Vascular surgery - Surgical managament summary

Question 1

Answer 1

Question 2

Answer 2

Overall mortality from AAA rupture is estimated at 80–90%.

Approximately half of all patients with ruptured AAA die before reaching a hospital.

Those who do arrive to the hospital alive, about 50% will die.

Management:
ABCDE
Obtain IV access but limit fluids.

Permissive hypotension (as low as 70 mmHg), maintain mentation.
Repair via open or EVAR.

Question 3

Answer 3

Question 4

Answer 4

Intermittent claudication
Lifestyle modification: quit smoking (vital); manage comorbid conditions (hypertension, high cholesterol and DM)

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

What is the management for varicose veins ?

Answer 11

Question 12

What is the BIGGEST risk factor for an Aortic Dissection ?

Answer 12

Hypertension

Question 13

1- What are the two types of Aortic Dissection using the Stanford classification?

2- What is the biggest risk factor?

3 - How will a patient present?

4- What investigations?

5 - What is the treatment ?

Answer 13

Question 14

1- What are the risk factors for AAA?

2- What are the signs of AAA?

3- What is the best investigation for surveillance ?

4 - What is classed as a small/medium/large AAA?

5- What is the best investigation for treatment?

6- What surgical treatment options are they?

7 - How would you manage a ruptured AAA?

Answer 14

Question 15

1- Where is the common location that an emboli form, and therefore causing a stroke?

2- What is the best imaging for carotid stenosis?

3- What is the surgery for carotid stenosis?

4- Who qualifies for this surgery?

Answer 15

Question 16

What is the most common pathological change associated with PAD?

What is the most common symptom of PAD?

Answer 16

Question 17

What are the symptoms of chronic limb ischaemia?

What symptoms would you see if this turned into critical limb ischaemia?

What examination can you do to check for this?

What investigations/ imaging should be done?

What is a normal ABPI ?

What is the management for intermittent claudication?

What is the management for critical limb ischaemia ?

What is the biggest sign for loss of limbs for patients with limb ischaemia ?

Answer 17

Question 18

What is acute limb ischaemia?

What causes acute limb ischemia?

What are the classical features of acute limb ischemia?

How would the presentation differ between embolus and thrombus?

Answer 18

Question 19

What is Amaurosis Fugax ?

Answer 19

Amaurosis fugax – transient monocular visual disturbance “like a curtain coming down over one eye”, lasting several minutes.

Question 20

What is the amount of Carotid stenosis that indicates a carotid endarterectomy?

Answer 20

Patients with > 50% to 99% stenosis
CEA (carotid endarterectomy) recommended within 3-6 months of symptoms.

Question 21

What is this?

Answer 21

Lipodermatosclerosis

Question 22

What is a saddle embolus ?

Answer 22

A saddle pulmonary embolism is a life-threatening condition characterised by a large blood clot that lodges at the bifurcation of the pulmonary artery, obstructing blood flow to both lungs. It can also happen in the iliac arteries.