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Flashcards in VASCULAR SYSTEM Deck (66):
1

what gender is more likely to be affected by an AAA?

male

2

what percentage of men of 65 have an AAA?
a) 5%
b) 15%
c) 25%
d) 35%

a) 5%

3

what symptoms might you get with an AAA pre-rupture?

none

4

give 2 symptoms of a patient with ruptured AAA?

collapse
intense abdo/back pain

5

what happens to the blood pressure of a patient with AAA?

drops

6

what kind of shock would a patient with an AAA enter?

hypovolaemic

7

give a vascular cause of AAA

Atherosclerosis
Hypertension

8

give 2 infective causes of AAA

syphilis
e coli
salmonella

9

give an extrinsic cause of AAA

trauma

10

give 2 genetic causes of AAA

marfan's
ehler's-danlos

11

What are the non pathological risk factors of AAA?

smoking
obesity
Age >50
Male
FHx *8

12

give 2 endocrine/hormone risk factors for AAA

hyperlipidaemia
cholesterol
diabetes

13

describe an abdominal mass characteristic of AAA

pulsatile and expansile

14

where do 85% of AAAs lie?

below kidneys

15

what is an aortic dissection?

blood pools between the media and intima in vessel wall

16

what is the mortality of an AAA rupture?
a) 20%
b) 50%
c) 70%
d) 90%

d) 90%

17

if an AAA is more than 5.5cm, what treatment is given?

immediate surgical repair
Either endovascular = reinforce the aorta
Open surgery= graft

18

give 2 differential diagnoses for AAA

pancreatitis
renal colic
testicular pain

19

what gender is peripheral vascular disease most common in?

men

20

give a vascular cause of peripheral vascular disease

atherosclerosis

21

give 2 causes of ischaemia in peripheral vascular disease

emboli
thrombi
Acute compartment syndrome

22

give 10 symptoms of peripheral vascular disease

intermittent claudication
ulceration
gangrene
Loss of hair on the legs
Ulceration
Brittle nails
Loss of sensation
Cold legs
Erectile dysfunction in men
Wasting of muscles

23

what are the 6 P's of ischaemia in peripheral vascular disease?

pale
pulseless
painful
perishingly cold
paralysis
parasthesia

24

give 2 lifestyle risk factors for peripheral vascular disease

smoking
obesity

25

give 3 hormone/electrolyte risk factors for peripheral vascular disease

cholesterol
hyperlipidaemia
diabetes 1 and 2

26

give 3 cardiovascular risk factors for peripheral vascular disease

ischaemic heart disease
hypertension
previous MI/stroke
AF

27

what are the names for the two locations where peripheral vascular disease can be?

aorta-iliac
infra-inguinal

28

peripheral vascular disease can be
a) chronic
b) acute
c) both

c) both

29

what diagnostic test might you use in a patient with peripheral vascular disease?

doppler study

30

What is the fontaine classifcation of chronic limb ischaemia?

stage 1 = asymptomatic
Stage 2a= Intermittent claudication can walk more than 200 meters pain free
Stage 2b= Intermittent claudication = can't walk 200m pain free
Stage 3= Pain during rest and sleep
stage 4 = gangrene or necrosis

31

what 3 lifestyle recommendations might you give to a patient with peripheral vascular disease?

smoking cessation
weight loss
exercise

32

what drugs might you give in peripheral vascular disease?

Antiplatelets
Antihypertensives
Statins

33

why is cilostazol or naftidrofuryl oxolate given in peripheral vascular disease?

vasodilation and anti-coagulant for claudication

34

How is revasculisation done for PVD patients and what is the risk?

Angioplasty and bypass graft are the two main ways
Can cause compartment syndrome

35

what percentage of the UK have varicose veins?
a) 5-10%
b) 15-20%
c) 30-40%
d) 60-70%

c) 30-40%

36

give 4 symptoms that a patient may experience with varicose veins

pain
tingling
cramps
heaviness/restlessness

37

give 4 external signs that may be seen with a patient with varicose veins

visible veins on leg
oedema
eczema
ulcers
lipodermatosclerosis (submit fat inflammation) causing hardening, redness and swelling of the lower leg

38

what causes varicose veins?

incompetent valves

39

give 3 lifestyle risk factors for varicose veins

prolonged standing
the pill
obesity

40

give a physiological risk factor for varicose veins

pregnancy
family history
female
older age

41

in normal vein physiology, how does blood drain from superficial to deep veins?

via perforator veins

42

how is back flow of blood prevented in normal vein physiology?

valves

43

what occurs to veins when they become varicosed?

valves fail
veins become hyperextended and dilated

44

what occurs to blood in varicose veins?

pools

45

where would you palpate a patient during a cough impulse test for varicose veins?

sapheno-femoral junction

46

how would you perform a tourniquet test?

hold patients leg upwards until blood drains then apply a tourniquet then get them to stand up and see how quickly veins refill
if no refill = SFJ or above valve insufficiency
take off tourniquet and should be sudden gush of refilling

47

what medical imaging might you suggest to try and diagnoses varicose veins?

doppler ultrasound

48

suggest non-surgical therapy for varicose veins

Compression stocking
Radiofrequency ablation
Endovenous laser treatment
Ultrasound-guided foam sclerotherapy= scars the vein and forms a seal

49

suggest surgical therapy for varicose veins

saphenofemoral ligations and stripping

50

what is the main symptom you would expect in a femoral embolism?

shortness of breath

51

where is a venous embolism most likely to affect?

deep vein

52

what is most likely to cause an arterial femoral embolism?

atherosclerotic or thrombotic debris

53

give 2 serious consequences of femoral emboli

aneurysmal rupture
lower limb ischaemia

54

is a femoral embolism a medical emergency?

yes

55

give one serious complication of femoral emboli

compartment syndrome

56

what is the treatment for compartment syndrome?

fasciotomy

57

give 3 surgical options for treatment of femoral emboli

fogarty balloon catheter
angioplasty
bypass surgery
severely - amputation

58

give 2 generalised drug treatments for femoral emboli

anti-coagulation (long term)
thrombolysis

59

What are the complications of AAA?

Emboli
thrombis
Rupture
Fistulae
Pressure on surrounding structures

60

What is the pros and cons of endovascular surgery and open surgery for AAA?

Endovascular= Less change of bleeding, DVT and wount/chest infection but need to have regular scans and the reinforcement graft can move needing surgery again
Open= Greater risk but more stable the graft and long lasting

61

What si the treatment of acute compartment syndrome causing acute limb ischaemia?

Fasciotomy

62

What are the DD of chronic limb ischaemia?

Spinal stenosis
MSK
Diabetic neuropathy

63

What type of aneurysm is a AAA?

True aneurysm = affects all three layers of the aorta
Initima, media and adeventitia

64

10% of AAA are symptomatic, what are the symptoms?

Abdo/Back pain with distal embolic event

65

What are the main 4 risk factors for AAA?

Athesclerosis
Hypertension
Smoking
Family history

66

What are the 4 main risk factors for PVD?

Type 1 and 2 diabetes
Smoking
Hypertension
Hyperlipidaemia