Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI and Surgery > Vascular Surgery > Flashcards

Vascular Surgery Flashcards

1
Q

What CXR findings would you expect to see for an aortic dissection?

A

Widened mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What findings would you expect to see in a CT angiogram for aortic dissection?

A

False lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the indications for a limb amputation

A
  • Severe infection.
  • Gangrene (from PAD).
  • Serious trauma.
  • Deformed limb with limited function.
  • Complications from diabetes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the process of a limb amputation

A
  • Removal of section of limb.

Then, EITHER:

  • Shorten and smooth the bone in your remaining limb so that it’s covered by enough soft tissue and muscle.
  • Stitch the remaining muscle to the bones to strengthen the remaining limb (myodesis).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the possible complications of limb amputation

A
  • Heart complications.
  • DVT.
  • Slow wound healing and infection.
  • Pneumonia.
  • Phantom limb pain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Discuss rehabilitation for patients following limb amputation

A

Physiotherapy.
Occupation therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe function of valves in veins

A

Valves allow blood flow in one direction towards the heart. Leg muscles contract to squeeze blood upwards against gravity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List some complications of varicose veins

A
  • Prolonged and heavy bleeding after trauma.
  • Superficial thrombophlebitis (thrombosis and inflammation in the superficial veins).
  • Deep vein thrombosis.
  • All the issues of chronic venous insufficiency (e.g., skin changes and ulcers).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the features of a DVT

A

Unilateral symptoms:

  • Calf or leg swelling.
  • Dilated superficial veins.
  • Tenderness to the calf (particularly over the site of the deep veins).
  • Oedema.
  • Colour changes to the leg e.g. redness.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much is a significant difference in calf circumference between legs in a suspected DVT?

A

> 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you diagnose a DVT?

A
  • Doppler ultrasound of the leg.
  • NICE recommends repeating negative ultrasound scans after 6-8 days if a positive D-dimer and the Wells score suggest a DVT is likely.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the management of a DVT

A
  • DOAC (apixaban or rivaroxaban) first line.
  • Catheter-directed thrombolysis in patients with a symptomatic iliofemoral DVT and symptoms lasting less than 14 days.
  • Long-term anticoagulation: DOAC, warfarin (target INR 2-3, first line in antiphospholipid syndrome), or LMWH (first line in pregnancy).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Name an intervention that can be used for patients with recurrent PEs or those unsuitable for anticoagulation

A

Inferior vena cava filter to filter any blood clots travelling from venous system towards heart and lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you be investigating for in an unprovoked DVT/PE?

A
  • Cancer.
  • Antiphospholipid syndrome - check antiphospholipid Abs (after anticoagulation).
  • Hereditary thrombophilias (only if they have a first-degree relative also affected by a DVT or PE, and after anticoagulation).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define lymphoedema

A

A chronic condition caused by impaired lymphatic drainage, resulting in areas of the body being swollen with excess, protein-rich fluid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the types of lymphoedema

A
  • Primary lymphoedema is a rare, genetic condition, which usually presents before aged 30. It is a result of faulty development of the lymphatic system.
  • Secondary lymphoedema is due to a separate condition that affects the lymphatic system. The most common example is when patients develop lymphoedema after breast cancer surgery, due to the removal of axillary lymph nodes in the armpit.
17
Q

A positive Stemmer’s sign suggests…

A

Lymphoedema

18
Q

Describe the management of lymphoedema

A

Non-surgical treatments:

  • Massage techniques (manual lymphatic drainage).
  • Compression bandages.
  • Specific lymphoedema exercises to improve lymph drainage.
  • Weight loss.
  • Good skin care.

Lymphaticovenular anastomosis: attaching lymphatic vessels to nearby veins, allowing the lymphatic vessel to drain directly into the venous system.

Antibiotics are required if cellulitis develops.

19
Q

A young male smoker with painful blue fingertips

A

Buerger disease (thromboangiitis obliterans).

20
Q

Define Buerger disease

A
  • An inflammatory condition that causes thrombus formation in the small and medium-sized blood vessels in the distal arterial system (affecting the hands and feet).
  • Affects men aged 25-35 and has a very strong association with smoking.
21
Q

What is the most important aspect for managing Buerger disease?

A

Stop smoking

22
Q

Define carotid artery stenosis

A
  • Narrowing of the carotid arteries in the neck, usually secondary to atherosclerosis.
  • There is a risk of parts of the plaque breaking away and becoming an embolus, travelling to the brain and causing an embolic stroke.
23
Q

How would you investigate carotid artery stenosis?

A

Carotid US initially, then CT/MRI angiogram for more detail assessment.

24
Q

What sign on examination would suggest carotid artery stenosis?

A

Carotid bruit

25
Q

How is carotid artery stenosis usually diagnosed?

A

After a TIA or stroke

26
Q

Describe the management plan for carotid artery stenosis

A

Addressing modifiable risk factors and medical therapy:

  • Healthy diet and exercise.
  • Stop smoking.
  • Management of co-morbidities (e.g., hypertension and diabetes).
  • Antiplatelets (e.g., aspirin, clopidogrel and ticagrelor).
  • Lipid-lowering medications (e.g., atorvastatin).

Surgery:

  • Carotid endarterectomy (first line).
  • Angioplasty and stenting.
27
Q

Name one risk factor for acute limb Ischaemia

A

AF

28
Q

Management of an AAA > 5.5cm

A

Refer within 2 weeks to vascular surgeon

29
Q

Which AAA require urgent surgery rather than elective?

A

Symptomatic aneurysm or emergency rupture.

30
Q

Which AAA require elective surgery?

A
  • An asymptomatic aneurysm larger than 5.5 cm in diameter.
  • An asymptomatic aneurysm which is enlarging by more than 1 cm per year.
31
Q

A 62-year-old diabetic man presents with longstanding plantar ulcer he has clinical evidence of a Charcot foot.

A

Neuropathic ulcer

32
Q

A 66-year-old female has long standing mixed arteriovenous ulcers of the lower leg. Over the past 6 months one of the ulcers has become much worse and despite a number of different topical therapies is increasing in size.

A

Marjolin’s ulcer (squamous cell carcinoma occurring at sites of chronic inflammation or previous injury).

33
Q

A 28-year-old man undergoes a ileocaecal resection and end ileostomy for Crohn’s disease. One year later he presents with a deep painful ulcer at his stoma site.

A

Pyoderma gangrenosum

34
Q

Deep ulcer on toe/heel

A

Arterial ulcer

35
Q

Outline the management of thrombophlebitis

A
  • Superficial thrombophlebitis: compression stockings.
  • Long saphenous vein superficial thrombophlebitis: US to exclude underlying DVT.
36
Q

Outline the management of critical limb ischaemia

A
  • Endovascular revascularisation (angioplasty +/- stent): short segment stenosis (e.g. < 10 cm), aortic iliac disease and high-risk patients.
  • Surgical revascularisation (bypass): long segment lesions (> 10 cm), multifocal lesions, lesions of the common femoral artery and purely infrapopliteal disease.
  • Amputation: patients not suitable for other interventions, all treatments failed, gangrene & sepsis.

GI and Surgery (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions