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Cardio > Cardiovascular Conditions > Flashcards

Cardiovascular Conditions Flashcards

1
Q

A pattern of consistently elevated diastolic pressure, systolic pressure, or both

A

Hypertension

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2
Q

Causes of arterial insufficiency

A

Atherosclerosis
Vasculitis

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3
Q

Prevalence for peripheral vascular diseases

A

M > F

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4
Q

Risk factors for PVD

A

DM
Hypertension
AbN platelet activation
Smoking
Hyperlipidemia
Old age
Metabolic dse

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5
Q

Precipitation of Immunoglobulins when exposed to cold temperatures

A

Cryoglobulinemia

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6
Q

An acute necrotizing vasculitis that affects primarily medium-sized and small arteries

A

Polyarteritis

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7
Q

Thickening, hardening, and losing elasticity of the arterial walls

A

Arteriosclerosis

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8
Q

Plaque formation

A

Atherosclerosis

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9
Q

Common manifestations of pts c Atherosclerosis Obliterans

A

Intermittent claudication
Resting pain
Tropic changes

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10
Q

Arteries affected by ASO

A

Medium to Large arteries

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11
Q

Extremity affected by ASO

A

LE > UE

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12
Q

inflammation leads to arterial occlusion and
tissue ischemia

A

Thromboangitis Obliterans

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13
Q

Risk factors for TAO

A

Young male
Smoking

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14
Q

Arteries affected by TAO

A

small to medium arteries

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15
Q

Extremity affected by TAO

A

UE > LE

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16
Q

a vasomotor disease of small arteries and arterioles

A

Raynaud’s disease

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17
Q

Raynaud’s dse is commonly characterized by

A

Pallor of fingers
Cyanosis of fingers

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18
Q

Triggers of Raynaud’s dse

A

Emotional upset
Cold

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19
Q

a peripheral sign of a long-standing disease process

A

Ulceration

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20
Q

Incidence of ulcers caused by arterial insufficiency

A

10% - 25%

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21
Q

Common manifestations of PVDs

A

U/L or bilat LBP
Hip, Groin, or leg pain
Intermittent claudication
Trophic changes (ulcerations, rubor, gangrene)

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21
Q

Skin temperature of pts c arterial insufficiency upon palpation

A

Cool

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22
Q

Common site of ulcerations or wounds for pts c arterial insufficiency

A

Lateral malleoli
Toes
1/3 lower leg
Dorsum of feet

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23
Q

Clinical s/sx of arterial insufficiency that is common in pts c diabetic atherosclerosis

A

Changes in vision
Fatigue upon exertion

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24
Q

1st sign of vascular occlusive dse

A

Loss of hair in toes

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25
Q

Skin characteristics of pts c arterial insufficiency

A

dry
scaly
shiny

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26
Q

2nd most important s/sx in pts c chronic arterial dse

A

intermittent claudication
ischemic resting pain

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27
Q

most common site of pain in pts c arterial occlusive dse

A

Superficial femoral a.

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28
Q

pulses on site of occlusion in pts c arterial occlusion

A

normal

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28
Q

where can abnormal or absent pulse be detected in pts c arterial occlusion?

A

Below the occluded a.

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29
Q

most common complications of arterial dse

A

Ulceration
Gangrene

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30
Q

Type I Cryoglobulin

A

generally IgM and IgG

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31
Q

Type II Cryoglobulins

A

Monoclonal IgM and Polyclonal IgG

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32
Q

Type III Cryoglobulins

A

Polyclonal IgM and IgG

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33
Q

an acute necrotizing vasculitis that affects primarily medium-sized and small arteries

A

Polyarteritis (Nodosa)

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34
Q

What are involved or affected in Polyarteritis?

A

Kidneys
Joints
Skin
Nerves

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35
Q

What blood vessels are spared by Polyarteritis?

A

Aorta and its major branches
Capillaries
Small arterioles
Venous system

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36
Q

Vasculitis of medium-sized arteries results in

A

Levido
Reticularis
Nodules
Ulcerations
Digital ischemia

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37
Q

Treatment for idiopathic PAN

A

Corticosteroids
Cytotoxic agents

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38
Q

What aggravates intermittent claudication?

A

Walking

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39
Q

What relieves intermittent claudication?

A

Rest

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40
Q

Common sites or intermittent claudication

A

Calf
Arch of foot

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41
Q

Less common site of intermittent claudication

A

Above the knee

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42
Q

Why is intermittent claudication not commonly found above the knee?

A

Because the thigh has a rich collateral circulation

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43
Q

Pathophysiology of vascular intermittent claudication

A

Increased O2 demand
Decreased blood supply

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44
Q

Pain description of vascular intermittent claudication

A

Burning, cramping, sharp pain

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45
Q

6 Ps of vascular intermittent claudication

A

Pain
Pallor
Paresthesia
Paralysis
Pulselessness
Poikilothermia (Polar)

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46
Q

PT goal for vascular intermittent claudication

A

amb in 6 wks
Increased training time without pain

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47
Q

Early warning sign of ASO

A

Intermittent claudication

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48
Q

Late sign of ASO

A

gangrene

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49
Q

Nonatherosclerotic segmental vasculitis that affects small and medium arteries and veins of the hands and feet

A

Thromboangitis Obliterans (TAO) / Buerger’s dse

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50
Q

Pathophysio of TAO

A

Recurring progressive inflammation and thrombosis

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51
Q

1st possible manifestation of TAO

A

Superficial phlebitis

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52
Q

refers to intermittent episodes of arteriolar vasoconstriction during which small arteries or arterioles in extremities constrict

A

Raynaud’s phenomenon

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53
Q

Cause of Raynaud’s phenomenon episodes

A

cold temperature
strong emotion

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54
Q

Cause of primary Raynaud’s dse

A

Idiopathic

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55
Q

associated with connective tissue or collagen vascular disease

A

Secondary Raynaud’s dse

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56
Q

Diseases associated with Secondary Raynaud’s

A

Scleroderma
Polymyositis/Dermatomyositis
SLE
RA

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57
Q

Unilateral Raynaud’s phenomenon indication

A

Hidden neoplasm

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58
Q

primary vasospastic or vasomotor disorder

A

Raynaud’s disease

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59
Q

Causes of Raynaud’s dse

A

Hypersensitivity of digital arteries to cold
Release of serotonin
Congenital predisposition to vasospasm
Common in females 20-49 y/o

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60
Q

How is Raynaud’s dse distinguished from secondary Raynaud’s phenomenon?

A

At least 2 years with no progression of symptoms
No evidence of underlying cause

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61
Q

Clinical S/Sx of Raynaud’s dse

A

Pallor
Cold or numbness
Cyanosis
Intense redness

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62
Q

How can the exacerbation of Raynaud’s dse be relieved?

A

Place hands in axilla
Wiggle fingers
Move or walk

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63
Q

Laterality affected in Raynaud’s dse

A

Symmetrical

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64
Q

Laterality of affectation in Raynaud’s phenomenon

A

Mostly can be seen in one hand only or even in two fingers only

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65
Q

A specific name for Raynaud’s phenomenon

A

Vibration syndrome

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66
Q

Caused by vibratory tools

A

Vibration syndrome

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67
Q

Occlusive disease in the hands can result from trauma to the hypothenar area caused by using the palm as a hammer in an activity that involves pushing, pounding, or twisting

A

Hypothenar Hammer Syndrome

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68
Q

The hypothenar hammer syndrome causes injury to what artery?

A

Ulnar a.

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69
Q

Test for Hypothenar Hammer Syndrome

A

Allen’s test

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70
Q

Progressive, symptomatic ischemia leading to necrosis of the extremities

A

Critical Limb Ischemia

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71
Q

Indications for revascularization

A

Pain at rest
Gangrene
Non-healing ischemic ulcer

72
Q

What pulse should be taken for the ABI in the UE?

A

Radial

73
Q

What pulse should be taken for the ABI in the LE

A

Dorsalis pedis

74
Q

Formula for ABI

A

LE SBP/UE SBP

75
Q

> 1.2 ABI

A

Falsely elevated
Arterial dse
Diabetes

76
Q

1.19 - 0.95 ABI

A

Normal

77
Q

0.94 - 0.75 ABI

A

Mild arterial dse + Intermittent claudication

78
Q

0.74 - 0.50 ABI

A

Moderate arterial dse + resting pain

79
Q

< 0.50 ABI

A

Severe arterial dse

80
Q

arterial closing and opening pressure at a
specific anatomic location

A

Segmental pressure measurement

81
Q

Sites of measurement for segmental pressure measurement

A

Upper thigh
Lower thigh
Upper calf
Lower calf

82
Q

Indication of 10-15 mmHg difference in segmental pressure measurement

A

Aortoiliac obstruction

83
Q

Pressure gradient located between the upper and lower thigh cuffs indication

A

Superficial femoral artery obstruction

84
Q

Gradient between the lower thigh and upper calf cuffs indication

A

Distal or superficial femoral or popliteal artery obstruction

85
Q

Gradient between the upper and lower calf cuffs indication

A

Infrapopliteal dse

86
Q

Use of ultrasound

A

Duplex scanning

87
Q

Duplex scanning helps assess pts c

A

iliofemoral stenosis

88
Q

traditional gold standard for LE evaluation

A

Contrast arteriography

89
Q

A mainstay for preoperative imaging of abdominal aortic aneurysm

A

CT angiography

90
Q

CT angio uses

A

X-ray

91
Q

MR Angio uses

A

sound waves

92
Q

Optimum imaging is an alternative for

A

pregnant pts
pts c iodinated contrast allergy

93
Q

Contraindicated for pregnant pts

A

CT angio

94
Q

Advantages of MR Angio

A

Not compromised by overlying bone, bowel gas, or calcification

95
Q

Gadolinium plays a role in inducing

A

Nephrogenic Systemic Fibrosis

96
Q

Survival rates of asymptomatic pts

A

50%

97
Q

Survival rates of symptomatic pts

A

25-50%

98
Q

Survival rates of severe symptomatic pts

A

15%

99
Q

Statin therapy medications

A

Simvastatin
Rosuvastatin
Atorvastatin

100
Q

LDL threshold maintained for the general population

A

< 100 mg/dL

101
Q

LDL threshold maintained for pts c atherosclerotic dse

A

< 70 mg/dL

102
Q

Things to watch out for during statin therapy

A

Elevation of liver enzymes
Myopathy and Rhabdomyolysis

103
Q

Anti-hypertensives

A

Captopril
Enalapril
Fosinopril
Lisinopril

104
Q

Agents for Intermittent Claudication

A

Cilostazol
Pentoxifylline

105
Q

Parameters for Cilostazol

A

100 mg orally BID

106
Q

Contraindications for Cilostazol

A

pts c heart failure

107
Q

Rehab for pts c arterial disease

A

Wear protective footwear
Avoid extreme temperatures
Regular LE exercises

108
Q

Endovascular interventions

A

Angioplasty/stenting
Peripheral Bypass Graft Surgery
Amputation
Optimal medication therapy - anti-coagulants

109
Q

Distention or swollen superficial veins

A

Varicose veins

110
Q

What structure is affected in varicose veins?

A

Valves

111
Q

What happens to the layers of the blood vessels when a pt has Atherosclerosis Obliterans?

A

Fibrosis of tunica intima
Calcification of tunica media

112
Q

Prevalence of Varicose veins

A

F > M

113
Q

Pathogenesis of varicose veins

A

valves become incompetent
lack of pumping action of the LE muscles

114
Q

S/Sx of varicose veins

A

aching, heavy leg with the appearance of varicose veins

115
Q

Clinical manifestations of varicose veins

A

hemosiderin staining
fatigue brought on by periods of standing
cramps of the lower leg (m/c at night)
dilated elongated veins readily seen when standing

116
Q

Another name for spider veins

A

Telangiectasia

117
Q

What is involved in spider veins?

A

Broken capillaries

118
Q

Special tests for varicose veins

A

Brodie’s Trendelenburg test
Manual compression test
Percussion test

119
Q

Treatment for varicose veins

A

rest periods with feet slightly elevated above the heart
elastic stocking
muscle contractions

120
Q

Medical management for varicose veins

A

Compression sclerotherapy
Ligation and stripping
Radiofrequency ablation
Laser therapy

121
Q

Swelling of a vein because of vein wall inflammation (phlebitis) occurring as a result of thrombus (blood clot) deposition in the vein

A

Superficial Vein Thrombosis

122
Q

Veins affected by Superficial Vein Thrombosis

A

Great and small saphenous vein

123
Q

Cause of SVT

A

Iatrogenic - caused by medical procedure

124
Q

Clinical manifestations of SVT include

A

Dull, aching, tight feeling or pain the calf
Dilation of superficial veins
Pitting Edema
Warmth, redness

125
Q

CM of pulmonary emoblism

A

Pleuritic chest pain
Diffuse chest discomfort
Tachypnea
Tachycardia
Dyspnea

126
Q

What is used in identifying or diagnosing DVT?

A

Well’s Clinical Decision Rule for DVT

127
Q

How can SVT be diagnosed?

A

Well’s risk assessment
Contrast venography
Doppler ultrasonography
Venous duple sonography

128
Q

Clinical presentations with a score of 1 in Well’s risk assessment

A

Active cancer (> 6 mos)
Paralysis or recent immobilization of LE
Bedridden for > 3 days
Major surgery in the past 4 wks
Localized tenderness in the LE
Entire LE swelling
U/L calf swelling
U/L pitting edema
Collateral superficial veins

129
Q

Clinical presentation in Well’s risk assessment with a score of -2

A

Alternative diagnosis

130
Q

Management for SVT

A

prevent PE
Early mobilization
Anti-coagulants
Pneumatic pressure devices
Ankle pumps
ROM exercises
Early amputation

131
Q

What should be avoided for SVT?

A

Putting pillows under the legs

132
Q

How is pain from SVT relieved?

A

Bed rest + leg elevation

133
Q

Another name for Chronic venous insufficiency

A

Postphlebitic syndrome
Venous stasis

134
Q

Causes of chronic venous insufficiency

A

Leg trauma
Varicose veins
Neoplastic obstructions

135
Q

Pathogenesis for chronic venous insufficiency

A

damaged valves resulting in poor venous return

136
Q

Clinical manifestations of chronic venous insuficciency include

A

Progressive edema of the leg
Thickening of skin around the ankles
Venous ulcers
Hemosiderin staining around the ankles

137
Q

What causes the hemosiderin staining?

A

pooling of blood

138
Q

Advanced venous insufficiency occurs when

A

Perforator or deep vein valves are incompetent

139
Q

Interventions for venous insufficiency include

A

Compression therapy
Exercise
Avoid whirlpool

140
Q

Excessive fluid in the tissue

A

Lymphedema

141
Q

Cause of lymphedema

A

Accumulation of fluid due to problems with the lymphatic system

142
Q

Factors contributing to lymphedema include

A

Decreased lymphatic transport capacity
Increased lymphatic load

143
Q

Pathogenesis of lymphedema

A

Lymph valvular insufficiency

144
Q

Idiopathic lymphedema that appears at birth

A

Connatal/Milroy’s dse

145
Q

Lymphedema that appears at puberty caused by genetic disorder

A

Praecox

146
Q

Lymphedema appearing in people past 35 y/o

A

Tarda

147
Q

A type of lymphedema wherein lymphatic collectors are absent

A

Aplastic/Aplasia

148
Q

Most common type of lymphedema wherein there are less than normal lymphatic collectors

A

Hypoplastic

149
Q

A type of lymphedema wherein there is overdilation and enlargement of lymphatic vessels leading to varicose

A

Hyperplastic

150
Q

A parasitic infection carried by mosquitoes

A

Filariasis

150
Q

Acquired lymphedema

A

Secondary lymphedema

151
Q

Most common cause of secondary lymphedema

A

filariasis

152
Q

Where does filariasis commonly occur in?

A

Tropical regions

153
Q

commonly associated with filariasis, a condition caused by filarial worms transmitted by mosquitoes in tropical regions.

A

Elephantiasis

154
Q

A stage of lymphedema where lymph transport is reduced however, no clinical edema is present

A

Stage 0 - Latent Lymphedema

155
Q

A stage of lymphedema where there is a presence of soft-pitting edema and is still reversible

A

Stage 1 - reversible

156
Q

A stage of lymphedema where there is a presence of a non-pitting edema along with increase in connective and scar tissue

A

Stage 2 - Irreversible

157
Q

A stage of lymphedema where there is atrophic changes and a sever non-pitting fibrotic edema

A

Stage 3 - Elephantiasis

158
Q

Clinical presentation of pts c lymphedema

A

Swelling is not relieved by elevation
Fatigue, heaviness, and pressure
Discomfort varying from mild to intense
Loss of mobility and ROM
Impaired wound healing

159
Q

Clinical S/Sx of lymphedema

A

Edema on the dorsum of hand or foot
Decreased ROM
U/L edema

160
Q

Special test for primary lymphedema

A

Stemmer’s sign

161
Q

Management for lymphedema

A

Weight reduction
Compression
Exercises
Lymphatic mobilization
Dietary modification
Surgery

162
Q

Types of compression used for patients c lymphedema

A

Elastic compression garments
Pneumatic compression

163
Q

Two phases of complete decongestive therapy

A

Phase I - intensive
Phase II - self-management

164
Q

Three phases of healing

A

Inflammation
Proliferation
Maturation/Remodeling

165
Q

Time frame of phase I

A

onset up until day 10

166
Q

time frame of phase II

A

day 3 up until day 20

167
Q

time frame of phase III

A

day 9 up until 2 years

168
Q

Moisture softens wound scab and eschar; under the right conditions, the body’s own enzymes will dissolve the eschar in a process.

A

Autolytic debridement

169
Q

Healing by primary intention occurs when a healthcare provider closes a wound by bringing the edges
together.

A

Primary intention wound closure

170
Q

Closure and subsequent healing by secondary intention occurs when a wound is left open to heal on its own.

A

Secondary intention wound closure

171
Q

This type of closure occurs when a wound is allowed to heal by secondary intention and then is closed by
primary intention as the final treatment.

A

Tertiary intention wound closure

172
Q

Another name for tertiary intention wound closure

A

delayed priamry

173
Q

How are superficial wounds closed?

A

Re-epthilialization

174
Q

How are partial-thickness wounds closed?

A

Re-epithelialization + minimal contraction

175
Q

How are full thickness wounds closed?

A

Closed by contraction and scar formation

176
Q

is identified if the presence of bacteria or microorganisms is greater than 105 per gram of
tissue determined by a quantitative culture.

A

True infection

177
Q

Examples of intrinsic factors of wound healing

A

underlying diseases

178
Q
A

Cardio (15 decks)

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