Venous Disease 2

Question 1

causes of chronic swelling (5)

Answer 1

arterial problems (post op, rest pain, etc.) venous problems (chronic occlusion or venous insufficiency). lymphatic problems. musculoskeletal problems (baker’s cyst, tumors). abnormal growths.

Question 2

why is venous disease more important? males vs. females?

Answer 2

chronic venous disease 10X more common than arterial. more common in women - 1 in 5

Question 3

lymphedema: pitting? cause? how is it different from venous/cardiac swelling

Answer 3

non pitting, relentless, doesn’t disappear easily –> because the lymphatic system is failing = swelling. woody, not pitting like it would be in venous/cardiac swelling.

Question 4

lymphatic system: what? does what?

Answer 4

linear network of connected vessels and 2ndary lymph organs - removes excess interstitial fluid and protein from tissues, removes fats from gut, transports WBCs

Question 5

chronic venous insufficiency: main problem is?

Answer 5

elevation in ambulatory venous pressure

Question 6

venous ulcer: characteristics?

Answer 6

irregular deep ulcer. draining. pigmentation. subcutaneous stiffness (lipodermatosclerosis). edema. varicosities and spider veins

Question 7

CVI: prevalence of DVT? genetics?

Answer 7

most patients have NOT had a DVT in the past. strong genetic components.

Question 8

pathogenesis of CVI

Answer 8

calf pump failure = capillary/venular elongation and dilation = more tissue fluid, with more fibrinogen = increased fibrin deposition and brown pigment from hemosiderin (from RBCs), lipodermatosclerosis

Question 9

relationship between ambulatory venous pressure and ulcer incidence?

Answer 9

<45 mmHG = no ulcers. increase it and you get more ulcers. 80 mmHg = 80% chance of ulcers

Question 10

CEAP classification stands for?

Answer 10

clinical, etiology, anatomy, pathophysiology

Question 11

graduated compression therapy: does 4 things?

Answer 11

increases venous return to heart, removal of fibrin. decreases edema, distention of superficial veins

Question 12

venous ulcer: pain? treatment?

Answer 12

painless unless infected. treat: compression, treat wound –> multilayered compression bandage

Question 13

CVI: when is surgery recommended?

Answer 13

if there is recurrence, but surgery also done in conjunction with stockings

Question 14

sclerotherapy

Answer 14

inject hypertonic saline/chemical to cause a phlebeitic reaction in the vein; successful for small volumes