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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
Q

Inflammation of medium and large-sized arteries most exclusively occur in >50 y.o. characerized by fever, headache, anemia, increased ESR

A

Giant Cell Arteritis a.k.a Temporal Artery arteritis

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26
Q

Giant cell arteritis is associated with ________

A

Polymyalgia rheumatica

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27
Q

Dramatic clinical response of giant cell arteritis to

A

prednisone

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28
Q

Diagnosis of giant cell arteritis is based on

A

biopsy of the temporal artery

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29
Q

3 layers of the arteries

A

Tunica Intima
Tunica Media
Tunica Adventitia

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30
Q

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

A

Arteria intima

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31
Q

Composed of smooth muscles that dilate and constrict to accommodate blood pressure and flow. IWith internal and external elastic laminae. Vasa Vasorum perfuse it.

A

Tunica Media

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32
Q

Outermost layer of the artery that contain nerve fibers and vasa vasorum

A

Tunica adventitia

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33
Q

Order of atherosclerosis Timeline

A. Foam Cells
B. Intermediate lesion
C. Atheroma
D. Fatty streak
E. Complicated lesion rupture
F. Fibrous plaque
A

A-D-B-C-E-F

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34
Q

Diameter of small arteries

A

<2mm

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35
Q

Diameter of arterioles

A

20-100micrometers

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36
Q

Diameter of capillaries

A

7-8 microns in diameter, have endothelial lining but no media

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37
Q

Coronary and renal arteries are examples of

a. Large
b. Medium
c. Small

Arteries

A

B

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38
Q

_______ is due to elastic recoil and smooth muscle contraction and relaxation in the media of large and medium sized arteries

A

Arterial pulsatile flow

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39
Q

Resistance to blood flow occurs primarily in the _____

A

Arterioles

40
Q

Difference between deep veins and superficial veins

A

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
Q

The saphenous veins are examples of
A. Superficial veins
B. Deep veins

A

A

42
Q

________ connect the two saphenous veins that are readily visible when dialted

A

Anastomotic veins

43
Q

______ connect the superficial system with the deep system

A

Bridging or perforating veins

44
Q

The horizontal group of superficial inguinal nodes drain the ff except

a. Suerficial portions of lower abdomen
b. Buttock.
c. Testes
d. Anal canal

A

C

45
Q

The vertical group superficial inguinal nodes cluster near the upper part of the _________ and drains a corresponding region of the leg

A

Saphenous vein

46
Q

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

A

Peripheral Arterial Disease

47
Q

The ff are involved in peripheral arterial disease EXCEPT

a. brachial artery
b. radial artery
c. Femoral artery
d. Coronary artery

A

D

48
Q

Risk factors for lower-extremity peripheral artery disease

  1. Age younger than ____ with diabetes, or athersclerosis risk factor of _____, _____, _____, _____
A

50 yrs

smoking
dyslypidemia
hypertension
hyperhomocysteinemia

49
Q

Risk factors for lower-extremity peripheral artery disease

Age ____ to ____ and history of smoking or diabetes.

A

50 to 69

50
Q

Risk factors for lower-extremity peripheral artery disease

age ____ yrs or older

A

70

51
Q

Risk factors for lower-extremity peripheral artery disease

Leg symptoms with ________

A

exertion or ischemic rest pain

52
Q

Risk factors for lower-extremity peripheral artery disease

Known atherosclerotic _______, _______, or _______artery disease

A

coronary, carotid or renal

53
Q

Symptom location suggests the site of arterial ischemia:

buttock, hip: ________

A

arotoiliac

54
Q

Symptom location suggests the site of arterial ischemia:

rectile dysfunction: ______

A

iliac pudendal

55
Q

Symptom location suggests the site of arterial ischemia:

thigh: ______

A

common femoral or aortoiliac

56
Q

Symptom location suggests the site of arterial ischemia:

upper calf: _______

A

superficial femoral

57
Q

Symptom location suggests the site of arterial ischemia:

lower calf: ______

A

popliteal

58
Q

Symptom location suggests the site of arterial ischemia:

foot: _______

A

tibial or peroneal

59
Q

PAD warning signs (5)

A

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
Q

Treatment of PAD (5)

A 
Risk factor modification
antiplatelets
ACE inhibitors
Beta Blocker
Statins
61
Q

_____ increases claudication distance by 40-60%

A

Cilostazol

62
Q

______ increase blood flow to the microcirculation and enhances tissue oxygenation

A

Pentoxifylline

63
Q

Normal ABI value

A

> 0.90

64
Q

Mild PAD ABI value

A

0.60 to 0.89

65
Q

Moderate PAD ABI value

A

0.40 to 0.59

66
Q

Severe PAD ABI value

A

< 0.40

67
Q

Atherosclerotic renal artery disease

affects what percent of edults older than 65 years?

A

7%

68
Q

___% to ___% of those with atherosclerotic renal artery disease have PAD

A

22-55%

69
Q

How much of these with PAD have documented CAD?

A

30%

70
Q

Angiographic appearance of Fibromuscular Dysplasia

A

“string of beads”

71
Q

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

A

E

a. Below 30
b. Below 55

72
Q

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

A

E

73
Q

Infrarenal Aortic diameter in AAA

A

3.0CM

74
Q

Rupture and mortality rates dramatically increase for AAAs exceeding ___ cm in diameter

A

5.5 cm

75
Q

It is recommended to do a one time screening by utz in men between ___ and ___ years with a history of “ever smoking”

A

65 and 75

76
Q

“ever smoking” is defined as

A

100 cigarettes in a lifetime

77
Q

Abdominal pain, food fear, and weight loss suggest intestinal ischemia of the celiac or superior or inferior mesenteric arteries

A

Mesenteric Ischemia

78
Q

2 conditions with asymmetric BP

A

Coarctation of the aorta

Dissecting aortic aneurysm

79
Q

_______ of the amr and hand may follow axillary node dissection and radiation therapy

A

Lymphedema

80
Q

Sensitivity of aortic palpation in detecting AAA >4cm is

A

60%

81
Q

Grading of pulses

Bounding

A

3+

82
Q

Grading of pulses

Brisk, expected

A

2+

83
Q

Grading of pulses

Diminished, weaker than expected

A

1+

84
Q

Grading of pulses

Absent, unable to palpate

A

0

85
Q

Location of dorsalis pedis pulse

A

lateral to extensor tendon of great toe

86
Q

Location of posterior tibial pulse

A

Behind and slightly below the medial malleolus of the ankle

87
Q

sudden arterial occlusion from embolism or thrombosis causes pain and numbness or tingling.

Limb distal to the occlusion becomes cold, pale and pulseless

A

Acute arterial occlusion

88
Q

Stages of limb ischemia:

Limb viable, not immediately threatened

A

I

89
Q

Stages of limb ischemia:

Marginally threatened, salvageable if immediately threatened

A

IIa

90
Q

Stages of limb ischemia:

Limb Threatened

A

II

91
Q

Stages of limb ischemia:

Salvageable with immediate revascularization

A

IIb

92
Q

Stages of limb ischemia:

Permanent nerve damage inevitable

A

III

93
Q 
Stages of limb ischemia Stage I
Sensory Loss:
Muscle Weakness:
Arterial:
Venous:
A

Sensory Loss: None
Muscle Weakness: None
Arterial: Audible
Venous: Audible

94
Q 
Stages of limb ischemia Stage IIa
Sensory Loss:
Muscle Weakness:
Arterial:
Venous:
A

Sensory Loss: Minimal (toes)
Muscle Weakness: None
Arterial: often inaudible
Venous: Audible

95
Q 
Stages of limb ischemia Stage IIb
Sensory Loss:
Muscle Weakness:
Arterial:
Venous:
A

Sensory Loss: More than toes, associated
Muscle Weakness: mild or moderate
Arterial: usually iaudible
Venous: Audible

96
Q 
Stages of limb ischemia Stage III
Sensory Loss: 
Muscle Weakness:
Arterial:
Venous:
A

Sensory Loss: Profound, anesthetic
Muscle Weakness: Profound, paralysis
Arterial: Inaudible
Venous: Inaudible

M3 (66 decks)

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