Peripheral vascular disease

Question 1

clinical features of chronic lower limb ischaemia

Answer 1

diminished pulses
bruits
reduced skin temp
buerger's sign
muscle wasting
dry skin
hair loss

Question 2

2 types of chronic lower limb ischaemia

Answer 2

IC (due to one plaque)

critical limb ischaemia (multi plaque)

Question 3

treatment for IC

Answer 3

best medical therapy (BMT)

Question 4

what is done in best medical therapy

Answer 4

ABCDES

• antiplatelet (aspirin or clopidog)
• BP rx
• cholesterol (diet and statin)
• diabetes rx
• exercise
• smoking cessation

Question 5

types of surgery (4)

Answer 5

angioplasty
stenting
endarterectomy
bypass

Question 6

what is critical limb ischaemia

Answer 6

rest (night) pain requiring opiates +/- tissue loss (ulceration or gangrene) for >2 wks with ankle BP <50

Question 7

key finding in hx

Answer 7

relief when hanging leg out of bed

Question 8

rx of critical limb ischaemia

Answer 8

surgical bypass

endovascular revascularisation by angioplasty or stenting

Question 9

causes of acute limb ischaemia

Answer 9

thrombosis
embolus
trauma

Question 10

6 Ps of acute ischaemia

Answer 10

pain, pallor, pulselessness, perishing cold, paraesthesia, paralysis

Question 11

rx acute limb ischaemia

Answer 11

iv heparin bolus