Title 29 Vascular LMV 5.1.pdf ✅

1 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com Vascular Version 5.1 Corrected, Updated, Lighter PLAB 1 Keys is for PLAB-1 and UKMLA-AKT (Based on the New MLA Content-Map) With the Most Recent Recalls and the UK Guidelines ATTENTION: This file will be updated online on our website frequently! (example: Version 2.7 is more recent than Version 2.6, and so on) Key 1 (6P features of Acute Limb Ischemia) → Pain (Sudden), Pallor, Pulselessness, Paralysis, Paraesthesia (Numbness), Perishing cold. ◙ Acute limb ischemia is a surgical emergency that requires urgent revascularisation (Angioplasty or Open surgery) in 4-8 hours to save a limb. Thus, it needs to be referred urgently to a vascular surgeon. Plab1keys.com Strict Copyrights! No Sharing or Copying Allowed by any means Compensations and Penalties Worldwide System is Active
2 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com ◙ In the presence of acute limb ischemia + Irregular pulse (likely due to Arterial Fibrillation), the likely cause of this limb ischemia is → Embolus. Key 2 Painless, Pulsatile mass (swelling) → Aneurysm e.g. painless pulsatile mass near the groin → Femoral artery aneurysm. Key 3 Renal cell carcinoma can cause → Varicocele “Bluish, bag of worms sensation, dragging pain or painless scrotal swelling” → Reassure or do surgery if severe persistent pain or infertility Renal Cell Carcinoma can also cause → Inferior Vena Cava Syndrome “Occlusion of IVC → pitting, non-tender edema of the lower limbs + dilated veins on the lower abdomen”. Key 4 Buerger’s disease [Thromboangiitis Obliterans]
3 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com ◙ A small and medium vessel vasculitis. ◙ Strongly associated with smoking – especially in Young men 25-45 YO. ◙ Features √ Extremity ischaemia: intermittent claudication, rest pain, ischaemic ulcers. √ Superficial thrombophlebitis √ Raynaud’s phenomenon ◙ STOP SMOKING Example, A 29 YO male was admitted for severe right calf pain. This pain has been increasing over the las 3 months. He is smoker but with no Hx of HTN or DM. O/E → loss of dorsalis pedis and posterior tibial pulsation + Non-healing ulcer over the right first metatarsophalangeal joint. The likely Dx → Thromboangiitis Obliterans (Buerger’s Disease). Do not get confused: ◘ Buerger’s → Vascular → Thromboangiitis Obliterans
4 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers) Copyrights @ Plab1Keys.com “Typically, a young man with a strong Hx of smoking presenting with chronic limb ischemia e.g. no pulse, ischemic non healing ulcer, claudication and rest leg pain”. ◘ Berger’s → IgA Nephropathy “Typically, a young adult with haematuria 1-2 days after an URTI”. Key 5 A 66 YO smoker and hypertensive patient presents with a sudden onset weakness of the right arm with dysphasia that resolved within 24 hours. ♦ The likely Dx → Transient Ischemic Attack (TIA). (Resolved within 24 hours) ♦ The best next modality → Carotid Doppler Scanning Carotid duplex should be done within 2 weeks of admission to check for carotid artery stenosis to assess for the need of carotid endarterectomy. When to perform Carotid endarterectomy? √ If internal carotid artery stenosis is ≥ 50% in ♂ (Men) √ If internal carotid artery stenosis is ≥ 70% in ♀ (Women)