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Cardiovascular > Venous and Lymphatic Disease > Flashcards

Venous and Lymphatic Disease Flashcards

1
Q

What are varicose veins?

A

Veins that have become enlarged and twisted

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2
Q

Why do varicose veins happen?

A

Because the leaflet valves in veins are leaky and so veins swell and enlarge.

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3
Q

Where are varicose veins usually found?

A

Greater saphenous vein

Lesser saphenous vein

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4
Q

What is the prevalence of varicose veins?

A

20-25% in females

10-15% in men

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5
Q

What are the signs and symptoms of varicose veins?

A 
Localised or generalised discomfort in the leg
Nocturnal cramps
Swelling
Acute haemorrhage
Superficial thrombophlebitis
Pruritus - itching
Skin changes
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6
Q

What should be asked when taking a history for varicose veins?

A 
Occupation 
Pregnancies - twins or big babies 
Previous DVT (or good reason for DVT such as white leg of pregnancy) 
Family history 
When the veins appeared
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7
Q

What are the indications for intervention with varicose veins?

A

Superficial thrombophlebitis
Signs of chronic venous insufficiency
Bleeding
Cosmetic

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8
Q

What is the surgical treatment of varicose veins?

A 
Superficial venous surgery 
Ligation of the sapheno-femoral or sapheno-popliteal junction 
Vein stripping 
Multiple stab avulsion 
Perforate invaginate stripping
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9
Q

What are the contraindications for superficial venous surgery?

A

Previous DVT
Arterial insufficiency
Patients co morbidity
Morbid obesity

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10
Q

What are common complications of varicose vein surgery?

A 
Minor haemorrhage 
Thrombophlebitis 
Haematoma 
Wound problems 
Severe pain
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11
Q

What is thrombophlebitis?

A

Vein inflammation related to thrombus

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12
Q

What are the more rare complications of varicose vein surgery?

A

Damage to deep veins, arteries and nerves

DVT

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13
Q

What are the minimally invasive treatments of main trunk varicosities?

A

Foam sclerotherapy
Endogenous laser ablation
Radio frequency ablation

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14
Q

What is EVLA?

A

Endogenous laser ablation

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15
Q

What is VNUS?

A

Radio frequency ablation

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16
Q

How is EVLA done?

A
  1. Micro puncture needle inserted into saphenous vein using ultrasound
  2. Guidwire moved to saphenous junction with deep vein
  3. Catheter and laser fibre put in 1cm below the junction
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17
Q

How does VNUS work?

A
  1. Catheter inserted into vein
  2. Vein heated to 85 degrees and collapsed
  3. Catheter slowly withdrawn, closing vein
18
Q

How is foam sclerotherapy done?

A
  1. Needle inserted into vein using ultrasound

2. Foam injected

19
Q

What is the conservative option for varicose vain treatment?

A

Compression hosiery

20
Q

What is chronic venous insufficiency?

A

When veins cannot pump enough blood back to the heart

21
Q

What are the symptoms of chronic venous insufficiency?

A 
Ankle oedema 
Telangiectasia 
Venous eczema 
Haemosiderin pigmentation 
Hypopigmentation 
Lipodermatosclerosis 
Venous ulceration
22
Q

What is the pathophysiology of CVI?

A

Venous hypertension
Venous engorgement and stasis
Imbalance of Starling forces and fluid exudate

23
Q

What is ambulatory venous pressure?

A

The blood pressure in the veins during active movement

24
Q

What is normal AVP?

A

30mmHg

25
Q

What does it mean if AVP is high?

A

Failure of muscle pump, valves or outflow obstruction

Venous hypertension

26
Q

What are some possible reasons for the failure of the calf muscle pump?

A 
Superficial venous reflect 
Depp venous reflux 
Venous obstruction 
Neuromuscular 
Obesity 
Inactivity
27
Q

What is a leg ulcer?

A

Breach in the skin between the knee and ankle joint, present for over 4 weeks

28
Q

What is the differential diagnosis for leg ulceration?

A 
Venous disease 
Arterial disease 
Diabetes 
Rheumatoid arthritis 
Vasculitis 
Connective tissue disease
29
Q

What investigations should be done on patients with leg ulceration?

A

Ankle brachial pressure index

Duplex ultrasonography

30
Q

Where are leg ulcers typically found in venous disease?

A

Above lateral and medial malleoli

31
Q

Where are leg ulcers typically found in atrial disease?

A

Over toe joint
Anterior shin
Over malleoli
Under heel

32
Q

Where are leg ulcers typically found in neuropathic disease?

A 
Over toe joint 
Under metatarsal head 
Under heel 
Over malleoli 
Medial side of the first metatarsal head
33
Q

What is the treatment of leg ulcers?

A

Compression therapy
Dressings
Systemic and topical therapy
Exercise

34
Q

What are the surgical treatments of CVI?

A 
Ligation
Vein stripping 
Surgical repair
Endovenous Laser Ablation
Vein transplant
Subfascial endoscopic perforator surgery
35
Q

What are the conservative treatment methods of CVI?

A 
Manual compression 
Skin lubrication
Sequential compression pump
Ankle pump
Compression stockings
Blood pressure medication
Elevating the legs above the heart level
36
Q

What is lymphoedema?

A

Localised fluid retention and tissue swelling because of a compromised lymphatic system

37
Q

What is Klippel-Trenaunay Syndrome?

A

A rare congenital medical condition in which blood vessels and/or lymph vessels fail to form properly.

38
Q

What are the primary types of lymphoedema?

A

Congenital
Praecox
Tarda

39
Q

What are the possible causes of secondary lymphoedema?

A

Malignancy
Surgery
Radiotherapy
Infection

40
Q

What are the signs and symptoms of lymphoedema?

A 
Swelling of the limbs
A feeling of heaviness or tightness
Restricted range of motion
Aching or discomfort
Recurring infections
Hardening and thickening of the skin
41
Q

What is the treatment of lymphoedema?

A

Manual lymphatic drainage
Compression bandages
Skin care
Exercise

Cardiovascular (34 decks)

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