Venous disorders

Question 1

Superficial Thrombophlebitis- Eti

Answer 1

• Partial or complete obstruction of superficial vein- due to local irritation/ injury, pregnancy, abd. CA, occult DVT
• Virchows triad- stasis, hypercoaguable, vessel damage

Question 2

Superficial Thrombophlebitis- Sx

Answer 2

• Dull vein pain
• Induration and erythema- linear along vein
• Cord-like vein
• Local to including saphenous vein

Question 3

Superficial Thrombophlebitis- Dx

Answer 3

• CBC- fever chills
• Culture if sepsis
• Underlying etiologies

Question 4

Superficial Thrombophlebitis- Tx

Answer 4

• Rest, heat, elevation
• Removal of saphenous vein
• Coverage for staph

Question 5

Chronic venous insufficiency- Eti

Answer 5

• Postphlebetic syndrome
• Chronic swollen limb- stasis dermatitis, subq tissue induration, ulceration
• after phlebitis- incompetent veins

Question 6

Chronic venous insufficiency- Sx

Answer 6

• Capillary leakage of fluid & RBCs
• Hg causes imflammatory rxn, fibrosis- brown pigmentation
• Itchy, scale rash at medial malleolus
• Pitting to induration edema
• Hypoxia -> ulcers

Question 7

Chronic venous insufficiency- Dx

Answer 7

• Venogram = gold standard

- Clinical picture highly diagnostic

Question 8

Chronic venous insufficiency- Tx

Answer 8

• Difficult- tx stasis- ulna boots, excision, grafts
• Dematitis- burrows solution, topical steroids, zinc
• stockings, elevation

Question 9

DVT- Eti

Answer 9

• 1 million pts/year
• DV lower legs, pelvis
• 80% in calf
  Risk: immobilization, illness, estrogen, obseity, CA, Hx

Question 10

DVT- Sx

Answer 10

• Asymptomatic
• Dull to frank pain in calf, leg, buttock
• edema
• Distention of superficial collaterals
• Fever, tachy, cyanosis, SOB

Question 11

DVT- Dx

Answer 11

• Fibrin D-dimer
• Venography = gold standard-invasive
• Duplex doppler US

Question 12

DVT- Tx

Answer 12

• Prevention
• Stockings, elevation
• Anticoag.

Question 13

Varicose veins- ETi

Answer 13

• Inherited venous valve incompetence
• Poor return of blood- stasis and pooling
• Pressure-> stretching and vein distention
• 15% adults
• women who have been pregnant
• standing and lifting

Question 14

Varicose veins-Sx

Answer 14

• Fatigue, dull aching pain-> standing
• asymptomatic
• visible, dilated veins
• Trendelenberg test

Question 15

Trendelengerg test-

Answer 15

• superficial saphenous femoral valve versus perforator incompetence
• Compress, stand
• Superficial: varicosities flat
• Perforator- varicosities apparent within 35 sec

Question 16

Varicose veins- Tx

Answer 16

Elevation, stocking, excision, sclerotherapy, wt loss