Venous Insuffeciency Flashcards

1
Q
A
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2
Q

Where are venous ulcers usually found?

A

Medial malleolus

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3
Q

What causes venous ulceration?

A

Venous hypertension which is causes by a calf pump failure

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4
Q

What is deep venous insufficiency and what is it caused by?

A

Similar pathophysiology to varicose veins but just affects deep veins not superficial

Failure of the venous system due to valvular reflux, venous hypertension and obstruction, leading to pain/ulcers/swelling

Usually caused by DVT or valvular insufficiency

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5
Q

What are some risk factors for deep venous insufficiency?

A
  • Increasing age
  • Female
  • Pregnancy
  • Previous DVT or phlebitis
  • Obesity
  • Smoking
  • Long periods of standing
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6
Q

What are some of the presenting features of deep venous insufficiency?

A

- Chronically swollen lower limbs which can be aching, pruitic, painful

- Venous claudication which is pain on walking which resolves on leg elevation

- Signs like varicose eczema, thromophlebitis, haemosiderin skin staining, lipodermatosclerosis, atrophie blanchae, pitting oedema

- Venous ulcers

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7
Q

What is post thrombotic syndrome?

A

Syndrome that occurs after DVT

  • Heaviness
  • Cramps
  • Pain
  • Pruitic
  • Paraesthesia
  • Pretibial oedema
  • Venous ectasia
  • Hyperpigmentation
  • Ulceration
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8
Q

How is deep venous insufficiency diagnosed?

A

- Doppler US: assess extent of venous reflux, look for stenosis, rule out DVTs and varicose veins

- Routine blood tests: FBC, U+Es LFTs and ECHO to rule out other causes such as cardiac

- Document foot pulses and ABPI

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9
Q

How is deep venous insufficiency managed?

A

Early management reduces long term complications

Conservative (more common)

  • Compression stockings, if venous ulcer do 4 layer bandage
  • Suitable analgesia
  • Elevate foot above level of heart

Surgical (less effective)

  • Valvuloplasty
  • Venous stenting
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10
Q

What are some complications of deep venous insufficiency?

A
  • Swelling
  • Recurrent cellulitis
  • Chronic pain
  • Ulceration

Less common: DVT, secondary lymphoedema, varicose veins

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