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Flashcards in Vascular history and examination Deck (23):
1

3 things to take in history

name
age
occupation

2

5 things to ask to diagnose leg effects of atherosclerosis

-nature/site of pain
-how far can you walk before pain starts (some distance)
-how far before you have to stop
-does pain go away on rest
-does pain come on quicker when walking up hills/ hurrying

3

3 diagnosing factors for critical ischaemia

-rest pain affecting foot when elevated at rest (eg at night)
-tissue loss (ulceration)
-gangrene

4

5 risk factors for vascular disease

-smoking
-hypertension
-diabetes
-hypercholesterolaemia
-family history

5

7 types (+ names) of medications pt with vascular disease may be taking

SAME AS ANGINA DABDS
-anti-platelets (aspirin, clopidogrel)
-statins
-ACE inhibitors (pil)
-B blockers (lol)
-calcium antagonists
-diuretics
-vasodilators

6

6 signs of vascular problems

-arcus senilis (white crescent around pupil due to hypercholesterolaemia)
-xanthelasma (white patch on eyelid. hypercholesterolaemia)
-angular stomatitis (red, swollen corners of mouth. indicates anaemia)
-embolic digital ischaemia (embolus lodged in digital aa --> tissue necrosis
-splinter haemorrhage: micro-emboli. sign of valvular heart disease/ septic endocarditis
-clubbing: arterial venous shunts/splints, sign of sianotic heart disease --> oedema of fingerbed, loss of angle of nail

7

details of 3 main areas of atherosclerosis effects

-BRAIN: stroke, TIA, amaurosis (vision loss)
-HEART: angina, MI (if cardiac muscle has died)
-LEG: intermittent claudification (muscle pain), critical ischaemia

8

4 trophic changes with atherosclerosis

dry skin (bc sweat glands die)
hair loss (follicles die)
nail changes
cold

9

what to check with the pulse 6

presence/absence
-rate
-rhythm
-volume

10

4 places to check pulse for atherosclerosis

-dorsalis pedis
-posterior tibial
-popliteal (behind knee)
-femoral (groin)

11

describe Buergers test

pallor on elevation
rubor on dependency

12

3 signs of diabetic foot

ischaemia
neuropathy
infection

13

5 signs of neuropathy with atherosclerosis

hot water bottle burn
friction from bed clothes
burning and tingling --> throws bedclothes off at night
loss of pinprick sensation
neuropathic ulcers (painless, over bony prominences)

14

what causes patchy localised infarction

embolism

15

how to diagnose pvd 4

-ABPI: ancho-brachial pressure index
take bp using Doppler probe
lower bp in feet than arm
-duplex doppler ultrasound --> spectoral analysis, digital
-MRA magnetic resonance angiogram (map of arteries)
-digital subtraction angiography: contrast injected through vessels

16

most important method of treating vascular disease

controllng risk factors (inc exercise, lower cholesterol, stop smoking)

17

2 other treatment methods of vascular diseas

-angioplasty/stent through femoral artery
-lower limb arterial bypass: use vein (turned around) to replace artery

18

what is an aortic aneurysm and common site

abnormal dilation of a. 5.5cm dilation --> can leak/burst --> death
infrarenal abdominal a

19

risk group of aortic aneurysms

men 65+yo

20

what is done to control aortic aneurysm levels

national screening program of men 65+yo with ultrasound

21

tx of aortic aneurysm 2 and which is better and why

-surgery: replace dilated tissue with patch
-EVAR (endovascular aneurysm repair): stent placed to stop blood flowing through dilation. uses radiography
EVAR is better. less invasive, less QoL impact on pt

22

explain carotid a disease

plaque forms in internal carotid a at bifurtation of common carotid a--> turbulent flow --> embolus breaks off --> lodges in cerebral a --> TIA or stroke

23

difference between TIA and stroke

TIA: transient ischaemic attack, 24hr