Vascular High Yield Flashcards
> 10mmHg BP difference between both arms
aortic dissection, proximal coarctation, subclavian artery stenosis
carotid bruit
carotid artery stenosis
Trophic changes (shiny thinned skin, hair loss, ulcers), w/bilateral callous formation, and early ulceration
CABG vein grafting scar
axillofemoral / axillobifemoral bypass - aortoiliac occlusive disease
femorofemoral - unilateral iliac disease
midline laparotomy scar + bilateral groin scars
aortobifemoral bypass - aortoiliac occlusive disease (axillofemoral if pt unable to tolerate this procedure)
iliofemoral - unilateral iliac disease
femoropopliteal / tibial / distal - femoropopliteal disease
Ix and imaging for PAD
MRA vs catheter angiography
Mx of PAD
✅ Conservative (All Patients)
Smoking cessation (most important).
Exercise therapy (supervised walking programs).
Statins (Atorvastatin 80mg) + Antiplatelet (Clopidogrel 75mg).
Diabetes & Hypertension Control.
✅ Medical Therapy
Cilostazol, Naftidrofuryl oxalate, Pentoxyfiline (for intermittent claudication if lifestyle changes fail).
✅ Intervention (If Severe/Lifestyle-Limiting)
Angioplasty +/- Stenting (First-line for short, focal stenosis).
Bypass Surgery (If long segment disease).
Amputation (Last resort if critical limb ischaemia with gangrene).
🔹 Critical Limb Ischaemia = Rest pain, ulcers, gangrene → Urgent referral for vascular intervention.
Stages of venous insufficiency
RFs for VTE
- Prolonged immobility (e.g., prolonged bed rest, long-haul flights).
- History of previous DVT or PE (pulmonary embolism).
- Cancer, especially with advanced disease or on chemotherapy.
- Surgery or trauma, particularly orthopedic procedures (e.g., hip or knee replacement).
- Oral contraceptive use or hormone replacement therapy (HRT).
Virchow’s Triad
DVT Ix
Well’s score for DVT
Varicose vein definition
Enlarged, twisted veins, usually in the legs, caused by weakened or damaged valves, leading to blood pooling.
RFs for varicose veins
Age, family history, female gender, pregnancy, obesity, prolonged standing or sitting.
Assoc. skin changes w/varicose veins
Hyperpigmentation, eczema, lipodermatosclerosis, venous ulcers, atrophie blanche.
Gold standard varicose veins dx?
Duplex ultrasound: Non-invasive and assesses blood flow and valve function.
Mx options for varicose veins
Conservative: Compression stockings, lifestyle changes.
Sclerotherapy: Injection of a solution to close the vein.
Endovenous laser therapy (EVLT): Laser to close the vein.
Surgical ligation/stripping: Removal of the vein in severe cases.
Indications for vascular referral of varicose veins
Bleeding
Symptoms (e.g. pain, aching, discomfort, swelling, heaviness and itching)
Venous eczema/pigmentation,
Superficial vein thrombosis
Venous ulceration
What is saphena varix?
A saphena varix is a dilated or swollen area of the great saphenous vein at its junction with the femoral vein, often presenting as a palpable lump or swelling in the groin or thigh.
It may be mistaken for a hernia but can be differentiated by performing a Valsalva maneuver (hernia will not change in size, but a saphena varix will).
Tredelenburg test in venous exam
