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Surgery > venous diseases > Flashcards

venous diseases Flashcards

1
Q

phlebothrombosis

A

dvt

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2
Q

virchows triad

A

stasis hypercoagulability vein wall injury

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3
Q

major causes of dvt

A

childbirthbtrauma immobility travel oral contraceptives obesity estrogen postop visceral neoplasm(Y?)
polycythemia thrombocytosis protein c s def thrombophilia etc
recent mi heart failure nephrotic synfrome

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4
Q

paget shroetter syndrome

A

primary upper limb dvt

subclavian vein compression in thoracic outlet syndrome

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5
Q

secondary upper limb dvt causes

A

cvp line pacemaker thrombocytosis malignancy surgery radiotherapy

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6
Q

common sites for thrombosis in leg veins

A

soleus veins femoral vein/iliofemoral vein (Y?)

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7
Q

phlegmasia alba dolens

A

dvt of femoral vein
painful congestion nd edeema with lymphangitis
white leg

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8
Q

phlegmasia cerulea dolens

A

extensive dvt of iliac and pelvic veins
blue leg
venous gangrene

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9
Q

eraliest symptom of dvt

A

fever?

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10
Q

features of dvt

A

fever pain swelling
tense tender warm pale shiny leg
can also b asymptomatic
features of pulm embolism

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11
Q

signs of dvt

A

homans moses neuhofs

inverted champagne bottle

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12
Q

homans sign

A

passive forceful dorsiflexion of foot
extndd knee
tenderness in calf

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13
Q

mose s sign

A

gentle squeezing of lower part of calf side to side

pain

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14
Q

neuhof s sign

A

palpatind deep in calf muscles

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15
Q

linton s test

A

apply tourniquet to sfj
walk
elevate limb
persisting prominent superficial veins

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16
Q

dd dvt

A

ruptured bakers cyst

ruptured plantaris tendon calf muscle hematoma cellulitis superficial thrombophlebitis

17
Q

investigations dvt

A

VENOUS DOPPLER WITH DUPLEX SCANNING
venogram………..
radioactive iodine 125 fibrinogen study…..
hemogram
d dimer
ventilation perfusion scanning pulm ct pulm angio

18
Q

treatment dvt general measures

A

rest elevation of limb bandaging the entire limb with crepe

anticoagulants

19
Q

dvt fixed thrombus

A

high dose of heparin 25k units per day x 7 dys

warfarin 3-6 months( start from day 1 of heparin therapy)

20
Q

heparin dosage for dvt

A

80 units/kg bolus of heparin followed by 15 units/kg infusion

21
Q

drug of choice during pregnancy nd postpartum

A

lmwh

22
Q

dvt free thrombus

A

fibrinolysins
venous thrombectomy using fogarty venous catheter
ivc filter
ralma operation may husni operation

23
Q

fibrinolysin for dvt

A

streptokinase 6 lakhs nd then 1 lakh hourly
tpa
urokinase
reptilase

24
Q

prevention of dvt

A

catetgorize
position
pressure bandage massaging early ambulation hydration
low dose heparin 5k subcutaneously 2 hrs before surgery
elastic stockings electric stimulation pneumatic compresssion
dextran
stop ocps nd estrogens prior to surg
stop smoking

25
Q

effects and sequelae of dvt

A 
pulm embolism
infection 
gangrene
chronic venous insufficiency.....
recurrent dvt
26
Q

tao commonly seen in

A

males smokers tobacco users south asia jewish lower socioeconomic factors rec feet injuries poor hygiene
si>300
pyi>40
before 45?

27
Q

what is tao?

A

nonatherosclerotic inflammatory disorder
cell mediated hypersensitivity to type 1 nd 111 collagen
segmental progressive occlusive inflammatory disease of small nd medium sized vessels

28
Q

pathogenesis of tao

A

co nicotinic acid carboxyhb vasospasm hyperplasia thrombosis obliteration panarteritis nerve involvement ischemia compensatory decompensatory critical limb ischemia

29
Q

classification of tao

A 
types 
I ul 
2 crural or infrapopliteal
3 femoropopliteal
4 aortoiliofemoral
5 generalised
30
Q

clinical features of tao

A 
intermittent claudication
rest pain ulceration gangrene
recurrent migratory superficial thrombophlebitis
absence or feeble pulses 
raynauds phenomenon
31
Q

investigations tao

A 
hb% sugar abpi
arterial doppler duplex
ct angio
transfemoral retrtograde angio-corkscrew inverted tree/spider collaterals distal run off
transbrachial angiogram
us abdomen
biopsy?
32
Q

treatment tao

A 
stop smoking
aspirin 75 mg od
prostacyclins ticlopidine praxilene carnitine?
statin cilostazole?
analgesics
xanthine nicotinate
naftidofuryl
gene therapy (vegf)
beurgers position nd exercise
chiropady....
chemical sympathectomy
surgery-omentoplasty profundoplasty lumbarv sympathectomy amputation ilzarov method
33
Q

care of foot in tao

A

avoid hot cold trauma dryness
oil
socks
heel raise

Surgery (6 decks)

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