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R - Cardiovascular (Unknown) > Venous and Lymphatic Disease > Flashcards

Venous and Lymphatic Disease Flashcards

1
Q

Which disease affects the superficial veins only?

A

Varicose Veins

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2
Q

Varicose veins in more common in…

A

Middle aged women

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3
Q

Name the two superficial veins in the leg

A 
Short saphenous (greater)
Long Saphenous (lesser)
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4
Q

Describe the drainage of superficial veins

A

Long Saphenous- drains into the femoral at the proximal medial thigh.
Short Saphenous- drains into the popliteal at the back of the knee.

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5
Q

Describe the pathophysiology of VV

A

Valves are damaged which allows backflow & pooling of blood in veins.
Can be hereditary or secondary to venous disease.

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6
Q

Which vein is more commonly affected?

A

Long Saphenous (80%)

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7
Q

Points to look for in a history and why?

A 
Age- indicate primary vs secondary
Occupation- standing all day?
Pregnancy- big baby/ twins
Previous DVT/ major trauma
Family History
Impact on lifestyle
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8
Q

Name 5 symptoms of VV

A
  1. Cosmesis- look ugly
  2. Localised or General discomfort in legs
  3. Nocturnal Cramps
  4. Swelling
  5. Venous eczema/ itching
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9
Q

Name two signs which would be indications for intervention

A
  1. Acute Haemorrhage- fragile skin and blood under pressure leads to bleeding
  2. Superficial Thrombophlebitis- thrombus in vein leads to swelling and inflammation.
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10
Q

Investigations for VV

A

Duplex Ultrasound

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11
Q

Findings on D.U.S

A

Backflow of blood

Check patency of deep veins in case of surgery.

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12
Q

Indications for intervention VV

A
  • Bleeding
  • Impacting on functionality
  • thrombophlebitis
  • signs of chronic venous insufficiency.
  • anxiety or depression.
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13
Q

Options for treatment of VV

A
  1. Surgery
  2. Foam Sclerotherapy
  3. Minimally invasive therapy
  4. Conservative- compression
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14
Q

Describe the process of surgery

A

Open vein and strip it out- pull it out at the junction with the saphenous.

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15
Q

Contraindications for surgery in VV

A

Previous DVT
Arterial Insufficiency
Morbid obesity
Co-morbidity

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16
Q

Possible complications of surgery in VV

A 
Wound pain
Thrombophlebitis
Scarring
Damage to sural or saphenous nerve.
Damage to arteries, nerves, deep veins, DVT.
17
Q

Name two types of Minimally Invasive procedures

A
  1. EVLA- endovenous laser ablation

2. VNUS- radiofrequency ablation- heat (85 degrees)

18
Q

Advantages of less invasive

A

Local Anaesthetic ( surgery needs GA)
No operating theatre
Shorter recovery time.

19
Q

Chronic Venous Insufficiency- what is it?

A

Failure of calf muscle pump, valve failure or obstruction leads to high AVP, leads to venous hypertension, leads to imbalance of starling forces (oedema), portal hypertension and potential R heart failure.

20
Q

what is AVP?

A

Ambulatory Venous Pressure

21
Q

Factors affecting the calf muscle pump?

A

Inactivity (bedridden)
Obesity
Superficial/deep venous reflux
Neuromuscular disease.

22
Q

5 Signs of CVI

A 
Ankle oedema
Telangectasia- spider veins
Venous eczema
Haemosiderin Pigmentation
Hypopigmentation
Lipodermatosclerosis
Venous Ulceration.
23
Q

Define a leg ulcer

A

Breach of skin between knee and ankle for over 4 weeks.

24
Q

Differential diagnosis in CVI and leg ulcers

A

80% venous
20% arterial
Also Diabetes, Rheumatoid Arthritis, CT disease.

25
Q

Investigations for CVI

A

ABPI & Duplex US

26
Q

Treatment for CVI

A

Compression
Dressings
Systemic or topical therapy
Exercise and elevate at rest

27
Q

When would you not use compression?

A

In arterial disease- would further limit perfusion.

28
Q

Name two main types of Lymphoedema

A

Primary

Secondary

29
Q

Name three subtypes of primary Lymphoedema

A
  1. congenital
  2. praecox- before 30
  3. tarda- after 30
30
Q

Name 3 causes of Secondary Lymphoedema

A
  • Malignancy
  • Radical Mastectomy
  • radiotherapy
  • infection (TB/filariasis)
31
Q

What is hyperplasia?

A

Enlarged but dysfunctional lymph vessels.

32
Q

Treatment for Lymphoedema

A
  1. Elevation
  2. Manual Drainage
  3. Compression Bandaging
  4. Pneumatic Compression

R - Cardiovascular (Unknown) (18 decks)

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