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Revision Cards > Week 226 - Varicose Veins > Flashcards

Week 226 - Varicose Veins Flashcards

1
Q

Week 226 - Varicose Veins: What are the three main types of oedema?

A
  • Lymphoedema
  • Lymphovenous oedema
  • Dependency oedema
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2
Q

Week 226 - Varicose Veins: In terms of capillary filtration what occurs during lymphoedema, lymphovenous oedema and dependency oedema?

A
  • Lymphoedema - Normal capillary filtration.
  • Lymphovenous filtration - Increased
  • Dependency oedema - Increased
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3
Q

Week 226 - Varicose Veins: What is dependency oedema?

A

Oedema caused by immobile limbs resulting in reduced venous return.

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4
Q

Week 226 - Varicose Veins: What is lymphoedema?

A
  • Caused by inadequate drainage.
  • There is normal capillary filtration.
  • An increase in protein concentration.
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5
Q

Week 226 - Varicose Veins: What is lipoedema?

A
  • Symmetrical fatty deposits, bilaterally.

* Possible due to disturbed venous function.

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6
Q

Week 226 - Varicose Veins: Which three types of chronic oedema lead to lymphatic overload/failure?

A
  • Lymphovenous oedema
  • Dependency Oedema
  • Lipoedema
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7
Q

Week 226 - Varicose Veins: What is the definition of chronic oedema?

A

Persistent (>3 months) swelling due to excess accumulation of fluid in the tissues.

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8
Q

Week 226 - Varicose Veins: What are the signs and symptoms of lymphovenous oedema?

A
  • Subcutaneous tissues are generally soft and pitting.
  • Swelling reduces with elevation.
  • Skin and tissue changes occur over time.
  • Patients often complain of discomfort and restlessness.
  • Rarely affects areas other than the lower limb.
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9
Q

Week 226 - Varicose Veins: What skin changes can occur with lymphovenous oedema?

A
  • Haemosiderin staining
  • Ulceration
  • Varicose eczema
  • Lipodermatosclerosis
  • Varicose veins + telangiectasia
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10
Q

Week 226 - Varicose Veins: Dependency oedema is usually present in those with immobile limbs, which conditions can exacerbate it?

A
  • Arthritis
  • Chronic respiratory/cardiac problems.
  • Age
  • Advanced cancer, cardiac or renal failure.
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11
Q

Week 226 - Varicose Veins: What are the signs of dependency oedema?

A
  • Skin is usually translucent and shiny in appearance.
  • Subcutaneous are very soft and pit.
  • Can lead to lymphorrhoea.
  • Generally responds well to elevation.
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12
Q

Week 226 - Varicose Veins: What is the incidence of lymphoedema?

A

2 per 1000

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13
Q

Week 226 - Varicose Veins: What are the primary types of lymphoedema?

A
  • Congenital - Aplasia, Hypoplasia, Hyperplasia, Valvular incompetence.
  • Hereditary - Milroy’s Disease, Sex linked, Dominant trait.
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14
Q

Week 226 - Varicose Veins: What are the secondary causes of lymphoedema?

A
  • Parasitic infection.
  • Obstruction/obliteration of vessels (Due to surgery, tumour, radiotherapy)
  • Trauma
  • Infection
  • Venous disease
  • Immobility
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15
Q

Week 226 - Varicose Veins: What are the complications of chronic oedema?

A
  • Dry/flaky skin
  • Eczema
  • Contact dermatitis
  • Fungal infections
  • Hyperkeratosis
  • Papillomatosis
  • Lymphangiomata
  • Lymphorrhoea
  • Ulceration
  • Folliculitis
  • Fibrosis
  • Cellulitis
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16
Q

Week 226 - Varicose Veins: What is Papillomatosis?

A

A possible complication of chronic oedema.

Wart like raised areas of skin due to hyperplasia and enlargement of contiguous dermal papillae.

17
Q

Week 226 - Varicose Veins: What is Lymphangiomata?

A

A benign tumour formed of dilated and newly created lymph vessels, a possible complication of lymphoedema.

18
Q

Week 226 - Varicose Veins: What is the first line treatment for cellulitis?

A

• Amoxicillin 500mg TDS +/- Flucloxacillin

Erythromycin if penicillin allergy

19
Q

Week 226 - Varicose Veins: What is the management/treatment of lymphoedema?

A
  • Multilayer lymphoedema bandaging.
  • Skin care
  • Exercises
  • Compression garments
  • Self-massage
  • Patient education including weight management.
20
Q

Week 226 - Varicose Veins: What type of bandage should be used for management of lymphoedema (Long-stretch or short-stretch)? What is the advantages?

A
  • Short-stretch
  • Doesn’t create champagne shape or cause distortion of forefoot and toes.
  • Promotes tissue healing.
21
Q

Week 226 - Varicose Veins: What are the five treatment options for varicose veins?

A

1) Surgery
2) Radiofrequency ablation (RFA)
3) Endo venous laser treatment (EVLT)
4) Foam sclerotherapy
5) Compression

22
Q

Week 226 - Varicose Veins: What are the characteristics of a typical venous leg ulcer?

A
  • Large, shallow, painless.

* Tend to appear around the medial and lateral malleoli.

23
Q

Week 226 - Varicose Veins: What is the broad pathology behind the development of venous ulcers?

A
  • Incompetent valves in the veins of the legs lead to blood being pushed into the superficial veins.
  • This causes oedema, which can lead to venous eczema and ulceration.
24
Q

Week 226 - Varicose Veins: What are the characteristics of a typical arterial ulcer?

A
  • Often distal, found on the toes or the dorsum of the foot.

* Deeper and more painful than venous ulcers.

25
Q

Week 226 - Varicose Veins: What is the broad treatment for venous leg ulcers?

A

1) Gradual compression.
2) Debridement and cleaning.
3) Dressing

4) Antibiotics in infected ulcers.
5) Topical steroids may be useful for treating surrounding areas.

Revision Cards (61 decks)

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