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ICC1 > venous vascular disease > Flashcards

venous vascular disease Flashcards

1
Q

what are the types of inflammatory venous diseases ?

A

superficial thrombophlebitis

thrombophlebitis migrans

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2
Q

when do you see thrombophlebitis migrans ?

A

in the cases of abdominal cancers such as pancreatic cancers- known as Trousseau’s sign

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3
Q

when do you see superficial thrombophlebitis ?

A

appears spontaneously in patients with varicose veins , in Buergers disease, after IV therapy

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4
Q

what is the treatment for superficial thrombophlebitis ?

A

NSAIDs, elevation of the limb, local application of heat are the primary treatment

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5
Q

when is surgery indicated with superficial thrombophlebitis ?

A

after 2 weeks of the primary treatment if there is no effect

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6
Q

what are the causes of DVT?

A

stasis of blood flow
hypercoaguability
endothelial damage

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7
Q

what factors increase the risk of DVT?

A 
immobilization 
hypercoaguability 
surgery 
trauma 
malignancy 
pregnancy 
venulitis
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8
Q

what are examples of venulitis?

A

Buerger’s disease
Behcet’s disease
homocysteinuria

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9
Q

what is Homan’s sign ?

A

calf pain on passive dorsiflexion ( not very accurate)

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10
Q

what are the stages of complications of DVT ?

A

phlegmasia alba dolens
phlegmasia cerulea
venous gangrene

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11
Q

what investigation are required to make a diagnosis of DVT ?

A

duplex ultrasound

MRA

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12
Q

what are the different outcomes of DVT ?

A

post-phlembetic syndrome

paradoxical embolisms

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13
Q

who are the potential candidates for prophylactic care of DVT ?

A
  • elderly patients undergoing major abdominal surgery or orthopaedic surgery
  • patients with major trauma
  • prolonged immobility >3 days
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14
Q

what are the approaches to preventing DVT ?

A

1.pharmacological - low dose unfractioned heparin
low molecular weight heparin
2.mechanical -early ambulation
elastic stocking
intermittent pneumatic compression device

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15
Q

why is the treatment of DV necessary ?

A
  • to limit further thrombosis
  • to prevent morbidity related to pulmonary embolism
  • to decrease the recurrence rate
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16
Q

what are the different treatment options for DVT ?

A

antithrombotics
thrombolytic
IVC filters
Thrombolectomy

17
Q

when are thrombolytics indicated ?

A

when phlegmasia develops

18
Q

when are IVC filters indicated ?

A

indicated to whom antithrombotic therapy is contraindicated or failure of anticoagulation

19
Q

when is thrombolectomy indicated ?

A

indicated phlegmasia cerulae dolens and impending venous gangrene

20
Q

what are the types of primary venous insufficiency ?

A

Telangiectasia
reticular vein
Varicose vein

21
Q

how do varicosities develop?

A

failure of one or more of these factors

  • valvular competence
  • patency of veins
  • calf muscle pump
22
Q

what are the sources of venous hypertension ?

A

gravitational

dynamic ( muscular contraction)

23
Q

what is CEAP classification ?

A

C - clinical
E - etiological
A - anatomical
P - pathophysiological

24
Q

what is a saphenovarix ?

A

is a dilation of the saphenous vein at its junction with the femoral vein in the groin

25
Q

what is the gaiter’s zone associated with ?

A

handbreadth area around the malleoli , where complications of venous disease occurs

26
Q

what are the minimally invasive methods used in varicose veins

A

sclerotherapy
endovascular laser
radiofrequency ablation
foam sclerotherapy

27
Q

what is lipodermatosclerosis ?

A

pigmentation
thickening
induration of the skin due to venous disease

28
Q

what other manifestations may be seen with lipodermatosclerosis ?

A

inverted champagne bottle ( prominent calf and thin ankle), contracted skin and subcutaneous tissue

29
Q

what are the clinical methods for testing varicose veins ?

A

trendelenburg’s test
ochsner-Mahorner test
schwartz test
modified perthe’s test

30
Q

what may a patient with venous vascular disease complain of ?

A

heaviness, swollen leg

31
Q

what are the pharmacological treatments of varicose veins ?

A

calcium dobesilate
diosmin
rutin, troxerutin

32
Q

what are the indications for Trendelenburg surgery?

A

varicosity more than 4 mm
varicosity with complication
refractory to medical therapy

33
Q

what surgery could be indicated in the presence of lipodermatosclerosis ?

A

subfascial endoscopic perforator surgery

34
Q

what clinical method can be used to test the competence of a specific perforator ?

A

Ochsner- Mahorner test ( multiple tourniquet test )

35
Q

what type of compression therapy can be used in varicose ?

A

pneumatic compression

elastic graduated compression stockings

36
Q

when are class II stockings used ?

A

uncomplicated varicose veins

37
Q

when are class III stockings used ?

A

complicated varicose veins

38
Q

when are stockings contraindicated ?

A

peripheral arterial disease
heart failure
never in DVT

ICC1 (50 decks)

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