Venous Emergencies

Question 1

Primary Varicose veins risk factors?

Answer 1

Females, obesity, birth control pills

Question 2

Secondary varicose veins are caused by two types

Answer 2

DVT and AVF’s

Question 3

Compression of the pelvic veins leads to a certain AVF pathology, what is it called?

Answer 3

May-Thurner syndrome

Question 4

What are the clinical signs of CVI?

Answer 4

Leg heaviness/ pain relieved by leg elevation, night cramps, etc…

Question 5

When doing a thrill on cough test, what do we expect for a CVI?

Answer 5

Thrill on the saphenofemoral junction

Question 6

Explain the single tourniquet test

Answer 6

Patient is supine, raises leg, tourniquet placed below saphenous opening, and then patient stands up

Question 7

Which single tourniquet results means there is infact, saphenofemoral incompetence?

Answer 7

The veins full up quickly

Question 8

Investigation of choice?

Answer 8

Duplex ultrasound

Question 9

Surgical treatment for primary varicose veins, for those with long or short saphenous insufficiency?

Answer 9

Saphenofemoral disconnection combined with “Ligation and Stripping”

Question 10

The ligation of only the saphenofemoral junction is called what?

Answer 10

Trendlenberg’s stripping

Question 11

Most DVTs involve the proximal veins, which ones specifically?

Answer 11

Popliteal vein and superficial femoral

Question 12

Gold standard investigation?

Answer 12

Ultrasound

Question 13

Treatment of DVT has a protocol, what are the two steps

Answer 13

Anticoagulation followed by Thrombolysis

Question 14

Explain protocol of anticoagulation

Answer 14

IV heparin, LMWH, etc…

Question 15

Explain protocol of Thrombolysis

Answer 15

Urokinase and Streptokinase given via CDT to reduced systemic actions

Question 16

Primary Varicose vein endogenous ablation is done on which vein

Answer 16

Long saphenous vein

Question 17

What is a Venous Thromboembolism

Answer 17

Term used to describe both DVTs and PE’s.

Question 18

Clinical presentation of VTE

Answer 18

Although half are asymptomatic, there is pain, edema, discoloration, etc…

Question 19

When placing IVC filters to treat DVT, where do we place it?

Answer 19

Through the femoral vein.

Question 20

What is the typical INR target range for patients on warfarin for VTE

Answer 20

2-3

Question 21

Which anticoagulant is preferred in patients with end stage renal disease

Answer 21

Unfractionated heparin

Question 22

What is the standard treatment for venous ulcers in CVI?

Answer 22

Compression therapyb

Question 23

What is a classic clinical sign of DVT elicited by dorsiflexion of the foot?

Answer 23

Brodie-Trendelenburg sign

Question 24

What treatment method involves placing a device to prevent emboli from reaching the lungs?

Answer 24

IVC filter

Question 25

What is the Antidote for a Warfarin overdose?

Answer 25

Vitamin K

Question 26

What is the direct thrombin inhibitor used in the treatment of VTE

Answer 26

Dabigatran

Question 27

A negative D-dimer test in suspected VTE is useful for what?

Answer 27

Ruling out DVT in low-risk patients

Question 28

First line treatment for spider veins in varicose veins?

Answer 28

Injection-foam scleropathy.

Question 29

Which vein is commonly treated with ligation and stripping

Answer 29

Long saphenous vein

Question 30

What test detects sapheno-femoral incompetence

Answer 30

Trendelenburg’s test