275 PAOD Flashcards
Vasculitic disorder associated with exposure to cold. Raised erythematous lesions develop on the lower part of legs and feet in cold weather
Pernio
Effective treatment of pernio
Sympatholytic drugs and dihydropyridine calcium channel antagonist
Raynauds phenomenon occurs in how many percent in systemic sclerosis
Raynauds phenomenon occurs 80-90% of patient with systemic sclerosis and presenting symptom in 30%
Leading cause of PAOD in patients more than 40 years
Atherosclerosis
High prevalence of atherosclerotic PAOD occurs in what age
6th and 7th decade of life
Most common symptom of PAOD
Intermittent claudication
Important physical findings of PAD
Decreased or absent pulses distal to obstruction
Presence of bruit over narrowed artery
Muscle atrophy
Normal ankle:brachial index
1.0-1.4
Borderline ABI
0.91- 0.99
Phosphodiesterase inhibitor with vasodilator and antiplatelet properties increases claudication by 40-60%
Cilostazol
Substituted xanthind derivative that increases blood flow to the microcirculation and enhances tissue oxygenation
Pentoxifylline
Hyperpladtic disorder that affects medium-sized and small arteries especially the renal and carotid arteries;; occurring predominantly in females
Finbromuscluar dyplasia
Histologic classification of finbromuscluar dysplasia. Which is the most common type
Intimak fibroplasia
Medial dysplasia– most common type
Adventitial hyperplasia
Inflammatory occlusive vascular disorder involving small and medium sized arteries and veins in distal upper and lower extremities associated with cigarette smoking
Thromboangitis obliterans
Occurs when arterial occlusion results in sudden cessation of blood flow to an extremity
Acute limb ischemia
Principal causes of acute arterial occlusion
Embolism, thrombus in situ, arterial dissection, trauma
Most common causes of arterial emboli
Heart
Aorta
Large arteries
Instances of paradoxical embolus. Arterial Occlusion from A venous thrombus
Via patent foramen ovale or septal defect
Treatment of acute limb ischemia of less than 2 weeks esp when surgery is contraindicated or there is poor access
Intra arterial thrombolytic therapy with reteplase, tenecteplase
Treatment of acute limb ischemia when it’s more than 2 weeks
Percutaneous mechanical thrombectomy
Complex symptom resulting from compression of neurovascula bundle at neck and shoulder area
Throacic outlet compression syndrome
Venous compression causing thrombosis of subclavian and axillary veins associated with effort
Paget- schroetter syndrome
Occurs when gastrocnemius or popliteal muscle compressed popliteal artery causing claudication and triggered by ankle dorsiflexion and plantar flexion
Popliteal artery entrapment
Most common peripheral artery aneurysm
Popliteal artery aneurysm
Common clinical presentation of popliteal artery aneurysm and when is surgical repair indicated
Most common clinical manifestation is limb ischemia
Repair is indicted when diameter exceeds 2-3 cm
Compression of large arteriovenous fistula causes reflex slowing of the heart rate
Nicoladoni- Branham sign
Rare case of arteriovenous fistula
Rupture of arterial aneurysm into vein
Characterized by episodic digital ischemia manifested by sequential development of digital blanching, cyanosis and rubor of finger or toes after cold exposure
Raynauds phenomenon
Drugs implicated in raynauds phenomenon
Ergot preparations
Methysergide
Beta adrenergic receptor antagonist
Chemotherapeutic agents: bleomycin, vinblastine, cisplatin, gemcitabine
Condition characterized by arterial vasoconstriction and secondary dilatation of capillaries and venues in hand and less frequently the feet. How is it different from Raynauds phenomenon?
Acrocyanosis. It’s persistent and no blanching compared to episodic in Raynauds
