Arterial Disease of the Limbs

Question 1

what is peripheral arterial disease

Answer 1

it is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs, your extremities don’t receive enough blood flow to keep up with demand

Question 2

what is chronic limb ischaemia

Answer 2

it is peripheral arterial disease that results in symptomatic reduced blood supply to the limbs

Question 3

where does acute ischaemia occur

Answer 3

where there is a sudden lack of blood flow to a limb

it is inhibition of blood flow to/through the limb

Question 4

what causes acute ischaemia

Answer 4

embolism or thrombosis

also rarely caused by dissection or trauma

Question 5

describe diabetic foot disease

Answer 5

it is the foot affected by ulceration that is associated with neuropathy and/or peripheral arterial disease of the lower limb in a patient with diabetes

Question 6

at what vertebral level does the aorta split into the iliac arteries

Answer 6

T10

Question 7

what usually causes critical limb ischaemia

Answer 7

obstructive atherosclerotic disease

Question 8

what can critical limb ischaemia also be caused by apart from obstructive atherosclerotic disease

Answer 8

atheroembolic or thromboembolic disease,
vasculitis, 
in situ thrombosis related to hyper coagulable states,
thromboangitis obliterans, 
cystic adventitial disease,
popliteal entrapment,
trauma

Question 9

what does critical limb ischaemia refer to

Answer 9

a condition characterised by chronic ischaemic at-rest pain, ulcers, or gangrene in one or both legs attributable to objectively proven arterial occlusive disease

Question 10

what are the risk factors of critical limb ischaemia

Answer 10

male
age
smoking
hypercholesterolaemia
hypertension
diabetes

Question 11

state peripheral arterial disease symptoms

Answer 11

painful cramping in your hip, thigh or calf muscles after certain activities, such as walking or climbing stairs
claudication
leg numbness or weakness
coldness in your lower leg or foot, especially when compared with the other side
shiny skin
brittle toenails
hair loss on your legs and feet
the pulse in your leg being very weak or undetectable
leg ulcers

Question 12

symptoms associated with stage 1

Answer 12

asymptomatic

incomplete blood vessel obstruction

Question 13

symptoms associated with stage 2

Answer 13

mild claudication pain in limb

Question 14

symptoms associated with stage 2A

Answer 14

claudication when walking a distance of greater than 200m

Question 15

symptoms associated with stage 2B

Answer 15

claudication when walking a distance of less than 200m

Question 16

symptoms associated with stage 3

Answer 16

pain at rest, mostly in the feet

Question 17

symptoms associated with stage 4

Answer 17

necrosis and/or gangrene of the limb

Question 18

state 5 risk factors associated

Answer 18

over the age of 50
history of diabetes
history of smoking
obesity
high blood pressure

Question 19

state 3 signs of chronic ischaemia on examination

Answer 19

ulceration
pallor
hair loss

Question 20

state 3 signs of chronic ischaemia when feeling

Answer 20

capillary refill times
temperature
pulses
peripheral sensatin

Question 21

state the 2 special tests practiced on examination of peripheral arterial disease

Answer 21

the ankle brachial pressure index test and the Buerger’s test

Question 22

describe the ankle brachial pressure index test

Answer 22

it is a test widely used to diagnose peripheral arterial disease, as well as assess how well you are responding to treatment

your blood pressure is measured in your upper arms and your ankles when your are lying down

measurements are taken with a Doppler probe

Question 23

describe Buerger’s test

Answer 23

it is a noninvasive bedside test used to assess the adequacy of the arterial supply of the leg and is performed in 2 stages

the patient lies flat on his back with both legs elevated to an angle of 45 degrees

Question 24

is there a cure for peripheral arterial disease

Answer 24

no, lifestyle changes and medication can help reduce the symptoms