Module 4 Logbooks - Varicose Veins

Front 1

Module 4 - logbook 3: definition

Back 1

Veins that have enlarged and become twisted (tortuous). Can be staged with Clinical picture, Etiology, Anatomical distribution and Pathophysiology (CEAP)

Front 2

Module 4 - logbook 3: epidemeology

Back 2

Very common. 2% Incidence (more common in women than men (child birth)

Front 3

Module 4 - logbook 3: risk factors

Back 3

Genetics, gender and increasing age are

BMI, adequate physical exercise, smoking, sedentary activities and hypertension

Front 4

Module 4 - logbook 3: common presentation

Back 4

Itching, discomfort and heaviness of the legs, night cramps, oedema, burning sensations, paraesthesia, exercise intolerance, or restless legs

Also cosmetic

Front 5

Module 4 - logbook 3: investigations

Back 5

Duplex ultrasound is NICE's investigation of choice

Hand-held Doppler - can show retrograde flow.

Front 6

Module 4 - logbook 3: pathophysiology

Back 6

Leakage in a valve causes retrograde flow back into the vein. Superficial veins cannot withstand high pressure and eventually become dilated and tortuous. The failure of one valve puts pressure on its neighbours and may result in retrograde flow, and hence varicosity, of the entire network

Front 7

Module 4 - logbook 3: anatomy

Back 7

Femoral vein > long saphenous vein > short saphenous vein branches off. Popliteal vein in the knee

Front 8

Module 4 - logbook 3: prognosis

Back 8

Tend to get worse over time and lead to venous ulcers. Surgery often needs to be re-done within a few years

Front 9

Module 4 - logbook 3: management

Back 9

Primary care: Lifestyle changes + compression stockings. Refer if active bleeding or skin changes/large extent and size

Secondary care: NICE: radiofrequency ablation, endovenous laser therapy or sclerotherapy. Also avulsion and stripping

Front 10

Module 4 - logbook 3: drugs - PROCHLORPERAZINE

Back 10

Phenothiazine - less dopamine in brain - blocks D2 somatodendritic receptors

Front 11

Module 4 - logbook 3: eitology

Back 11

Anything producing pressure: age, hypertension and pregnancy (hormonal and pressure from fetus)