Vascular Sx handbook conditions

Question 1

6 Ps of acute arterial occlusion/insufficiency?

Answer 1

pain
pallor
pulselessness
paraethesia
paralysis
poikilothermia (perishingly cold)

Question 2

how long in acute arterial occlusion before irreversible tissue damage?

Answer 2

6 hours

Question 3

non medical management for chronic limb ischaemia?

Answer 3

surveillance
smoking cessation
weight loss
WALKING PROGRAM

Question 4

medical management for chronic limb ischaemia?

Answer 4

ASA/clopidogrel
statins
ACEi
glucose control

Question 5

surgical management for chronic limb ischaemia?

Answer 5

angio
endarterectomy
stent
bypass

Question 6

AAA definition

Answer 6

dilation of aorta >1.5x normal

3cm dilation for abdo aorta

Question 7

triad of ruptured AAA?

Answer 7

abdo pain
hypotension
pulsatile mass

Question 8

Ix for AAA?

Answer 8

u/s surveillance

CTA for operative planning

Question 9

AAA what size to repair men v women if asymptomatic?

Answer 9

men: >5.5 cm
women >5cm
or rapidly expanding >1cm/year

Question 10

AAA what size to repair if symptomatic?

Answer 10

any size

Question 11

Management of ruptured AAA?

Answer 11

bloods
type and cross 10 units
permissive hypotension SBP 80-100
pain mx

Question 12

AAA etiology?

Answer 12

hypertension
connective tissue: Marfans, Ehler-Danlos, 
mycotic aneurysm, 
trauma, 
vasculitis

Question 13

clinical triad for aortic dissection?

Answer 13

1. sudden tearing pain in posterior chest/back
2. variation in pulse >20 SBP L v R arm
3. mediastinal/aortic widening on CXR

Question 14

what is stanford type A aortic dissection? DeBakey type I and II

Answer 14

any involving ascending aorta - immediate surgery

Question 15

what is stanford type B aortic dissection? DeBakey type III

Answer 15

any NOT involving ascending aorta

Question 16

distribution of aortic dissection %?

Answer 16

DeBakey I: 50%
DeBakey II: 35%
DeBakey III: 15%

Question 17

4 types of blunt aortic injury, which ones sx mx?

Answer 17

I: intimal tear
II: intramural haematoma
III: pseudoaneurysm
IV: rupture
Type II, III, IV surgical

Question 18

Carotid stenosis <50% do what?

Answer 18

medical management

Question 19

when surgical for Carotid stenosis?

Answer 19

asymptomatic >60%, life exp >5yr
NNT if 70-99% asympomatic: 33
NNT if 50-79% stenosis symptomatic: 22
NNT if 70-99% stenosis symptomatic: 6

Question 20

clinical presentation of chronic venous disease?

Answer 20

telangiectasia
varicose veins
chronic venous insufficiency: pain, edema, hemosiderin, statis dermatitis, lipdermatosclerosis, ulcers