseline value of the patient

Question 14

Mortality rate of a ruptured AAA

Answer 14

80%

Question 15

Size of AAA for surgery

Answer 15

For man 5.5 cm
For women 5 cm

Question 16

Management of different sizes of AAA

Answer 16

Ultrasound:
3-3.9 cm - 24 m
4-4.5 cm - 12m
4.6 - 5 - 6 m
More than 5 cm - 3 m

Question 17

Sudden acute calf pain

Answer 17

Ischaemia

Urgent CT angiogram

Question 18

treatment for carotid stenosis

Answer 18

Carotid endarterectomy

Question 19

Worst sign of intermittent claudication that requires surgery

Answer 19

Rest pain

Question 20

Anticoagulation after surgery

Answer 20

Low molecular heparin first - enoxaparin

Then after 24 to 48 hours warfarin

Once I NR is in therapeutic Range warfarin can be stopped (can take five days)

Question 21

If patient is on warfarin but develops further thrombosis

Answer 21

Switch to heparin and consider inferior vena cava filters

Question 22

Superficial thrombophlebitis at cannulation site

Answer 22

NSAIDs

Question 23

Stenosis of left renal artery treatment

Answer 23

Angioplasty

Question 24

Contraindication to compression stockings

Answer 24

Ankle brachial pressure index less than 0.8

Question 25

Driving after AA A

Answer 25

No driving for four weeks Three months for commercial

Question 26

Complication of femoral artery catheterisation

Answer 26

Pseudo aneurysm - pulsatile painful mass in the groin Treatment Injection of thrombin into the mass

Question 27

Management of aortic dissection and ruptured AAA before surgery:

Answer 27

Dissection: B-blockers (to prevent further dissection) AAA: slow IV infusion

Question 28

Most common sight of acute ischaemia

Answer 28

Common femoral artery

Question 29

Ankle brachial index measured

Answer 29

By colour Doppler 0.9-1.1 - normal 0.3 gangrene

Question 30

Buttock pain on walking - stenosis of

Answer 30

Common Iliac artery

Question 31

Most common site affected causing intermittent claudication

Answer 31

Superficial femoral artery

Question 32

Calf claudication - stenosis of

Answer 32

Superficial femoral artery

Question 33

DVT treatment

Answer 33

Heparin first Warfarin within one two days Once INR reached heparin can be withheld Warfarin for six months

Question 34

Most common causes of acute limb ischaemia

Answer 34

Thrombosis

Question 35

Raynaud phenomenon treatment

Answer 35

Avoid precipitating factors Nifedipine

Question 36

Sydenham chorea treatment

Answer 36

Carbamazepine

Question 37

Coagulation after embolectomy

Answer 37

Heparin and then warfarin for 3-6 months

Question 38

DVT in pregnancy treatment

Answer 38

LMWH for three months therapeutic dose Then prophylactic dose until 6 weeks postpartum

Question 39

Warfarin in pregnancy

Answer 39

Is contraindicated due to embryopathy

Question 40

Suspected PE Inv

Answer 40

1, ECQ 2. CXR 3. VQ or CTPA