Vascular

Question 1

Investigations for Acute limb ischaemia/claudication

Answer 1

• ABPI
• Duplex US
• CT angiography
• MR angiography

Question 2

Differentials for claudication

Answer 2

Chronic pain

• intermittent claudication
• musculoskeletal (osteoarthritis)
• spinal claudication/stenosis
• diabetic neuropathy

Acute

• acute limb ischaemia (occlusion - thrombus rupture of plaque, embolus (AF), trauma)
• DVT
• compartment syndrome

Question 3

Venous vs arterial ulcer

Answer 3

Venous

• medial malleolus
• not painful
• oedema, haemosiderin deposits, lots of exudate
• sloped

Arterial

• lateral malleolues, feet, toes
• painful
• no oedema , not much exudate
• punched out

Question 4

Dysphagia differential

• neuromuscular
• obstructive

Answer 4

Neuromuscular

• achlasia
• oesophageal spasm
• scleroderma
• stroke
• parkinsons, huntingtons, Myasthesia gravis, multiple sclerosis

Obstructive

• tumour
• stricture
• foreign body
• lymphadenopathy, infeciton
• zenkers diverticulum

Question 5

Causes of Neck swelling
Midline

Lateral

Answer 5

Midline - goiter

• thyroglossal cyst (are attatched to tongue so move when poke it out)
• lymph nodes
• parathryoid gland

Lateral

• lymph nodes
• salivary gland
• sebaceous cyst
• lipoma
• branchial cyst

Question 6

Investigations for neck lump

Answer 6

Imaging
-US
=MRI CT ( metastistis)

biopsy
-Fine needle aspiration

Thyroid function tests
Radioisotope scans

Question 7

Swellings of salivary glands

Answer 7

-Parotid and submandibular glands
-Infective (mumps, parotitsi)
-Obstructive (calculi)
bening tumours
malignnat tumors

Question 8

Differentials for goiter

Answer 8

• multinodular goiter
• graves disease
• solitary nodule (adenoma/carcinoma)
• Hashimotos thyroiditis
• Subactue thryoditisi

Question 9

Causes of hypothryoidism

Answer 9

• Autoimmune
• Acquired(iodine deficiecney, subacute thryoditis, iatrogenic- surg, radiation, lithium, amiodarone )
• Secondary - panhypopiturtarism