Venous Disease and Clinical History

Question 1

Name the 2 types of venous disease

Answer 1

1) acute obstruction (thrombosis)
2) chronic insufficiency

Question 2

For an acute DVT where is they most frequently originate at

Answer 2

venous valves or sinuses

Question 3

What is the great clinical dancer of an acute DVT

Answer 3

Pulmonary embolism

Question 4

What is the most likely complication from an acute DVT

Answer 4

venous insufficiency

Question 5

Name the 4 symptoms of an acute DVT

Answer 5

1) pain
2) swelling
3) redness
4) warmth

Question 6

Risk factors that contribute to the formation of clots describes

Answer 6

Virchows triad

Question 7

Name the 3 factors of virchows triad

Answer 7

1) trauma
2) stasis
3) hypercoagulability

Question 8

Catheters, PICC lines, and IV’s are examples of what risk factor for virchows triad

Answer 8

Intrinsic trauma

Question 9

Bed rest, obesity, pregnancy, paralytics, CHF, and surgery are examples of what type of factor for Virchows triad

Answer 9

Stasis

Question 10

Increased clotting of blood, pregnancy, cancer, oral contraceptives, and inherited stasis are examples of what type of factor for virchows triad

Answer 10

Hypercoagulability

Question 11

Stress or effort of thrombosis of subclavian or axillary due to repetitive trauma to vessel describes

Answer 11

Paget-Schroetter

Question 12

Left compression of the CIV is what syndrome

Answer 12

May-Thurner Syndrome

Question 13

Compression of the left renal vein by the SMA and Aorta describes what syndrome

Answer 13

Nutcracker syndrome

Question 14

Thrombosis or compression of the SVC by a mass that causes bilateral facial swelling, bilateral upper extremity swelling, and dyspnea describes what syndrome

Answer 14

SVC syndrome

Question 15

Pain, swelling, white and triggers arterial spasms are symptoms of what

Answer 15

Phlegmasia alba dolens

Question 16

pain, swelling, blue, and reduces arterial inflow are symptoms of what

Answer 16

Phlegmasia cerulea dolens

Question 17

Valvular incompetence where valves leak and no longer maintain uniderectional flow that causes venous hypertension describes

Answer 17

Venous insufficiency

Question 18

Hypoplastic or absent deep veins describes what

Answer 18

Klippel-Trenauny

Question 19

What are the 2 types of edema

Answer 19

1) pitting
2) non-pitting

Question 20

This type of edema happens when manual pressure is applied and leaves a dent in the skin

Answer 20

Pitting

Question 21

Fluid retention, renal dysfunction, and increased venous pressure go with what type of edema

Answer 21

Pitting

Question 22

This type of edema happens when the tissue is so engorged with fluid that is caused by lymphedema

Answer 22

Non-pitting

Question 23

Hardening of the skin due to constant irritation of tissue describes what

Answer 23

Lipodermatosclerosis

Question 24

shallow, oozy, less painful, irregular, brawny and swelling are symptoms of

a) venous
b) arterial

Answer 24

a) venous

Question 25

Where are venous ulcers usually located

Answer 25

on the medial malleolus or calf

Question 26

Where are arterial ulcers usually located

Answer 26

on the toes or bony regions

Question 27

Deep, dry, very painful, regular, dry skin, and thick toenails are symptoms of

a) venous
b) arterial

Answer 27

b) arterial

Question 28

Which of the following can be responsible for primary varicose veins

a) post-phlebitic syndrome
b) obesity
c) pregnancy
d) klippel-Trenauny

Answer 28

d) Klippel-Trenauny

-primary varicose veins are caused by congenital venous abnormalities such as hypoplastic or absent valves

Question 29

What best describes post-thrombotic syndrome

a) edema due to increased capillary pressure
b) hemosiderin deposits in the subcutaneous tissue
c) reduced arterial inflow due to venous obstruction
d) valvular damage and insufficiency

Answer 29

d) valvular damage and insufficiency

-This is the most common complication of DVT. Valvular damage due to thrombus and venous stretching results in chronic venous insufficiency

Question 30

What hemodynamic result will exercise cause in a patient with an ineffective calf muscle pump

a) decreased venous volume
b) decreased venous pooling
c) increased venous pressure
d) increased venous return

Answer 30

c) increased venous pressure

-exercise would worsen the venous pressure in a patient with incompetent valves since the calf contraction ejects blood in all directions

Question 31

What mechanism of disease best relates to Paget-Schroetter

a) stasis
b) trauma
c) compression
d) hypercoaguability

Answer 31

b) trauma

• Paget-Schroetter is caused by repetitive trauma and stress thrombosis of the upper extremity veins. This can also be considered the venous component of TOS

Question 32

Where is a venous ulcer most likely to occur

a) anterior to superficial veins
b) toes and dorsum of foot
c) upper-third of calf
d) lower third of calf

Answer 32

d) lower third of calf

Question 33

What is the most common complication of acute DVT?

a) venous insufficiency
b) distal embolism
c) pulmonary embolism
d) acute arterial occlusion

Answer 33

a) venous insufficiency

-Thrombosis is most likely to cause valve damage resulting in chronic venous insufficiency. Pulmonary embolism would be the most serious complication but not the most common