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Adult/Gero I > Aneurysms and Vascular Disease > Flashcards

Aneurysms and Vascular Disease Flashcards

1
Q

What is PAD?

A

Thickening of the arteriole wall, causing narrowing/stenosis to the artery

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2
Q

What does PAD lead to?

A

Decreased perfusion of blood to the extremities

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3
Q

What is the leading cause of PAD?

A

Atherosclerosis

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4
Q

What are risk factors for PAD?

A 
Tobacco use
DM
Hyperlipidemia
Uncontrolled HTN
Obesity
Sedentary lifestyle
Stress
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5
Q

How does tobacco contribute to PAD?

A

Nicotine is a potent vasoconstrictor
Impairs transport and cellular use of O2
Increases blood viscosities

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6
Q

What is a clinical manifestation of PAD?

A 
Intermittent claudication (during exercise)
- Cramping from decreased blood flow and muscles not receiving enough O2 -> anaerobic metabolism
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7
Q

What are some complications from PAD?

A

Amputation

Ulcers from decreased circulation

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8
Q

How is PAD diagnosed?

A

Doppler studies
Ankle-brachial indexes
Angiography
MRI testing

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9
Q

How is PAD treated?

A 
Smoking cessation
Exercise
Maintaining an ideal body weight
Reviewing diet
Addressing BP issues
Drug therapy - oral antiplatelet (Aspirin or Plavix)
Surgery (bypass grafting)
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10
Q

What is venous thrombus disease?

A

Formation of clots in the venous system

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11
Q

What are the classifications of venous thrombus disease?

A

Superficial vein thrombosis
DVT
Venous thromboembolim

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12
Q

What is superficial vein thrombosis?

A

Formation of a thrombus in the superficial vein

Usually greater or lesser saphenous veins

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13
Q

What is DVT?

A

Thrombus in a deep vein

Usually in iliac or femoral vein

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14
Q

What is Virchow’s triad?

A

Three main contributing factors to the development of venous thromboembolism
Venous stasis
Damage of endothelium
Hypercoagulability of the blood

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15
Q

How does a patient with a venous clot present?

A

Lower extremity VTE may or may not have edema
May complain of tenderness on palpation
May have dilated superficial veins
May complain of a sense of fullness
Skin may be warm, reddened, or may have a temp >104

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16
Q

What diagnostic testing can be used for venous disease?

A 
Duplex study
Ultrasound
Blood studies
PTT, INR, bleeding time, HgB, HCt, platelet count
CT scan venography
MRI
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17
Q

What drugs can be used for VTE?

A

Warfarin/Coumadin to avoid further clotting
Heparin to prevent further clotting
Low molecular weight heparin (Lovonox)
Acava and Prodaxa

18
Q

PAD vs venous disease pulses:

A

PAD pulses: weak

venous disease pulses: bounding

19
Q

PAD vs venous disease cap refill:

A

PAD cap refill: >3 seconds

venous disease cap refill: <3 second

20
Q

PAD vs venous disease edema:

A

PAD: usually no edema

venous disease edema: common in lower legs

21
Q

PAD vs venous disease hair:

A

PAD: can be loss of hair

venous disease: can be loss of hair

22
Q

PAD vs venous disease pain:

A

PAD: intermittent claudication

venous disease: may complain of dull, achy pain, or heaviness

23
Q

PAD vs venous disease nails:

A

PAD: thickened, brittle nails

venous disease: normal or slightly thickened nails

24
Q

PAD vs venous disease skin:

A

PAD: cool skin that will get cooler toward distal extremity

venous disease: thick, hardened, indurated (raised) skin

25
Q

PAD vs venous disease pruritis:

A

PAD: no pruritis

venous disease: complains of pruritis

26
Q

PAD vs venous disease skin color:

A

PAD: feet can be red in color if in dependent position; elevated feet will appear pale
venous disease: feet can be red to brown/bronze from pooling of blood

27
Q

PAD vs venous disease optimal positioning:

A

PAD: dependent extremity to aid flow of blood from heart to extremity
venous disease: feet elevated above heart to assist gravity in moving blood towards heart

28
Q

What is an aneurysm?

A

A permanent, localized dilation/outpouching of a blood vessel wall

29
Q

Which gender are aneurysms more common in?

A

Men

30
Q

How are aneurysms classified?

A

True

False

31
Q

What is a true aneurysm and what are the 2 subclassifications?

A

The wall of the artery forms an aneurysm with at least one vessel layer still in tact
Fusiform aneurysm: circumferential and uniform in shape - circle entire aorta
Saccular aneurysm: pouch-like, with narrow neck connecting bulge of one side of the arterial wall

32
Q

What is a false aneurysm?

A

Disruption of the arterial wall layer with bleeding contained by surrounding anatomic structures

33
Q

What type of aneurysm is the most common site for dissection?

A

Thoracic aneurysms

34
Q

What is a dissection?

A

Different layers of the artery separating or tearing from each other

35
Q

What are signs of aneurysms?

A

Pain - can radiate to scapular area

Dypsnea, cough, hoarseness, dysphagia

36
Q

Why can people with abdominal aortic aneurysms “feel their heart beating”?

A

Due to an outpouching of the wall

37
Q

What is a hallmark complaint of an AAA?

A

Lower back pain

38
Q

What issues can an AAA lead to?

A

Dissection of the aorta

Rupture

39
Q

What is an aortic rupture?

A

Hole is created within the aorta - blood is released into the cavity and pt is at high risk for exsanguination

40
Q

How can you diagnose an AAA?

A

Ultrasound
Xray
MRI
Angiography

41
Q

How do you decide between a medical and surgical treatment for an AAA?

A

Size
Small aneurysms will be followed with frequently ultrasounds
Large or growing aneurysms will receive grafting

Adult/Gero I (3 decks)

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