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CMT-uno > Venous Diseases > Flashcards

Venous Diseases Flashcards

1
Q

Varicose Veins

Risk Factors

5

A
  1. pregnancy
  2. advanced age
  3. obesity
  4. family hx
  5. prolonged standing
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2
Q

Varicose Veins

clinical presentation
6

A
  1. ache/fatigue in limb that progresses throughout the day
  2. edema
  3. abnormal pigmentation
  4. dilated tortous veins
  5. spider veins
  6. telangiectasias
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3
Q

Varicose Veins

work up

2

A
  1. physical exam
  2. doppler studies
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4
Q

Varicose Veins

tx

6

A
  1. compression socks
  2. exercise
  3. elevation
  4. treatment of ulceration w wound care PRN
  5. refer to vascular/vein specialist
  6. surgery
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5
Q

Varicose Veins

what surgical options are there?

3

A
  1. endovenous abaltion
  2. sclerotherapy
  3. vein stripping
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6
Q

Venous insufficiency

A

Loss of wall tension/elasticity in veins leading to stasis of blood in the vein
Is a progression of varicose veins or trauma

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7
Q

Chronic Venous Insufficiency

stages

6

A
  • C1: spider veins
  • C2: varicose veins
  • C3: swelling
  • C4: skin changes
  • C5: healed ulcers
  • C6: venous stasis
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8
Q

Chronic Venous Insufficiency

risk factors

A
  1. hx of DVT
  2. hx of varicose veins
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9
Q

Chronic Venous Insufficiency

presentation

7

A
  1. progressive edema
  2. dull pain, esp with standing
  3. itching
  4. skin ulcerations
  5. shiny, thing, atrophic skin
  6. darkened pigment
  7. ulcerations (usually above the ankle)
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10
Q

Arterial vs Venous insufficiencies

A

Arterial
1. end of toes/top of feet/lateral ankle region
2. very little drainage from ulcer
3. little tissue granulatoin
4. deep, punched out margins

Venous
1. medial parts of lower legs/medial ankle region
2. swollen ulcer w/ drainage, shallow, irregular edges
3. granulation present (pink to red)

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11
Q

Chronic Venous Insufficiency

treatment

6

A
  1. prevention
  2. treatment of varicose veins
  3. elevating legs
  4. compression socks
  5. avoid excessive sitting/standing
  6. wound care
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12
Q

Thrombophlebitis

Virchow’s Triad (risk factors)

A
  1. Hypercoagulability
  2. Vascular Damage
  3. Circulatory Statis

Virchow’s triad: stasis, hypercoagulopathy, vascular injury

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13
Q

Thrombophlebitis

Key hypercoag risk factors

3

A
  1. estrogen therapy
  2. inflammation
  3. dehydration
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14
Q

Thrombophlebitis

key vascular damage risk factors

2

A
  1. physical trauma, strain, or injury
  2. microtrauma to vessel wall
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15
Q

Thrombophlebitis

key circulatory stasis risk factors

2

A
  1. congenital abnormalities
  2. low heart rate and bp
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16
Q

Thrombophlebitis

presentation

A
  • dull pain
  • erythema
  • tenderness
  • palpable induration or

(Most common presentation on PANCE questions will be patient post trauma, or at IV/PICC site)

17
Q

Thrombophlebitis

work up

Hx component, PE components, dx component

A
  1. Hx: look for Virchow’s Triad
  2. PE: erythema, tenderness
  3. US: r/o deep vein involvement or occlusion
18
Q

Thrombophlebitis

treatment

5

A
  1. rest
  2. warm compress, heat
  3. elevation
  4. NSAIDs
  5. abx if infection
19
Q

Deep Vein Thrombosis (DVT)

Risk Factors

8

A
  1. Virchow’s Traid (stasis, vasc injury, hypercoag)
  2. post major surgery (hips)
  3. prolonged bedrest/sitting (travel)
  4. lower extremity trauma
  5. OCPs/hormone replacement
  6. tobacco
  7. cancer associated inflammatory states
  8. Protein C, Protein S, Leiden Factor V, antithrombin deficiencies
20
Q

Deep Vein Thrombosis (DVT)

presentation

A
  1. edema (measure)
  2. heat
  3. erythema
  4. Homan’s sign
21
Q

Deep Vein Thrombosis (DVT)

what is Homan’s sign?

A

discomfort in the calf muscles on forced dorsiflexion of the foot with the knee straight

22
Q

Deep Vein Thrombosis (DVT)

Work up

A
  1. history/PE
  2. Doppler study
  3. D-dimer
  4. r/o PE with vq scan, CT chest)
23
Q

Deep Vein Thrombosis (DVT)

Tx

A
  1. determine if the event is provoked or unprovoked
  2. anti-coag therapy
  3. “usu oaxtx” (NOAC) for 3-6mo; before discontinuing, r/o residual clot
  4. if pt cannot take PO anti-coags, give IVC filter
24
Q

Deep Vein Thrombosis (DVT)

which meds are NOAC?

A
  1. rivaroxaban
  2. dabigatran
  3. apixaban
25
Q

Deep Vein Thrombosis (DVT)

prevention

A
  1. DVT prophylaxis considered on all in-patient hosptals (give renal dose)
  2. intermittent compression boots
  3. bed exercises/ambulation
  4. education
26
Q

what do each of these things describe?

  1. mild, non-pruritis pitting edema with atrophy and chronic pigmentation changes of the skin
  2. tender, erythematous area with palpable heat and cord
  3. unilateral edema with generalized heat, erythema, and tenderness with dorsiflexsion of the foot
  4. decreased hair growth, shiny atrophic skin, reduced pulse, reduced capillary refill
A
  1. chronic venous insufficiency
  2. thrombophlebitis
  3. DVT
  4. PAD
27
Q

varicose veins

A
28
Q
A
29
Q
A
30
Q

40 yo obese female presents work in for heaviness/ ache in legs at end of day. Works full time as a nurse- 12 hour shifts. No etoh, drugs, tobacco; 4 children. On physical exam + spider veins, no skin changes/heat/tenderness. Pulses/capillary refill intact.
The following interventions are appropriate except:
A- compression socks
B- exercise routine
C- ultrasound
D- ABIs

A

A treatment for chronic venous insuff/ varicose veins
B- treatment for chronic venous insuff/ varicose veins
C- work up for PVD or DVT
D- abi are work up for PAD

31
Q

80 yo female presents needs ORIF R hip. PMHX: tissue valve replacement, cardiac pace maker, HTN, osteoporosis.

What pre-op rx does she need?
What post-op rx does she need?
What is most likely post op complication?

A

Antibiotic prophylaxis on call
Post op DVT management and poss at DC

32
Q

You have a patient with a confirmed diagnosis of DVT. Which of the following is not indicated
1- rivaroxaban (VTE dosing)
2-D-Dimer
3-VQ scan
4-CT chest

A

D Dimer bc already confirmed

CMT-uno (54 decks)

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