VASCULAR SYSTEM Flashcards by Hannah Cook

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

male

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what percentage of men of 65 have an AAA?

a) 5%
b) 15%
c) 25%
d) 35%

a) 5%

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

none

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give 2 symptoms of a patient with ruptured AAA?

collapse

intense abdo/back pain

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

drops

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

hypovolaemic

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give a vascular cause of AAA

Atherosclerosis

Hypertension

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give 2 infective causes of AAA

syphilis
e coli
salmonella

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give an extrinsic cause of AAA

trauma

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give 2 genetic causes of AAA

marfan’s

ehler’s-danlos

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What are the non pathological risk factors of AAA?

smoking
obesity
Age >50
Male
FHx *8

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give 2 endocrine/hormone risk factors for AAA

hyperlipidaemia
cholesterol
diabetes

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describe an abdominal mass characteristic of AAA

pulsatile and expansile

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where do 85% of AAAs lie?

below kidneys

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what is an aortic dissection?

blood pools between the media and intima in vessel wall

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what is the mortality of an AAA rupture?

a) 20%
b) 50%
c) 70%
d) 90%

d) 90%

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

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

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give 2 differential diagnoses for AAA

pancreatitis
renal colic
testicular pain

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what gender is peripheral vascular disease most common in?

men

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give a vascular cause of peripheral vascular disease

atherosclerosis

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give 2 causes of ischaemia in peripheral vascular disease

emboli
thrombi
Acute compartment syndrome

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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

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

pale
pulseless
painful
perishingly cold
paralysis
parasthesia

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give 2 lifestyle risk factors for peripheral vascular disease

smoking

obesity

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give 3 hormone/electrolyte risk factors for peripheral vascular disease

cholesterol hyperlipidaemia diabetes 1 and 2

give 3 cardiovascular risk factors for peripheral vascular disease

ischaemic heart disease hypertension previous MI/stroke AF

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

aorta-iliac | infra-inguinal

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

c) both

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

doppler study

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

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

smoking cessation weight loss exercise

what drugs might you give in peripheral vascular disease?

Antiplatelets Antihypertensives Statins

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

vasodilation and anti-coagulant for claudication

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

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

c) 30-40%

give 4 symptoms that a patient may experience with varicose veins

pain tingling cramps heaviness/restlessness

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 ```

what causes varicose veins?

incompetent valves

give 3 lifestyle risk factors for varicose veins

prolonged standing the pill obesity

give a physiological risk factor for varicose veins

pregnancy family history female older age

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

via perforator veins

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

valves

what occurs to veins when they become varicosed?

valves fail | veins become hyperextended and dilated

what occurs to blood in varicose veins?

pools

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

sapheno-femoral junction

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

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

doppler ultrasound

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

suggest surgical therapy for varicose veins

saphenofemoral ligations and stripping

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

shortness of breath

where is a venous embolism most likely to affect?

deep vein

what is most likely to cause an arterial femoral embolism?

atherosclerotic or thrombotic debris

give 2 serious consequences of femoral emboli

aneurysmal rupture | lower limb ischaemia

is a femoral embolism a medical emergency?

yes

give one serious complication of femoral emboli

compartment syndrome

what is the treatment for compartment syndrome?

fasciotomy

give 3 surgical options for treatment of femoral emboli

fogarty balloon catheter angioplasty bypass surgery severely - amputation

give 2 generalised drug treatments for femoral emboli

anti-coagulation (long term) | thrombolysis

What are the complications of AAA?

``` Emboli thrombis Rupture Fistulae Pressure on surrounding structures ```

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 ```

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

Fasciotomy

What are the DD of chronic limb ischaemia?

Spinal stenosis MSK Diabetic neuropathy

What type of aneurysm is a AAA?

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

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

Abdo/Back pain with distal embolic event

What are the main 4 risk factors for AAA?

Athesclerosis Hypertension Smoking Family history

What are the 4 main risk factors for PVD?

Type 1 and 2 diabetes Smoking Hypertension Hyperlipidaemia

VASCULAR SYSTEM Flashcards

(66 cards)