Week 226 - Varicose Veins Flashcards
(25 cards)
Week 226 - Varicose Veins: What are the three main types of oedema?
- Lymphoedema
- Lymphovenous oedema
- Dependency oedema
Week 226 - Varicose Veins: In terms of capillary filtration what occurs during lymphoedema, lymphovenous oedema and dependency oedema?
- Lymphoedema - Normal capillary filtration.
- Lymphovenous filtration - Increased
- Dependency oedema - Increased
Week 226 - Varicose Veins: What is dependency oedema?
Oedema caused by immobile limbs resulting in reduced venous return.
Week 226 - Varicose Veins: What is lymphoedema?
- Caused by inadequate drainage.
- There is normal capillary filtration.
- An increase in protein concentration.
Week 226 - Varicose Veins: What is lipoedema?
- Symmetrical fatty deposits, bilaterally.
* Possible due to disturbed venous function.
Week 226 - Varicose Veins: Which three types of chronic oedema lead to lymphatic overload/failure?
- Lymphovenous oedema
- Dependency Oedema
- Lipoedema
Week 226 - Varicose Veins: What is the definition of chronic oedema?
Persistent (>3 months) swelling due to excess accumulation of fluid in the tissues.
Week 226 - Varicose Veins: What are the signs and symptoms of lymphovenous oedema?
- Subcutaneous tissues are generally soft and pitting.
- Swelling reduces with elevation.
- Skin and tissue changes occur over time.
- Patients often complain of discomfort and restlessness.
- Rarely affects areas other than the lower limb.
Week 226 - Varicose Veins: What skin changes can occur with lymphovenous oedema?
- Haemosiderin staining
- Ulceration
- Varicose eczema
- Lipodermatosclerosis
- Varicose veins + telangiectasia
Week 226 - Varicose Veins: Dependency oedema is usually present in those with immobile limbs, which conditions can exacerbate it?
- Arthritis
- Chronic respiratory/cardiac problems.
- Age
- Advanced cancer, cardiac or renal failure.
Week 226 - Varicose Veins: What are the signs of dependency oedema?
- Skin is usually translucent and shiny in appearance.
- Subcutaneous are very soft and pit.
- Can lead to lymphorrhoea.
- Generally responds well to elevation.
Week 226 - Varicose Veins: What is the incidence of lymphoedema?
2 per 1000
Week 226 - Varicose Veins: What are the primary types of lymphoedema?
- Congenital - Aplasia, Hypoplasia, Hyperplasia, Valvular incompetence.
- Hereditary - Milroy’s Disease, Sex linked, Dominant trait.
Week 226 - Varicose Veins: What are the secondary causes of lymphoedema?
- Parasitic infection.
- Obstruction/obliteration of vessels (Due to surgery, tumour, radiotherapy)
- Trauma
- Infection
- Venous disease
- Immobility
Week 226 - Varicose Veins: What are the complications of chronic oedema?
- Dry/flaky skin
- Eczema
- Contact dermatitis
- Fungal infections
- Hyperkeratosis
- Papillomatosis
- Lymphangiomata
- Lymphorrhoea
- Ulceration
- Folliculitis
- Fibrosis
- Cellulitis
Week 226 - Varicose Veins: What is Papillomatosis?
A possible complication of chronic oedema.
Wart like raised areas of skin due to hyperplasia and enlargement of contiguous dermal papillae.
Week 226 - Varicose Veins: What is Lymphangiomata?
A benign tumour formed of dilated and newly created lymph vessels, a possible complication of lymphoedema.
Week 226 - Varicose Veins: What is the first line treatment for cellulitis?
• Amoxicillin 500mg TDS +/- Flucloxacillin
Erythromycin if penicillin allergy
Week 226 - Varicose Veins: What is the management/treatment of lymphoedema?
- Multilayer lymphoedema bandaging.
- Skin care
- Exercises
- Compression garments
- Self-massage
- Patient education including weight management.
Week 226 - Varicose Veins: What type of bandage should be used for management of lymphoedema (Long-stretch or short-stretch)? What is the advantages?
- Short-stretch
- Doesn’t create champagne shape or cause distortion of forefoot and toes.
- Promotes tissue healing.
Week 226 - Varicose Veins: What are the five treatment options for varicose veins?
1) Surgery
2) Radiofrequency ablation (RFA)
3) Endo venous laser treatment (EVLT)
4) Foam sclerotherapy
5) Compression
Week 226 - Varicose Veins: What are the characteristics of a typical venous leg ulcer?
- Large, shallow, painless.
* Tend to appear around the medial and lateral malleoli.
Week 226 - Varicose Veins: What is the broad pathology behind the development of venous ulcers?
- Incompetent valves in the veins of the legs lead to blood being pushed into the superficial veins.
- This causes oedema, which can lead to venous eczema and ulceration.
Week 226 - Varicose Veins: What are the characteristics of a typical arterial ulcer?
- Often distal, found on the toes or the dorsum of the foot.
* Deeper and more painful than venous ulcers.
