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Peripheral Vascular Disease Flashcards

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1
Q

what is DVT

A

thrombus fired anywhere in venous circulation

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2
Q

what is PE

A

thrombus that has embolised and lodged in the pulmonary circulation

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3
Q

what does VTE stand for

A

venous thromboembolic disease

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4
Q

what is virchow’s triad

A

hyper-coagulable state
endothelial injury
circulatory stasis

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5
Q

what is an example of each of the factors of virchow’s triad

A

hyper coagulable state= pregnancy, malignancy
endothelial injury= venous disorders, trauma, atheroma
circulatory state= LV dysfunction, immobility

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6
Q

what does VitK reductase do

A

activates precursors 2,7,9,10 to become active clotting factors 2a,7a,9a,10a

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7
Q

what are risks of virchow’s triad occurring

A

surgery, trauma, acute HF/chronic, adv age, varicose veins, obesity, immobility, cancer, inflammatory disease

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8
Q

what are presenting symptoms of DVT

A

painful swollen red limb, heat and tenderness along vein

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9
Q

what are presenting symptoms of PE

A

sudden SOB, pleuritic pain

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10
Q

what ix is carried out for DVT?

A

pre-test scoring system, USS

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11
Q

what ix is carried out for VTE?

A

d-dimers

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12
Q

what is important to note of d-dimers

A

a +ve result isn’t a diagnosis in itself, -ve result can exclude VTE

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13
Q

what ix is carried out for PE

A

CT pulmonary angiogram, VQ scan, PESI score (1-4)

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14
Q

tx for DVT

A

DOACs

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15
Q

tx for PE

A

thrombosis & DOACs

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16
Q

what is a type of DOAC

A

rivaroxiban

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17
Q

what other anticoagulants can be given for PE

A

VitK antagonists (warfarin), LMWH

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18
Q

length of tx for provoked, provoked with reversible factor, unprovoked VTEs?

A

provoked: 3-6months
provoked w reversible factor: 3-6months
unprovoked: lifelong

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19
Q

what is post-thrombotic syndrome

A

occurs in 1/3 patients that have had idiopathic DVT

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20
Q

how does post-thrombotic syndrome present

A

pain, oedema, hyper pigmentation, eczema

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21
Q

what are the 2 types of stroke

A

haemorrhage, ischaemic (thrombus, embolus, stenosed artery)

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22
Q

what is a stroke

A

acute onset of focal neurological symptoms and signs due to disruption of blood supply

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23
Q

True/False…

Venous strokes lead to strokes

Study These Flashcards
A

False…

Arterial strokes usually do

24
Q

what usually cause strokes

Study These Flashcards
A

non modifiable: age, fhx, gender (male), race, pmhx

modificable: HT, HL, TIAs, smoking, AFib, diabetes, HF, obesity

25
what are rare causes of strokes in young people
homocysteinaemia, vasculitis, protein def
26
presenting symptoms of stroke
nausea, headache, sweatiness, speech impairment, numbness to face, confusion, visual impairment BE FAST
27
ix for ischaemic stroke
atheroembolism: carotid doppler scan, CT/MRI, angio of aortic arch cardioembolism: ECG, Echo
28
haemorrhage causes?
HT? aneurysm? | if multiple strokes consider vasculitis or Moya Moya disease
29
tx for stroke
thrombolysis/thrombectomy | surgical: haematoma evacuation, relief of inter cranial pressure, carotid endarectomy
30
what should be given to prevent another stroke & if stroke is caused by Afib
aspirin and if stroke due to Afib give DOACs/warfarin
31
what are TIAs due to
occlusion of artery causing temporary stop of blood flow
32
what are TIAs the brain equivalent of?
Angina
33
how are TIAs relieved?
can self dissolve the clot or angioplasty or clopidogrel/aspirin
34
what are 2 chronic arterial diseases
intermittent claudication and critical leg ischaemia
35
what is intermittent claudication
muscle ischaemia on exercise
36
what is critical leg ischaemia
pain at rest- sudden loss of blood supply to limb
37
what causes chronic arterial disease
damage to artery wall causing plaque formation or blockage of artery e.g. embolism, arterial dissection etc
38
what can cause damage to artery wall
smoking, HT, diabetes, HL
39
what are presenting symptoms of intermittent claudication
pain in limb with exercise
40
what are presenting symptoms of critical leg ischaemia
cool to touch, absence of peripheral pulses, pale, poor tissue nutrition, venous guttering, ulcers, gangrene, paraesthesia (pins & needles), paralysis
41
ix for chronic arterial disease
non-invasive: duplex USS, ankle brachial pressure index (ABPI) invasive: MR angio, CT angio, catheter angio
42
what range on ABPI shows claudication
0.4-0.85
43
what range on ABPI shows severe claudication
0.0-0.4
44
tx for intermittent claudication
remove risk factors e.g. smoking cessation, HL meds & anti platelets walking! angioplasty if severe
45
tx for CLI?
amputation or angioplasty & anticoags
46
what are 3 chronic venous diseases?
Varicose veins, chronic venous insufficiency, chronic venous ulceration?
47
what are varicose veins
dilated, tortuous veins
48
what is the pathophysiology of varicose veins?
due to abnormal transmission of deep venous pressure so blood pools in lower limbs
49
what are common causes of varicose veins?
comes on after DVT, age, pregnancy, obesity, fhx
50
what are presenting symptoms & signs of varicose veins?
asymptomatic | signs= bleeding, venules, recurrent, thrombophlebitis (inflamed vein)
51
what are signs of chronic venous insufficiency?
hemosiderin deposits (browning of skin due to red cell leakage), lipodermatosclerosis occurs (inflammation of layer of skin)
52
what is the main sign of chronic venous ulceration?
ulcers
53
what is the ix for chronic venous disease?
duplex USS
54
what is tx for chronic venous disease?
non-invasive: graduated compression stockings | invasive: foam sclerotherapy or thermal ablation
55
what are possible complications of chronic venous disease?
bleeding/ bruising, thrombophlebitis, skin staining, nerve damage
56
what is the difference between a doppler USS and a duplex USS?
Doppler: sound waves used that reflect off moving objects e.g. blood to monitor flow Duplex: sound waves that bounce off of blood vessels

Cardiovascular (12 decks)

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