Vascular

Question 1

Vessel used in CABG

Answer 1

Long “great” saphenous vein

Question 2

Incompetent venous valves allowing reflux of blood

Answer 2

Varicose veins

Question 3

Common varicose veins vessels

Answer 3

Long saphenous vein

Small saphenous vein

Question 4

Risk factors for varicose veins

Answer 4

Age
Female
Obesity
Pregnancy (compression of pelvic veins)

Question 5

Complications of varicose veins

Answer 5

Varicose eczema
Haemosiderin deposition (hyperpigmentation)
Lipodermatosclerosis
Atrophie blanche (hypo pigmentation)

Question 6

Management of mild-moderate varicose veins

Answer 6

Compression stockings
Weight loss
Leg elevation

Question 7

Management of severe varicose veins

Answer 7

Endothelial ablation

Foam sclerotherapy

Question 8

Aortic dissection = anterior chest pain

Answer 8

Anterior AD (Type A) - 66%

Question 9

Aortic dissection = back pain

Answer 9

Descending AD (Type B) - 33%

Question 10

Management of Anterior aortic dissection

Answer 10

Surgery + BP control

Question 11

Management of Posterior aortic dissection

Answer 11

IV Labetalol

Question 12

Investigations for aortic dissection

Answer 12

CT Angiography: false lumen
CXR: widening of aorta
Transoesophageal echo

Question 13

Aortic dissection with lucid period before death

Answer 13

Temporary haematoma

Question 14

Aortic dissections occur distal to

Answer 14

ligamentum arteriosum

Question 15

Classification index for Aortic dissection

Answer 15

Debakey classification

Question 16

Abdo pain
Pulsatile + expansile abdo mass
Back pain
Haemodynamic instability

Answer 16

Abdominal Aortic Anneurysm (AAA)

Question 17

Risk factors for AAA

Answer 17

Smoking
HTN 
Syphilis
Marfans
Ehler Danlos 
Connective tissue diseases

Question 18

AAA screening

Answer 18

Single US scan at 65

Question 19

Normal AAA at screening

Answer 19

< 3cm

No need to re-scan

Question 20

Small AAA at screening

Answer 20

3 - 4.4cm

Re-scan every 12 months

Question 21

Medium AAA at screening

Answer 21

4.5 - 5.4 cm

Re-scan every 3 months

Question 22

Large AAA at screening

Answer 22

> 5.5 cm

Re-scan every 2 weeks

Question 23

Increased AAA rupture risk if

Answer 23

> 1cm enlargement in a year

Question 24

Management of AAA

Answer 24

Elective endovascular repair (EVAR)

- via femoral artery

Question 25

ABPI < 0.5

Answer 25

Severe peripheral arterial disease

Question 26

ABPI < 1

Answer 26

Peripheral arterial disease

Question 27

ABPI 1 - 1.2

Answer 27

Normal

Question 28

ABPI > 1.2

Answer 28

Calcification of vessels | - common in diabetes

Question 29

Deposition of RBC + WBC into tissue due to back-log of venous pressure from: - venous HTN - chronic venous insufficiency

Answer 29

Venous ulcers

Question 30

Oedematous leg (due to WBC) Brown pigmentation (due to RBC) Lipodermatosclerosis Eczema

Answer 30

Venous ulcers

Question 31

Location of venous ulcers

Answer 31

Above ankle = painless | superficial

Question 32

Management for venous ulcers

Answer 32

``` Compression banding (4 x layer) Skin grafting ```

Question 33

Cold leg No pulses Painful lesion

Answer 33

Arterial ulcers

Question 34

Location of arterial ulcers

Answer 34

Toes + heel = painful

Question 35

Investigations for venous ulcer

Answer 35

Doppler US to look for reflux and veins

Question 36

Investigations for arterial ulcer

Answer 36

Doppler US | MR Angiography

Question 37

Complications of arterial ulcers

Answer 37

Gangrene

Question 38

Intermittent claudication (pain in posterior legs when walking) is an indicator of

Answer 38

Peripheral arterial disease

Question 39

Risk factors of peripheral arterial disease

Answer 39

Smoking HTN Diabetes Obesity

Question 40

Management of peripheral arterial disease

Answer 40

Exercise Statins Clopidogrel Surgery - angioplasty - stenting - bypass - amputation

Question 41

Complications of peripheral arterial disease

Answer 41

Arterial ulcers | Acute limb-threatening ischaemia

Question 42

6Ps of Acute limb threatening ischaemia

Answer 42

``` Pale Perishingly cold Pulseless Painful Paralysed Paraesthetic ```

Question 43

Inflammation + thrombosis of superficial veins

Answer 43

Superficial thrombophlebitis

Question 44

Risk of superficial thrombophlebitis

Answer 44

20% have underlying DVT 4% will progress to DVT The longer the vein the increased risk of DVT

Question 45

Management of superficial thrombophlebitis

Answer 45

NSAIDs Topical heparinoids Compression stockings LMWH

Question 46

Ulcers formed due to pressure and/or diabetes

Answer 46

Neuropathic ulcers (plantar surface)

Question 47

Management of neuropathic ulcers

Answer 47

Cushioned shoes | Amputation

Question 48

Ulcers that appear at sites of chronic inflammation in the lower limb (burns, osteomyelitis) Associated with SCC

Answer 48

Marjolin's ulcer | mixed atriovenous ulcers