12-12-2008, 02:10 AM
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nbme 4. answer this - vanco
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12-12-2008, 02:36 AM
Pt has superficial thromobophebitis-
T/t : Warm compress and pain meds
12-12-2008, 04:02 AM
showman, i agree with ur answer.
whats ur diagnosis? if u dont mind?
12-12-2008, 04:10 AM
Chronic Venous Insufficiency
Essentials of Diagnosis History of prior DVT or leg injury. Edema, stasis (brawny) skin pigmentation, subcutaneous liposclerosis in the lower leg. Large ulcerations at or above the ankle are common (stasis ulcers). Progressive edema of the leg (particularly the lower leg) is the usual initial symptom. Secondary changes in the skin and subcutaneous tissues develop. The usual symptoms are itching, a dull discomfort made worse by periods of standing, and pain if an ulceration is present. The skin at the ankle is usually thin, shiny, and a brownish pigmentation often develops. If the condition is long-standing, the subcutaneous tissues become thick and fibrous. Ulcerations may occur, usually just above the ankle, on the medial or anterior aspect of the leg (see photograph). Healing results in a thin scar on a fibrotic base that often breaks down with minor trauma or another bout of leg swelling. Varicosities frequently appear that are associated with incompetent perforating veins. Treatment Nonsurgical Measures Nonsurgical treatment is effective. Elastic graduated compression stockings (medium or heavy weight) give external support to the veins. These stockings may be useful in early varicosities to prevent progression of disease. When elastic stockings worn during standing are combined with elevation of the legs when possible, good control can be maintained and the development of complications can often be avoided. This approach may be used in elderly patients, in those who refuse or wish to defer surgery, and in those with mild asymptomatic varicosities.
12-12-2008, 04:12 AM
Varicose Veins
Essentials of Diagnosis Dilated, tortuous superficial veins in the lower extremities. May be asymptomatic or associated with aching discomfort or pain. Edema, pigmentation, and stasis ulcers of the skin may develop. Usually hereditary, with most patients reporting a family member with similar lesions. Increased frequency after pregnancy Clinical Findings Symptoms Symptom severity is not correlated with the number and size of the varicosities; extensive varicose veins may produce no subjective symptoms, whereas minimal varicosities may produce many symptoms. Dull, aching heaviness or a feeling of fatigue of the legs brought on by periods of standing is the most common complaint. Clinicians must be careful to identify symptoms of arteriosclerotic peripheral vascular disease, such as intermittent claudication and coldness of the feet, since occlusive arterial disease is usually a contraindication to the operative treatment of varicosities distal to the knee. Itching from a venous stasis dermatitis may occur either above the ankle or directly overlying large varicosities. Signs Dilated, tortuous veins beneath the skin in the thigh and leg are generally visible upon standing, although in very obese patients palpation may be necessary to detect their presence and location. Some swelling is common but secondary tissue changes may be absent even in extensive varicosities. However, if the varicosities are of long duration, brownish pigmentation and thinning of the skin above the ankle may be present. Treatment Nonsurgical Measures Nonsurgical treatment is effective. Elastic graduated compression stockings (medium or heavy weight) give external support to the veins. These stockings may be useful in early varicosities to prevent progression of disease. When elastic stockings worn during standing are combined with elevation of the legs when possible, good control can be maintained and the development of complications can often be avoided. This approach may be used in elderly patients, in those who refuse or wish to defer surgery, and in those with mild asymptomatic varicosities.
12-12-2008, 04:13 AM
superficial thrombophlebitis involvin only below knee veins
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