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Cardiovascular system 16/17 > Venous and lymphatic disease > Flashcards

Venous and lymphatic disease Flashcards

1
Q

What are varicose veins?

A

Tortuous dilated superficial veins

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2
Q

What causes primary varicose veins?

A

Valvular dysfunction

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3
Q

Where are the main sites of varicose veins?

A 
Long saphenous (80-87%) - midline
Short saphenous (21-30%) - back
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4
Q

What are some signs and symptoms of varicose veins?

A 
Localised or general discomfort
Nocturnal cramps
Swelling
Acute haemorrhage
Superficial thrombophlebitis
Pruritis
Skin change
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5
Q

How can you assess varicose veins?

A

Doppler ultrasonography - assess direction of blood flow

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6
Q

When should we intervene with varicose veins?

A 
Signs of venous insufficiency 
Superficial thrombophlebitis 
Bleeding
Cosmetic/anxiety
Painful
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7
Q

How can you treat varicose veins?

A

Surgery - high tie, stripping, stab avulsions
Injection - sclerotherapy
Compression - stockings

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8
Q

What are some contraindications for superficial venous surgery?

A

Previous DVT
Arterial insufficiency
Patient co-morbidity
Morbid obesity

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9
Q

What are some contraindications for varicose vein surgery?

A 
Haemorrhage
Thrombophlebitis
Haematoma
Pain
Infection 
Damage to neighbouring anatomy
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10
Q

List some minimally invasive treatments of varicose veins

A 
Foam sclerotherapy
Endovenous laser ablation (EVLA)
radiofrequency ablation (VNUS)
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11
Q

What are some advantages of minimally invasive procedures?

A

Reduce trauma
Reduced time off work
Do not require operating theatre
Increased patient throughput

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12
Q

To what temperature does raiofrequency ablation of varicose veins does the veins get heated to?

A

85C

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13
Q

What are some signs of chronic venous insufficiency?

A 
Ankle oedema
Telangectasia (spider veins)
Venous eczema
Haemosiderin pigmentation (brown iron)
Hypopigmentation (blanching)
Lipodermatosclerosis - inflammation of fat
Venous ulceration
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14
Q

What causes chronic venous insufficiency?

A

Failure of calf muscle pump

Venous hypertension and exudate

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15
Q

How is CVI treated?

A

Compression therapy

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16
Q

Define a leg ulcer

A

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

17
Q

How many ulcers are of arterial origin?

A

20%

18
Q

How many ulcers are of venous origin?

A

80%

19
Q

What causes leg ulcers?

A 
Arterial or venous disease, usually caused by:
 - diabetes
 - rheumatoid arthritis
 - vasculitis
 - connective tissue disease
Can be neuropathic
20
Q

What are the clinical signs of leg ulcers?

A

Signs of CVI
Oedema
Locomotor system affected

21
Q

What investigations are carried out for leg ulcers?

A

Ankle brachial pressure index

Duplex ultrasound

22
Q

Where are venous leg ulcers usually found?

A

Above the medial or lateral malleoli (ankles)

23
Q

Where are arterial leg ulcers usually found?

A

Anterior shin
Over toe joints
Under heel
Over malleoli

24
Q

Where are neuropathic leg ulcers usually found?

A 
Over toe joints 
Under metatarsal head
Under heel
Over malleoli
Inner side of first metatarsal head
25
Q

How do you treat ulcers?

A

Compression therapy in venous disease
Dressings
Systemic and topical antibiotic therapy
Exercise - calf muscle pump

26
Q

What syndrome can be confused with lymphoedema?

A

Klippel-Trénaunay syndrome, rare congenital condition in which blood vessels and lympathic vessels fail to form properly

27
Q

What are the 3 main features of Klippel-Trenaunauy syndrome?

A

Nevus flammeus (port wine stain)
Venous and lymphatic malformations
Soft tissue hypertrophy of affected limbs

28
Q

What causes primary lymphoedema?

A

Congenital

29
Q

What causes secondary lymphoedema?

A

Malignancy
Surgery
Radiotherapy
Infection

30
Q

How do you treat lymphoedema?

A 
Elevation 
Manual drainage
Compression
Exercise
Surgery e.g. lymph vessel grafting
Laser therapy

Cardiovascular system 16/17 (40 decks)

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