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Surgery > Venous Disease and Lymphedema > Flashcards

Venous Disease and Lymphedema Flashcards

1
Q

What is the term given for dilated small superficial veins seen in chronic venous disease?

A

Telangiectasia

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2
Q

To be categorized as a varicose vein they need to be >___ mm in size

A

3 mm

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3
Q

Varicose veins occur most commonly in what vein?

A

greater saphenous vein

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4
Q

chronic venous disease progression is related to what?

A

extent of venous valvular incompetence

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5
Q

swelling that goes away with limb elevation or overnight is consistent with chronic venous disease OR lymphadema?

A

chronic venous disease

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6
Q

a dorsal pedal hump is consistent with chronic venous disease OR lymphadema?

A

lymphadema

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7
Q

what is the distinguishing symptom with stasis dermatitis?

A

pruritus

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8
Q

What is the diagnostic study of choice for varicose veins? What is a positive finding?

A
  • venous duplex ultrasound

- retrograde flow > 0.5 s duration

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9
Q

what is the treatment of choice for chronic venous disease?

A

compression socks with 20-30 mmHg compression

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10
Q

What wound care treatment is used for chronic venous disease?

A

Apligraf

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11
Q

What do you do with a longstanding wound?

A

biopsy to check for cancer

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12
Q

What are the 3 indications for surgical intervention?

A
  • failure of conservative therapy
  • bleeding from varicosities/telangiectasia
  • phlebitis or thrombosis of superficial veins
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13
Q

What is the best ablation treatment for small spider veins?

A

sclerotherapy (Chemical ablation)

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14
Q

What is the best ablation treatment for recurring bleeding veins?

A

phlebectomy

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15
Q

Phlebectomy or ligation should only be used in what veins?

A

superficial vein system NOT including saphenous vein

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16
Q

What is the best ablation treatment for the greater saphenous vein insufficiency?

A

thermal ablation

need to have competent deep vein

17
Q

This is defined as interstitial collection of protein-rich fluid due to disruption of lymphatic flow

A

lymphedema

18
Q

What is the cause of primary vs. secondary lymphedema?

A
  • primary = congenital developmental abnormalities

- secondary = inflammatory or mechanical obstruction

19
Q

What are the 3 types of primary lymphedema and what differentiates them?

A
  • congenital lymphedema = occurs from birth-2 years old
  • lymphedema praecox = occurs during puberty/pregnancy prior to age 35
  • lymphedema tarda = occurs after age 35
20
Q

What is the most common cause of lymphedema worldwide?

A

Filarisis (infection by Wuchereria bancrofti)

21
Q

What is the most common cause of lymphedema in the developed world?

A
  • malignancy or treatment for malignancy
22
Q

Heaviness or tightness of the limb is consistent with chronic venous insufficiency OR lymphedema?

A

lymphedema

23
Q

What is the positive stemmer sign and what does it correlate with?

A
  • inability to lift skin of affected limb

- correlates with lymphedema

24
Q

How is extremity measurements for lymphedema completed?

A
  • measure extremity at 4 points in BOTH the affected and contralateral extremities
25
Q

What are the 4 points of measurement for upper extremity lymphedema?

A
  • At the metacarpal-phalangeal joints (if edematous)
  • Around the wrist
  • 10 cm below to the olecranon process
  • 10 cm above to the olecranon process
26
Q

What are the 4 points of measurement for lower extremity lymphedema?

A
  • At the metatarsal-phalangeal joints (if edematous)
  • 2 cm superior to the medial malleolus
  • 10 cm above the superior pole of the patella
  • 10 cm below the inferior pole of the patella
27
Q

A difference of more than ____ cm between the affected and contralateral arm is considered clinically significant for lymphedema

A

2

28
Q

What are the 4 clinical stages of lymphedema?

A

0 - swelling not evident
1 - subsides with elevation
2 - does not subside with elevation
3 - lymphostatic elephantiasis

29
Q

What is the mainstay of treatment for lymphedema?

A

compression therapy with 40mmHG compression

Surgery (7 decks)

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