Vascular disease

Question 1

where does atherosclerosis happen?

Answer 1

Large and medium sized conduit arteries
turbulence at bifurcations =important factor
coronary, carotid and lower limb arteries

Question 2

Describe chronic lower limb ischaemia

Answer 2

often bilateral

collateral circulation can develop over time

Question 3

Fontaine classification of limb ischaemia

Answer 3

asymptomatic
intermittent claudication
ischaemic rest pain
ulceration/gangrene = critical ischaemia

Question 4

Signs of critical ischaemia

Answer 4

gangrene, ulceration and foot pain at rest

Question 5

Describe acute limb ischaemia

Answer 5

surgical emergency
complete occlusion has occurred
very painful
6Ps

Question 6

Decribe Thrombobangittis obliterans

Answer 6

Inflammatory process (small and intermediate arteries)
Men heavy smokers
Autoimmune reaction to smoke
ulcerations and gangrene

Question 7

Describe varicose veins

Answer 7

persistent distended superficial veins
veins under pressure (up to 5-10X as much when person is erected)- pregnancy, pelvic are tumours
loss of supporting muscle/tissue
familial

Question 8

Describe PAD

Answer 8

Most common
fermoral, popliteal, tibial and fibular, aorta and iliac
Claudication
smooth shinny skin, no hair, increased toe nail thickness , small circular deep ulcers

Question 9

When is an acute peripheral occlusion like to occur and how?

Answer 9

Emboli

Post MI

Question 10

Describe PVD

Answer 10

Chronic venous insufficiency 
irregular shape, superficial 
No IC
normal nails
Varicose eczema (stasis dermatitis) 
Incompetent valves, pooling, DVT 
Normal pulses, brown patches, oedema

Question 11

How would you diagnose PAD?

Answer 11

Ankle, brachial index
brachial systolic vs systolic
BP of ankle is t least 90% of arm
USS