Vascular II DVT/PE

SUGGESTED READINGS
VASCULAR II

Current Surgical Diagnosis & Treatment, 12th Edition, Ch. 36.

OBJECTIVES
VASCULAR II

1. Discuss the diagnostic techniques in chronic venous disease:

a. venous duplex
b. ascending and descending venography

2. Define venous claudication.
3. Discuss the etiology, differential diagnosis and management of venous stasis ulcers.
4. Discuss the natural history of deep venous thrombosis.
5. Discuss what measures are effective in preventing deep venous thrombosis (DVT) and to which patients these should be applied.
6. Outline the diagnostic and management plan for pulmonary embolism.
7. Describe the methods of anticoagulant and thrombolytic administration and the modes of evaluating such therapy.
8. List the contradictions for thrombolytic and anticoagulant therapy.
9. Discuss the accuracy of radionuclide pulmonary scan vs. pulmonary angiogram vs. CT.

CASE HISTORIES
VASCULAR II

1. A 28-year old female is hospitalized in her 30th week of pregnancy because of acute onset of left leg swelling. Examination shows a swollen left leg, slightly warm, and somewhat cyanotic in appearance. What would be your course of evaluation and management?

2. A 60-year-old female has had a left hip fracture treated with an open reduction and internal fixation. On post-operatively day 3, she suffers an acute episode of shortness of breath and sharp chest pain on the right side. This improves with a 100% non-rebreather mask. Arterial blood gas shows a PH of 7.35, PO2 is 62, PCO2 is 32. What is the diagnosis and course of action.

3. A 48-year-old male presents to your office for the first time with complaints of left lower extremity edema that has been present over the past 20 years. Examination of his leg shows evidence of hyperpigmentation, eczema, edema, and 1 x 3 cm superficial ulcer just above the medial maleolus. What further integral parts of the history and physical examination are needed? What is the next course of action in regards to further testing and treatment?

Back to Objectives Main Page