Term
| What are elongated, dilated, tortuous superficial veins w/ congenitally absent valves, or valves that have become incompetent? |
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Definition
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Term
| What is the primary etiology of varicose veins? |
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Definition
| Genetic - x-linked dominant |
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Term
| If symtpomatic, what c/o do people w/ varicose veins have? |
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Definition
| dull aching heaviness, leg cramps, edema, fatigue when standing, sx worse during menses, pain if varicose ulcer dev. |
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Term
| What physical sx occurs later on in varicose veins? |
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Definition
| brownish pigmentation and thinning of skin above ankles |
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Term
| Name 7 risk factors for varicose veins. |
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Definition
| 1) Pregnancy 2) Occupations req. standing 3) Tight clothes 4) Obesity 5) Liver dz 6) Sedentary lifestyle 7) Northern european whites |
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Term
| Name 3 surgical procedures used to tx varicose veins. |
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Definition
| 1) ligation and stripping of saphenous vein 2) compression sclerotherapy 3) stab evulsion phlebectomy |
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Term
| What is an advanced stage of PVD resulting in swelling and ulceration of LE? |
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Definition
| chronic venous insufficiency |
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Term
| 2 risk factors for chronic venous insufficiency? |
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Definition
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Term
| Which is commonly as a result of trauma, varicose veins or chronic venous insufficiency? |
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Definition
| chronic venous insufficiency (varicose rarely d/t trauma) |
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Term
| What is the name used to describe the visual appearance of a leg w/ chronic venous insufficiency? |
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Definition
| Champagne bottle shaped leg - edema just above ankle |
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Term
| What other clinical finding are seen in a leg w/ chronic venous insufficiency? |
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Definition
| thin and shiny skin, brownish pigmentation, eczema w/ superficial weeping dermatitis |
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Term
| What is the imaging test used for chronic venous insufficiency? |
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Definition
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Term
| Name 3 general measures to tx chronic venous insufficiency. |
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Definition
| 1) leg elevation 2) Avoid long periods of sitting or standing 3) Compression hose from mid-foot to just below knee |
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Term
| Tx for acute weeping dermatitis? |
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Definition
| 1) wet compresses (boric acid, Al acetate, or saline) 2) hydrocortisone cream 3) systemic abx if active infxn present |
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Term
| Tx for subsiding or chronic dermatitis? |
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Definition
| 1) Hydrocortisone cream until no more improvement 2) Zinc oxide ointment w/ ichthammol 3) broad spectrum anti-fungal (clotrimazole or miconazole) |
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Term
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Definition
| compress of isotonic saline, may also use semi-rigid boot or non-elastic bandage |
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Term
| What is phlebitis associated with the formation of blood clots called? |
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Definition
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Term
| Name 4 etiologies for phlebitis. |
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Definition
| 1) Bacterial, chemical, or mechanical 2) Meds 3) Lupus 4) Genetic |
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Term
| Name 3 meds that cause phlebitis. |
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Definition
| 1) Celebrex 2) Olanzepine (zyprexa) 3) ADs |
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Term
| 9 risk factors for phlebitis. |
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Definition
| 1) Sedentary 2) Prolonged inactivity 3) Obesity 4) Smoking 5) Injury to arms or legs 6) Estrogen 7) Pregnancy 8) Varicose veins 9) CA or blood d/o |
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Term
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Definition
| erythema, pain or burning, edema |
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Term
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Definition
| 1) Compression hose 2) Anti-inflammatory meds 3) Elevation of leg 4) Warm compresses |
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Term
| Meds used if deep vein thrombophlebitis? |
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Definition
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Term
| What is the major clinical consequence of DVT? |
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Definition
| embolization part. to lung |
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Term
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Definition
| leg pain on dorsiflexion of the foot in DVT |
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|
Term
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Definition
| 1) Limb pain, dull ache, or tightness 2) Swelling 3) Homan's sign 4) Palpable tender cord in affected limb |
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|
Term
| Are warmth or redness over area of thrombosis common finding in DVT? |
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Definition
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Term
| What would fever in a pt suspected of DVT suggest? |
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Definition
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Term
| What is the name given to the 3 factors though to contribute to DVT? What are they? |
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Definition
| Virchow's triad: venous stasis, injury to vessel wall, hypercoagulability |
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Term
| What is the most common risk factor for idiopathic DVT? |
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Definition
| mutation on factor V conferring resistance to activated protein C |
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Term
| What is the gold standard test for DVT? |
|
Definition
| contrast venography (risk from contrast dye) |
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Term
| What is the most common test used to dx DVT? |
|
Definition
|
|
Term
|
Definition
| IV anticoagulant, 1-2 d bedrest, close obs for embolic event |
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Term
| Drug therapy for uncomplicated DVT? |
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Definition
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Term
| Drug therapy for comlicated DVT? |
|
Definition
| 1) Heparine 80U/kg IV bolus then cont. 18U/kg/hr 2) Warfarin 1-3d /p heparin started, 5mg/d |
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Term
| What levels of platelets indicates heparin should be d/c'd? |
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Definition
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|
Term
| what lab is used to monitor warfarin? What is the target? |
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Definition
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Term
| Which anticoagulant is teratogenic and t/f contraindicated in pregnancy? What can be used instead? |
|
Definition
| warfarin, can use intermittent SC heparin injection |
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Term
| How long do you need to tx the first episode of DVT? Subsequent episodes? |
|
Definition
| 3-6 mths, al least a year |
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Term
| What are considered relative contraindications for anticoagulation? (4) |
|
Definition
| 1) recent hemorrhage, 2) recent surgery except neuro, 3) significant PUD, 4) recent non-embolic stroke |
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