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Vascular Surgery for Final Medical
Vascular Surgery UnitVascular Surgery Unit
AMNCHAMNCH
www.perfuse.net
Introduction
Scope
Occlusive Vascular
disease
Aortic aneurysm
Carotid disease
Varicose veins
Occlusive venous
disease
Lymphoedema
Visceral arterial
occlusion
Peripheral
aneurysms
Arterial Trauma
Diabetic Foot
Hyperhidrosis
Venous access
Topics
Occlusive Vascular
disease
Aortic aneurysm
Carotid disease
Varicose veins
Occlusive venous
disease
Lymphoedema
Visceral arterial
occlusion
Peripheral
aneurysms
Arterial Trauma
Diabetic Foot
Hyperhidrosis
Venous access
Lecture topics
• Introduction
– History
– Physical examination
– Differential diagnosis
– Presentation
• Leg Ulcers
– clinical description
– clinical reasoning
– differential diagnosis
– Bayesian approach to
diagnosis
• Peripheral arterial occlusive
disease
– systemic disease
– differing end organ
manifestation
– holistic approach to therapy
– Indications for surgery
• Aortic aneurysms
– preparing patients for
complex surgery
– clinical decision making
Lecture topics
• Carotid disease
– evidence based medicine
– randomised trials in surgery
– choosing therapy
• Varicose veins
– relationship between
symptoms & conditions
– Risk/benefits in surgery
– Informed consent
• Diabetic foot
– systemic disease
– Warning signs
– Interventions
– Preventing amputations
Perfuse.net
Perfuse.net
Elements
• Theoretical knowledge
– anatomy
– physiology
– pathology
– pharmacology
– medicine
– surgery etc.
Normal & disease
Clinical skills
• History
• Physical examination
• Diagnosis
• Investigation
• Treatment
Patients present with symptoms and signs
rather than disease
Patients present with symptoms and signs
rather than disease
History
• Presenting problem
• Context
– personal
• age
• sex
• occupation
– social
• domestic
arrangements
• lifestyle
– medical
• chronic
illness
• medications
• previous
surgery
Process of communicationProcess of communication
History - II
• Obtain information from the patient
– listen
– identify precise symptoms
– avoid leading questions initially
– ask questions to fill in the gaps
• Collateral history
– trauma, confused, paediatric etc
All the information that cannot be
obtained by examining the patient
All the information that cannot be
obtained by examining the patient
Art of History Taking
Translate
Common language
• Standard formula
• Common among clinicians
• Precise terminology vs
– “haemorrhoids”
– “can’t breathe”
– “trouble passing water”
Physical examination
Differential diagnosis
• Consider all the possibilities
• Weight them
Diagnosis
• Test the hypothesis
• Re prioritise
Diagnosis
• Treat
• Evaluate response
Vascular Surgery Guide for Medical Students

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Vascular Surgery Guide for Medical Students

  • 1. Vascular Surgery for Final Medical Vascular Surgery UnitVascular Surgery Unit AMNCHAMNCH www.perfuse.net Introduction
  • 2. Scope Occlusive Vascular disease Aortic aneurysm Carotid disease Varicose veins Occlusive venous disease Lymphoedema Visceral arterial occlusion Peripheral aneurysms Arterial Trauma Diabetic Foot Hyperhidrosis Venous access
  • 3. Topics Occlusive Vascular disease Aortic aneurysm Carotid disease Varicose veins Occlusive venous disease Lymphoedema Visceral arterial occlusion Peripheral aneurysms Arterial Trauma Diabetic Foot Hyperhidrosis Venous access
  • 4. Lecture topics • Introduction – History – Physical examination – Differential diagnosis – Presentation • Leg Ulcers – clinical description – clinical reasoning – differential diagnosis – Bayesian approach to diagnosis • Peripheral arterial occlusive disease – systemic disease – differing end organ manifestation – holistic approach to therapy – Indications for surgery • Aortic aneurysms – preparing patients for complex surgery – clinical decision making
  • 5. Lecture topics • Carotid disease – evidence based medicine – randomised trials in surgery – choosing therapy • Varicose veins – relationship between symptoms & conditions – Risk/benefits in surgery – Informed consent • Diabetic foot – systemic disease – Warning signs – Interventions – Preventing amputations
  • 8. Elements • Theoretical knowledge – anatomy – physiology – pathology – pharmacology – medicine – surgery etc. Normal & disease
  • 9. Clinical skills • History • Physical examination • Diagnosis • Investigation • Treatment Patients present with symptoms and signs rather than disease Patients present with symptoms and signs rather than disease
  • 10. History • Presenting problem • Context – personal • age • sex • occupation – social • domestic arrangements • lifestyle – medical • chronic illness • medications • previous surgery Process of communicationProcess of communication
  • 11. History - II • Obtain information from the patient – listen – identify precise symptoms – avoid leading questions initially – ask questions to fill in the gaps • Collateral history – trauma, confused, paediatric etc All the information that cannot be obtained by examining the patient All the information that cannot be obtained by examining the patient
  • 12. Art of History Taking Translate
  • 13. Common language • Standard formula • Common among clinicians • Precise terminology vs – “haemorrhoids” – “can’t breathe” – “trouble passing water”
  • 15. Differential diagnosis • Consider all the possibilities • Weight them Diagnosis • Test the hypothesis • Re prioritise Diagnosis • Treat • Evaluate response