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SHU > Vascular Surgery > Flashcards

Vascular Surgery Flashcards

1
Q

What is the definition of an AAA?

A

Dilation of all arterial wall layers > 1.5 times the normal diameter
Normal = 2cm
Aneurysm = 3cm
(conservative treatment until > 5.5cm)

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2
Q

What are the risk factors for AAA?

A

Smoking, hypertension, hyperlipidaemia, male, positive family history
Diabetes is a protective factor

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3
Q

What are the complications of AAA?

A

Rupture, thrombosis, distal embolism, pressure on adjacent structures, fistula, infection

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4
Q

What are the important ranges of ankle brachial index (ABI)?

A

0.9-1.2 = normal
0.5-0.9 = claudication expected
< 0.5 = rest pain expected
> 1.2 = arterial calcification

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5
Q

What is the significance of toe pressures?

A

Indicates likelihood of wound / ulcer / stump to heal

>40mmHg required for healing

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6
Q

When would you perform a duplex ultrasound?

A

To assess arterial narrowing or dilation
Greyscale ultrasound detects vessel narrowing (>70% requires treatment)
Colour doppler detects flow velocity

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7
Q

On duplex ultrasound, a 75% stenosis is found. What is the next investigation to order?

A

Computed Tomography Angiography (CTA) to visualise arterial system

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8
Q

On duplex ultrasound, a 75% arterial stenosis is found. What is the next investigation to order?

A

Computed Tomography Angiography (CTA) to visualise arterial system

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9
Q

What imaging can be performed on the venous system?

A

CTA
Doppler ultrasound
Duplex ultrasound
Vein mapping

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10
Q

What is the treatment for mild vascular claudication?

A 
Smoking cessation
Exercise (to improve collaterals)
Weight loss
Aspirin +/- clopidogrel
Statin
\+/- ACEI
(bypass or angioplasty reserved for serious occlusion)
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11
Q

When is surgical carotid endarterectomy indicated?

A

When arterial occlusion is 70% or greater

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12
Q

What is lipodermatosclerosis?

A

Inflammation of subepidermal fat occurring in venous disease where increased pressure causes fibrin to leak out of capillaries (causes brown-red pigmentation and skin thickening)

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13
Q

What are the skin complications of venous disease

A

Venous ulcers
Lipodermatosclerosis
Venous stasis eczema
Haemosiderin staining

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14
Q

What are the treatment options for varicose veins?

A

Compression stockings
Vein ligation + stripping
Laser therapy
Sclerotherapy (injection of sodium tetradecyl sulphate)

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15
Q

What are the six P’s of arterial ulcers?

A 
Pallor
Pain (relieved by dangling leg)
Pulselessness
Paraesthesia
Paralysis
Poikilothermia
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16
Q

Compare the common locations of venous, arterial and neuropathic ulcers.

A

Venous: gaiter area, medial leg
Arterial: between toes, bony prominences
Neuropathic: sole of foot, pressure points

17
Q

Compare the appearance of venous, arterial and neuropathic ulcers.

A

Venous: irregular borders, large but shallow, oozing, yelllow fibrous base, venous skin changes surrounding
Arterial: punched-out, little bleeding, greyish, redness around bace, hairless/pale surrounding skin
Neuropathic: bleed briskly, pink/black/brown, irregular borders, often calloused surrounding skin

18
Q

Where can the femoral pulse be located?

A

Halfway between the ASIS and pubic symphysis (along the ingiunal ligament)

19
Q

What is Beurger’s Test?

A

Raise leg for 2-3 minute (should become pale) and then dangle off side of bed and look for colour change from red to purple

20
Q

What test should be done prior to creating a radial renal fistula or performing a radial artery ABG?

A

Allen’s test for collateral arterial supply to hand

compress ulna + radial arteries until hand is pale, then release ulna artery and look for the colour to return

21
Q

List 5 VTE risk factors.

A 
Age >40
Pregnancy
Malignancy
Thrombophilia
Previous DVT
Obesity
Immobility
OCP
Varicose veins
Central venous catheter
Hormone therapy
IBD
Infection / sepsis,
22
Q

What is Virchow’s triad?

A

Stasis, hypercoagulability and endothelial damage

23
Q

What are the complications of carotid endarterectomy?

A 
Perioperative stroke
MI
Hyperperfusion syndrome
Cervical haematoma (may compromise airway)
Nerve injury
Infection

SHU (10 decks)

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