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M3 > Cardio - Periheral Vascular Disease > Flashcards

Cardio - Periheral Vascular Disease Flashcards

1
Q

Venous Disorder characterized by clot formation and acute inflammation in a superficial vein

A

Superficial thrombophlebitis

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2
Q

Venous Disorder characterized by clot formation in a deep vein

A

Deep Venous thrombosis

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3
Q

Chronic venous engorgement secondary to venous occulsion or incompetency of venous valves

A

Chronic Venous Insufficiency

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4
Q

Inflammatory and thrombotic occlusions of small arteries and also of veins occuring in smokers

A

Thromboangitis obliterans

a.k.a Buerger’s Disease

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5
Q

Common vascular cuases of edema (give 3)

A
  1. Recent DVT
  2. Chronic Venous Insufficiency from previous DVT or incompetence of the venous valves
  3. Lymphedema
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6
Q

In DVT, edema in the entire leg is caused by occlusion of which vein/s?

A

iliofemoral veins

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7
Q

in DVT, swelling of the ankle is a manifestation of occlusion of which vein?

A

Popliteal vein

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8
Q

Edema is soft, with pitting on pressure, occassionally bilateral with brawny changes and skin thickening, especially near the ulceration, ankle. Ulceration, brownish pigmentation, and edema in the feet are common.

A. DVT
B. Chronic Venous Insuffieciency
C. Lymphedema

A

B

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9
Q

Soft edemain early stages and becomes indurated, hard and non-pitting. Skin is markedly thickened; ulceration is rare. There is no pigmentation. Edema is found in the feet and toes, often bilateral. Develops when lymph channels are obstructed by tumor, fibrosis, or inflammation.

A. DVT
B. Chronic Venous Insuffieciency
C. Lymphedema

A

C

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10
Q

Causes of pitting edema (give 5)

A 
CHILD
Cardiac Failure
Hypoalbuminemia
Insufficiency (venous)
Idiopathic
Liver disease
Drugs
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11
Q

In the Allen test, both radial and ulnar artery at the wrist are occluded causing the palm to be _____

A

pale

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12
Q

If you want to test the patency of the ulnar artery, how should you perform the Allen test?

A

Ask the patient to make a fist, occlude both radial and ulnar arteries, ask the patient to open fist, palm should be pale. Then, release ulnar artery, palm should be flushed.

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13
Q

Intermittnet claudication, decreased or absent pulses, esp. on elevation. Dusky red on dependency, cool temp, ulcers involving toes or points of trauma on feet.

A

Chronic Arterial Insufficiency

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14
Q

Episodic muscular ischemia induced by exercise due to atherosclerosis of large or medium-sized arteries

A

Intermittent claudication

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15
Q

Rest pain

A

Ischemia even at rest

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16
Q

Embolism, or thrombosis possibly superimposed on arteriosclerosis oliterans

A

Acute Arterial Occlusion

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17
Q

Episodic spasm of the small arteries and arterioles; no vascular occlusion

A

Raynaud’s disease

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18
Q

Syndrome secondary to other conditions such as collagen vascular disease, arterial occlusion, trauma, drugs

A

Raynaud’s phenomenon

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19
Q

Inflammatory occlusive vascular disorder involving small and medium-size arteries and veins in the distal upper and lower extremities

A

Buerger’s Disease

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20
Q

Develops most frequently in _____, less than _____ y.o.

a. Male, 50
b. Female, 40
c. Male 40
d. Female 50

A

C

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21
Q

Buerger’s disease is associated with

a. Smoking
b. Alcohol
c. Obesity
d. Diabetes

A

A

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22
Q

Inflammatory and stenotic disease of medium and large-sized arteries with a strong predilection for the aortic arch and its branches

A

Takayasu’s arteritis

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23
Q

Takayasu’s arteritis is most prevalent in male or female?

A

Female, adolescent girls and young women.

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24
Q

Most frequent arterial involvement in Takayasu arteritis is:

a. Subclavian
b. Brachial
c. Axillary
d. Coronary

A

A

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25
Inflammation of medium and large-sized arteries most exclusively occur in >50 y.o. characerized by fever, headache, anemia, increased ESR
Giant Cell Arteritis a.k.a Temporal Artery arteritis
26
Giant cell arteritis is associated with ________
Polymyalgia rheumatica
27
Dramatic clinical response of giant cell arteritis to
prednisone
28
Diagnosis of giant cell arteritis is based on
biopsy of the temporal artery
29
3 layers of the arteries
Tunica Intima Tunica Media Tunica Adventitia
30
single continuous lining of endothelila cells that synthesize regulators of thrombosis as well as prothrombotic molecules, and modulate blood flow and vascular reactivity and immune and inflammatory reactions
Arteria intima
31
Composed of smooth muscles that dilate and constrict to accommodate blood pressure and flow. IWith internal and external elastic laminae. Vasa Vasorum perfuse it.
Tunica Media
32
Outermost layer of the artery that contain nerve fibers and vasa vasorum
Tunica adventitia
33
Order of atherosclerosis Timeline ``` A. Foam Cells B. Intermediate lesion C. Atheroma D. Fatty streak E. Complicated lesion rupture F. Fibrous plaque ```
A-D-B-C-E-F
34
Diameter of small arteries
<2mm
35
Diameter of arterioles
20-100micrometers
36
Diameter of capillaries
7-8 microns in diameter, have endothelial lining but no media
37
Coronary and renal arteries are examples of a. Large b. Medium c. Small Arteries
B
38
_______ is due to elastic recoil and smooth muscle contraction and relaxation in the media of large and medium sized arteries
Arterial pulsatile flow
39
Resistance to blood flow occurs primarily in the _____
Arterioles
40
Difference between deep veins and superficial veins
Carry more of the venous return (90%) from the lower ex. Well supported by surrounding tissues unlike superficial veins that have poor tissue support
41
The saphenous veins are examples of A. Superficial veins B. Deep veins
A
42
________ connect the two saphenous veins that are readily visible when dialted
Anastomotic veins
43
______ connect the superficial system with the deep system
Bridging or perforating veins
44
The horizontal group of superficial inguinal nodes drain the ff except a. Suerficial portions of lower abdomen b. Buttock. c. Testes d. Anal canal
C
45
The vertical group superficial inguinal nodes cluster near the upper part of the _________ and drains a corresponding region of the leg
Saphenous vein
46
Stenotic, occlusive, and aneurysmal disease of the aorta and its visceral and arterial branches and the arteries of the lower ex exclusive of the coronary arteries
Peripheral Arterial Disease
47
The ff are involved in peripheral arterial disease EXCEPT a. brachial artery b. radial artery c. Femoral artery d. Coronary artery
D
48
Risk factors for lower-extremity peripheral artery disease 1. Age younger than ____ with diabetes, or athersclerosis risk factor of _____, _____, _____, _____
50 yrs smoking dyslypidemia hypertension hyperhomocysteinemia
49
Risk factors for lower-extremity peripheral artery disease | Age ____ to ____ and history of smoking or diabetes.
50 to 69
50
Risk factors for lower-extremity peripheral artery disease age ____ yrs or older
70
51
Risk factors for lower-extremity peripheral artery disease Leg symptoms with ________
exertion or ischemic rest pain
52
Risk factors for lower-extremity peripheral artery disease Known atherosclerotic _______, _______, or _______artery disease
coronary, carotid or renal
53
Symptom location suggests the site of arterial ischemia: buttock, hip: ________
arotoiliac
54
Symptom location suggests the site of arterial ischemia: rectile dysfunction: ______
iliac pudendal
55
Symptom location suggests the site of arterial ischemia: thigh: ______
common femoral or aortoiliac
56
Symptom location suggests the site of arterial ischemia: upper calf: _______
superficial femoral
57
Symptom location suggests the site of arterial ischemia: lower calf: ______
popliteal
58
Symptom location suggests the site of arterial ischemia: foot: _______
tibial or peroneal
59
PAD warning signs (5)
A. fatigue, aching, numbness, or pain that limits walking or exertion in the legs; B. Any poorly healing or non-healing wounds of the legs or feet C. Any pain present when at rest in the lower leg or foot and changes when standing or supine. D. Abdominal pain after meals and associated food fear and weight loss E. any first degree relatives with an abdominal aortic aneurysm
60
Treatment of PAD (5)
``` Risk factor modification antiplatelets ACE inhibitors Beta Blocker Statins ```
61
_____ increases claudication distance by 40-60%
Cilostazol
62
______ increase blood flow to the microcirculation and enhances tissue oxygenation
Pentoxifylline
63
Normal ABI value
> 0.90
64
Mild PAD ABI value
0.60 to 0.89
65
Moderate PAD ABI value
0.40 to 0.59
66
Severe PAD ABI value
< 0.40
67
Atherosclerotic renal artery disease affects what percent of edults older than 65 years?
7%
68
___% to ___% of those with atherosclerotic renal artery disease have PAD
22-55%
69
How much of these with PAD have documented CAD?
30%
70
Angiographic appearance of Fibromuscular Dysplasia
"string of beads"
71
The following should be screened for renal artery disease EXCEPT a. Hypertension before the age 40 b. severe hypertension after age 60 c. Accelerated, resistant or malignant hypertension d. New worsening of renal function or worsening after use of ACEI e. A and B
E a. Below 30 b. Below 55
72
Screening for renal artery disease recommended in the following a. Unexplained small kidney b. Sudden unexplained pulmonary edema c. Hypertension before age 30 d. Severe hypertension after age 55 e. AOTA
E
73
Infrarenal Aortic diameter in AAA
3.0CM
74
Rupture and mortality rates dramatically increase for AAAs exceeding ___ cm in diameter
5.5 cm
75
It is recommended to do a one time screening by utz in men between ___ and ___ years with a history of "ever smoking"
65 and 75
76
"ever smoking" is defined as
100 cigarettes in a lifetime
77
Abdominal pain, food fear, and weight loss suggest intestinal ischemia of the celiac or superior or inferior mesenteric arteries
Mesenteric Ischemia
78
2 conditions with asymmetric BP
Coarctation of the aorta | Dissecting aortic aneurysm
79
_______ of the amr and hand may follow axillary node dissection and radiation therapy
Lymphedema
80
Sensitivity of aortic palpation in detecting AAA >4cm is
60%
81
Grading of pulses | Bounding
3+
82
Grading of pulses | Brisk, expected
2+
83
Grading of pulses | Diminished, weaker than expected
1+
84
Grading of pulses | Absent, unable to palpate
0
85
Location of dorsalis pedis pulse
lateral to extensor tendon of great toe
86
Location of posterior tibial pulse
Behind and slightly below the medial malleolus of the ankle
87
sudden arterial occlusion from embolism or thrombosis causes pain and numbness or tingling. Limb distal to the occlusion becomes cold, pale and pulseless
Acute arterial occlusion
88
Stages of limb ischemia: | Limb viable, not immediately threatened
I
89
Stages of limb ischemia: | Marginally threatened, salvageable if immediately threatened
IIa
90
Stages of limb ischemia: | Limb Threatened
II
91
Stages of limb ischemia: | Salvageable with immediate revascularization
IIb
92
Stages of limb ischemia: | Permanent nerve damage inevitable
III
93
``` Stages of limb ischemia Stage I Sensory Loss: Muscle Weakness: Arterial: Venous: ```
Sensory Loss: None Muscle Weakness: None Arterial: Audible Venous: Audible
94
``` Stages of limb ischemia Stage IIa Sensory Loss: Muscle Weakness: Arterial: Venous: ```
Sensory Loss: Minimal (toes) Muscle Weakness: None Arterial: often inaudible Venous: Audible
95
``` Stages of limb ischemia Stage IIb Sensory Loss: Muscle Weakness: Arterial: Venous: ```
Sensory Loss: More than toes, associated Muscle Weakness: mild or moderate Arterial: usually iaudible Venous: Audible
96
``` Stages of limb ischemia Stage III Sensory Loss: Muscle Weakness: Arterial: Venous: ```
Sensory Loss: Profound, anesthetic Muscle Weakness: Profound, paralysis Arterial: Inaudible Venous: Inaudible

M3 (66 decks)

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