Vascular

Question 1

Indications for operating on AAA

Answer 1

1. Leaking or ruptured AAA
2. Symptomatic AAA: (ie. abdo pain, ureteric obstruction or embolism)
3. Expanding (expand at rate of >0.5cm per year)
4. Size (>5.5cm, or saccular aneurysm)

Question 2

Varicose vein complications

Answer 2

Eczema (lipodermatosclerosis)
Pain (ache after standing all day)
Bleeding
Thrombophlebitis 
Thrombosis 
Ulcer
Cosmetic

Question 3

Indications for varicose vein surgery

Answer 3

Aching on standing all day
Haemorrhage
Superficial thrombophlebitis
Venous skin changes (due to insufficiency)

Question 4

Treatments for varicose veins

Answer 4

1. Compression stockings
2. Injection sclerotherapy (for small veins below knee, but not big ones)
3. High saphenous ligation
   Long saphenous strip
   Avulsion of varicosities
4. Endovascular laser, radio frequency ablation

Question 5

What is reperfusion injury?

Answer 5

Occurs when tissue which has sustained a period of ischaemia is reperfused.
The production of free radicals during reperfusion can lead to local swelling and tissue damage.
Similarly development of toxic metabolites during the ischaemic episode enters the systemic circulation and can cause problems including SIRS response, hyperkalaemia and cardiac problems (arrhythmias, arrest)