Medicine an Surgery notes

Apr 24th, 2015
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VARICOSE VEINSDefinition:These are elongated, dilated, tortuous superficial veins with congenitally absent valves, or valves that have become incompetent. Affects legs where reverse flow occurs when dependent.Etiology:Faulty valves in one or more perforator veins in the lower leg causing secondary incompetence at the saphenofemoral junctionDeep thrombophlebitisIncreased venous pressure from any causeCongenital valvular incompetenceTrauma (should consider AV fistula - listen for bruit)In many individuals, no cause or precipitating factor foundRisk factors:PregnancyOccupations requiring prolonged standing, restrictive clothing (e.g., very tight girdles)ObesitySigns and symptoms:Leg muscular cramp (spasm)Dilatation, tortuosity of superficial veins chiefly in the lower extremitiesEdema of affected limbLeg achingFatigueSymptoms worse during mensesPain if varicose ulcer developsDifferential diagnosis:Nerve root compressionArthritisPeripheral neuritisTelangiectasia - smaller, visible blood vessels that are permanently dilatedDeep vein thrombosisPathology:Varicosities are particularly a problem for the multipara and may cause severe complications.

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