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Y3 CORE CONDITIONS > VASCULAR SYSTEM > Flashcards

VASCULAR SYSTEM Flashcards

1
Q

what gender is more likely to be affected by an AAA?

A

male

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2
Q

what percentage of men of 65 have an AAA?

a) 5%
b) 15%
c) 25%
d) 35%

A

a) 5%

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3
Q

what symptoms might you get with an AAA pre-rupture?

A

none

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4
Q

give 2 symptoms of a patient with ruptured AAA?

A

collapse

intense abdo/back pain

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5
Q

what happens to the blood pressure of a patient with AAA?

A

drops

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6
Q

what kind of shock would a patient with an AAA enter?

A

hypovolaemic

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7
Q

give a vascular cause of AAA

A

Atherosclerosis

Hypertension

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8
Q

give 2 infective causes of AAA

A

syphilis
e coli
salmonella

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9
Q

give an extrinsic cause of AAA

A

trauma

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10
Q

give 2 genetic causes of AAA

A

marfan’s

ehler’s-danlos

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11
Q

What are the non pathological risk factors of AAA?

A 
smoking
obesity
Age >50
Male
FHx *8
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12
Q

give 2 endocrine/hormone risk factors for AAA

A

hyperlipidaemia
cholesterol
diabetes

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13
Q

describe an abdominal mass characteristic of AAA

A

pulsatile and expansile

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14
Q

where do 85% of AAAs lie?

A

below kidneys

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15
Q

what is an aortic dissection?

A

blood pools between the media and intima in vessel wall

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16
Q

what is the mortality of an AAA rupture?

a) 20%
b) 50%
c) 70%
d) 90%

A

d) 90%

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17
Q

if an AAA is more than 5.5cm, what treatment is given?

A

immediate surgical repair
Either endovascular = reinforce the aorta
Open surgery= graft

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18
Q

give 2 differential diagnoses for AAA

A

pancreatitis
renal colic
testicular pain

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19
Q

what gender is peripheral vascular disease most common in?

A

men

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20
Q

give a vascular cause of peripheral vascular disease

A

atherosclerosis

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21
Q

give 2 causes of ischaemia in peripheral vascular disease

A

emboli
thrombi
Acute compartment syndrome

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22
Q

give 10 symptoms of peripheral vascular disease

A 
intermittent claudication
ulceration
gangrene
Loss of hair on the legs
Ulceration
Brittle nails
Loss of sensation
Cold legs 
Erectile dysfunction in men
Wasting of muscles
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23
Q

what are the 6 P’s of ischaemia in peripheral vascular disease?

A 
pale
pulseless
painful
perishingly cold
paralysis
parasthesia
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24
Q

give 2 lifestyle risk factors for peripheral vascular disease

A

smoking

obesity

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25
Q

give 3 hormone/electrolyte risk factors for peripheral vascular disease

A

cholesterol
hyperlipidaemia
diabetes 1 and 2

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26
Q

give 3 cardiovascular risk factors for peripheral vascular disease

A

ischaemic heart disease
hypertension
previous MI/stroke
AF

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27
Q

what are the names for the two locations where peripheral vascular disease can be?

A

aorta-iliac

infra-inguinal

28
Q

peripheral vascular disease can be

a) chronic
b) acute
c) both

A

c) both

29
Q

what diagnostic test might you use in a patient with peripheral vascular disease?

A

doppler study

30
Q

What is the fontaine classifcation of chronic limb ischaemia?

A

stage 1 = asymptomatic
Stage 2a= Intermittent claudication can walk more than 200 meters pain free
Stage 2b= Intermittent claudication = can’t walk 200m pain free
Stage 3= Pain during rest and sleep
stage 4 = gangrene or necrosis

31
Q

what 3 lifestyle recommendations might you give to a patient with peripheral vascular disease?

A

smoking cessation
weight loss
exercise

32
Q

what drugs might you give in peripheral vascular disease?

A

Antiplatelets
Antihypertensives
Statins

33
Q

why is cilostazol or naftidrofuryl oxolate given in peripheral vascular disease?

A

vasodilation and anti-coagulant for claudication

34
Q

How is revasculisation done for PVD patients and what is the risk?

A

Angioplasty and bypass graft are the two main ways

Can cause compartment syndrome

35
Q

what percentage of the UK have varicose veins?

a) 5-10%
b) 15-20%
c) 30-40%
d) 60-70%

A

c) 30-40%

36
Q

give 4 symptoms that a patient may experience with varicose veins

A

pain
tingling
cramps
heaviness/restlessness

37
Q

give 4 external signs that may be seen with a patient with varicose veins

A 
visible veins on leg
oedema
eczema
ulcers
lipodermatosclerosis (submit fat inflammation) causing hardening, redness and swelling of the lower leg
38
Q

what causes varicose veins?

A

incompetent valves

39
Q

give 3 lifestyle risk factors for varicose veins

A

prolonged standing
the pill
obesity

40
Q

give a physiological risk factor for varicose veins

A

pregnancy
family history
female
older age

41
Q

in normal vein physiology, how does blood drain from superficial to deep veins?

A

via perforator veins

42
Q

how is back flow of blood prevented in normal vein physiology?

A

valves

43
Q

what occurs to veins when they become varicosed?

A

valves fail

veins become hyperextended and dilated

44
Q

what occurs to blood in varicose veins?

A

pools

45
Q

where would you palpate a patient during a cough impulse test for varicose veins?

A

sapheno-femoral junction

46
Q

how would you perform a tourniquet test?

A

hold patients leg upwards until blood drains then apply a tourniquet then get them to stand up and see how quickly veins refill
if no refill = SFJ or above valve insufficiency
take off tourniquet and should be sudden gush of refilling

47
Q

what medical imaging might you suggest to try and diagnoses varicose veins?

A

doppler ultrasound

48
Q

suggest non-surgical therapy for varicose veins

A

Compression stocking
Radiofrequency ablation
Endovenous laser treatment
Ultrasound-guided foam sclerotherapy= scars the vein and forms a seal

49
Q

suggest surgical therapy for varicose veins

A

saphenofemoral ligations and stripping

50
Q

what is the main symptom you would expect in a femoral embolism?

A

shortness of breath

51
Q

where is a venous embolism most likely to affect?

A

deep vein

52
Q

what is most likely to cause an arterial femoral embolism?

A

atherosclerotic or thrombotic debris

53
Q

give 2 serious consequences of femoral emboli

A

aneurysmal rupture

lower limb ischaemia

54
Q

is a femoral embolism a medical emergency?

A

yes

55
Q

give one serious complication of femoral emboli

A

compartment syndrome

56
Q

what is the treatment for compartment syndrome?

A

fasciotomy

57
Q

give 3 surgical options for treatment of femoral emboli

A

fogarty balloon catheter
angioplasty
bypass surgery
severely - amputation

58
Q

give 2 generalised drug treatments for femoral emboli

A

anti-coagulation (long term)

thrombolysis

59
Q

What are the complications of AAA?

A 
Emboli
thrombis
Rupture
Fistulae
Pressure on surrounding structures
60
Q

What is the pros and cons of endovascular surgery and open surgery for AAA?

A 
Endovascular= Less change of bleeding, DVT and wount/chest infection but need to have regular scans and the reinforcement graft can move needing surgery again
Open= Greater risk but more stable the graft and long lasting
61
Q

What si the treatment of acute compartment syndrome causing acute limb ischaemia?

A

Fasciotomy

62
Q

What are the DD of chronic limb ischaemia?

A

Spinal stenosis
MSK
Diabetic neuropathy

63
Q

What type of aneurysm is a AAA?

A

True aneurysm = affects all three layers of the aorta

Initima, media and adeventitia

64
Q

10% of AAA are symptomatic, what are the symptoms?

A

Abdo/Back pain with distal embolic event

65
Q

What are the main 4 risk factors for AAA?

A

Athesclerosis
Hypertension
Smoking
Family history

66
Q

What are the 4 main risk factors for PVD?

A

Type 1 and 2 diabetes
Smoking
Hypertension
Hyperlipidaemia

Y3 CORE CONDITIONS (15 decks)

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