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