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PathoPharm 2 > ch 37 vascular disorders > Flashcards

ch 37 vascular disorders Flashcards

1
Q

what age, gender, and race is more likely to develop aneurysms

A

older age
men
whites

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2
Q

risk factors aneurysms (6)

A
  • smoking
  • salmonella
  • HIV
  • syphilis
  • atherosclerosis
  • trauma
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3
Q

complications of AAA

A

-dissection to massive hemorrhage

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4
Q

S+S AAA (2)

A
  • abdominal pulsation

- bruit

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5
Q

who gets ultrasound screening regularly to check for aneurysms (2)

A
  • smokers > 50 yo

- family h/o aneurysms

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6
Q

Dx for aneurysms (4)

A
  • ultrasound
  • CT (emergency)
  • MRI with contrast
  • angiography
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7
Q

treatment for small (<4 cm) aneurysm

A

ultrasounds q6months to monitor

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8
Q

treatment for large (5.5 cm+) aneurysm

A

surgery

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9
Q

what should you do preop for a bleeding aneurysm (2)

A
  • IV fluids

- PRBCs

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10
Q

postop care for AAA repair

A
  • check blood flow to lower extremities
  • check pulses regularly
  • stool softeners
  • splint with pillows
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11
Q

S+S burst AAA

A
  • tachycardia
  • hypotension
  • pale clammy skin
  • decreased urine output
  • altered LOC
  • abdominal pain
  • severe flank/back pain
  • bruising on abdomen/back
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12
Q

complications of AAA repair surgery

A
  • endoleak
  • recurring aneurysm
  • renal artery occlusion
  • graft thrombosis
  • intraabdominal hypertension
  • abdominal compartment syndrome
  • infection
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13
Q

risk factors PAD (6)

A
  • smoking
  • hyperlipidemia
  • hypertension
  • DM
  • african american
  • age >60 yo
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14
Q

classic symptom PAD

A

-intermittent claudication

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15
Q

S+S PAD (6)

A
  • intermittent claudication
  • paresthesia
  • thin, shiny, taut skin
  • loss of hair on lower legs
  • pallor
  • reactive hyperemia
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16
Q

what is reactive hyperemia

A

elevated legs: paleness

standing: very red and warm legs

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17
Q

what is intermittent claudication

A

cramping pains relieved with rest

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18
Q

late S+S of PAD

A

pain at rest - nighttime ischemia

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19
Q

complications of PAD (3)

A
  • atrophy skin/muscles
  • ulcerations
  • necrosis (leads to amputation)
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20
Q

Dx for PAD (3)

A
  • ankle brachial index (ABI)
  • bp upper extremities v lower extremities
  • if abnormal: CT w angiography
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21
Q

what pt is cilostazol contraindicated in

A

pt with HF

22
Q

Tx for PAD (6)

A
  • stop smoking
  • control HTN
  • H1C <7%
  • exercise - walking 30-60 mins/day
  • nutrition: low fat
  • alternative: B6, B12, gingko
23
Q

meds for Tx of PAD (4)

A
  • antiplatelets (aspirin, clopidogrel, ticlodipine)
  • ACE inhibitors (ramipril)
  • pentoxifyline (for intermittent claudication)
  • cilostazol (for intermittent claudication)
24
Q

what does pentoxifyline do

A

decreases blood viscosity

25
Q

what does cilostazol do

A

increases exercise tolerance and bloodflow

26
Q

surgery for PAD (2)

A
  • balloon angioplasty

- peripheral artery bypass

27
Q

inflammatory, vaso-occlusive disorder that is characterized by decreased blood flow to upper extremities (and is NOT due to atherosclerosis)

A

thromboangitis obliterans (buergers disease)

28
Q

highest risk factors for buergers disease (3)

A
  • young men
  • smoker
  • <40 yo
29
Q

S+S buergers disease (2)

A
  • intermittent claudication

- ischemic rest pain

30
Q

Tx buergers disease (3)

A
  • IV iloprost for acute use
  • stop smoking
  • amputations
31
Q

what does iloprost do for pts with buergers disease

A

vasodilation

32
Q

what is raynauds phenomenon

A

vasospasm response to extreme temps

33
Q

what age and gender is raynauds phenomenon most common in

A

women between 15-40 yrs

34
Q

treatment raynauds phenomenon

A

calcium channel blockers

35
Q

what are three major risk factors for blood clotting (virchows triad)

A
  • venous stasis (immobility)
  • endothelial damage (DM, HTN, smoking)
  • blood hypercoagulability (pregnancy)
36
Q

how to prevent DVTs (6)

A
  • lovenox or heparin
  • early ambulation
  • TED hose/SCDs
  • avoid prolonged sitting/bedrest
  • avoid crossing legs
  • no smoking
37
Q

S+S DVT (5)

A
  • redness
  • swelling
  • warmth
  • pain
  • unilateral pain
38
Q

what is important to remember when assessing pt with suspected DVT

A

-don’t dorsiflex foot or palpate - clot could dislodge

39
Q

S+S superficial thrombophlebitis (3)

A

-warmth
-swollen
-redness
(common with IVs)

40
Q

Dx superficial thrombophlebitis (3)

A
  • doppler ultrasound
  • D-dimer
  • venogram
41
Q

Tx options superficial thrombophlebitis (6)

A
  • heparin IV drip
  • subq enoxaparin
  • warfarin
  • factor 10a inhibitors
  • 6 months anticoagulants after 1st clot, lifelong after 2nd
  • thrombolytics
42
Q

what lab should you monitor q4-6 hrs for heparin

A

PTT

43
Q

antidote for heparin

A

protamine sulfate

44
Q

what is important to remember with IV drip admin of heparin

A

never piggy back, have to have 2nd pump

45
Q

INR for warfarin

A

2-3

46
Q

S+S varicose veins (2)

A
  • visible tortuous veins

- heavy aching with standing and walking

47
Q

Tx varicose veins (only if symptomatic)

A
  • laser surgeries

- ablation

48
Q

risk factors varicose veins (6)

A
  • female
  • smoking
  • obesity
  • old age
  • history of VTE
  • pregnancy
49
Q

prevention of varicose veins (6)

A
  • avoid sitting/standing for long periods of time
  • healthy body weight
  • avoid constrictive clothing
  • walk daily
  • elevate legs above heart
  • compression socks
50
Q

S+S chronic venous insufficiency (CVI) (4)

A
  • chronic skin changes
  • hardening of skin
  • dark plaques
  • venous stasis ulcers
51
Q

Tx chronic venous insufficiency (4)

A
  • compression dressings (Unna boot)
  • hydrocolloid dressings
  • antibiotics if infected wounds
  • pentoxifylline
52
Q

differences between PVD arterial (5) v venous (4) ulcers

A

ARTERIAL:

  • intermittent claudication
  • no/weak pulse
  • round smooth sores
  • black eschar
  • sores on toes and feet

VENOUS:

  • dull achy pain
  • lower leg edema
  • yellow slough, drainage
  • sores on ankles

PathoPharm 2 (33 decks)

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