1 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
Plab1keys.com
Strict Copyrights!
Vascular
No Sharing or Copying
Allowed by any means
Compensations and
Penalties Worldwide
Version 5.2
System is Active
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 (6P features of Acute Limb Ischemia) →
1
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.
Copyrights @ Plab1Keys.com
,2 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
◙ In the presence of acute limb ischemia + Irregular pulse (likely due to
Arterial Fibrillation), the likely cause of this limb ischemia is → Embolus.
Key Painless, Pulsatile mass (swelling) → Aneurysm
2
e.g. painless pulsatile mass near the groin → Femoral artery aneurysm.
Key Renal cell carcinoma can cause
3
→ 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 Buerger’s disease [Thromboangiitis Obliterans]
4
Copyrights @ Plab1Keys.com
,3 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
◙ 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
Copyrights @ Plab1Keys.com
, 4 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
“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 A 66 YO smoker and hypertensive patient presents with a sudden onset
5 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)
Copyrights @ Plab1Keys.com
Plab1keys.com
Strict Copyrights!
Vascular
No Sharing or Copying
Allowed by any means
Compensations and
Penalties Worldwide
Version 5.2
System is Active
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 (6P features of Acute Limb Ischemia) →
1
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.
Copyrights @ Plab1Keys.com
,2 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
◙ In the presence of acute limb ischemia + Irregular pulse (likely due to
Arterial Fibrillation), the likely cause of this limb ischemia is → Embolus.
Key Painless, Pulsatile mass (swelling) → Aneurysm
2
e.g. painless pulsatile mass near the groin → Femoral artery aneurysm.
Key Renal cell carcinoma can cause
3
→ 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 Buerger’s disease [Thromboangiitis Obliterans]
4
Copyrights @ Plab1Keys.com
,3 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
◙ 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
Copyrights @ Plab1Keys.com
, 4 | P a g e [ V a s c u l a r ] © Copyright www.plab1keys.com (Constantly updated for online subscribers)
“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 A 66 YO smoker and hypertensive patient presents with a sudden onset
5 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)
Copyrights @ Plab1Keys.com
