Ex2 Peripheral vascular dx Flashcards
PAD - acute is due to
arterial embolism
PAD - chronic is due to
atherosclerosis
peripheral arterial insufficiency is defined as
Ankle brachial index < 0.9
How to measure ankle brachial index
SBP ankle/SBP brachial artery
S/S PAD
intermittent claudication + pain
most reliable physical finding: decreased/absent pulses
Surgical repair of PAD - anesthetic choice
Regional
When is epidural placed for PAD surgery?
1 hour prior
*intraop heparinization
Raynauds- regional: avoid?
Epi in LA
Leading cause of periop morbidity + mortality
DVT + subsequent PE
What is associated with lower DVT/PE after total knee/hip arthroplasty?
regional anesthesia
Virchow’s Triad
Venous stasis
Hpercoagulability
Disruption of vascular endothelium
Takayasaus Arteritis s/s
Neuro: vertigo/syncope
CV: occlusion of peripheral arteries
Lungs: pHTN
Musc: ankylosing spondylitis
Takayasaus Arteritis tx
glucocorticoids
*supplemental corticosteroids intraop if on gluco. at home
Takayasaus Arteritis management intraop
careful w/ head positioning
Temporal (Giant Cell) Arteritis - complication
blindness
*cannot reverse
Tx: prompt corticosteroids
s/s kawasaki dx
Swollen erythematous hands/feet, truncal rash, cervical lymphadenopathy
Thromboangiitis Obliterans (Buergers Dz) risks
men <45
Tobacco**
Thromboangiitis Obliterans intraop considerations
padding
avoid epi in LA
Azotemia
excess of nitrogen containing compounds in blood d/t renal dx
Azotemia is s/s of which disease
Wegeners Granulomatosis
Tx Wegeners Granulomatosis
Glucocorticoids + cyclophosphamide
Cyclophosphamide can cause
immunosupression, leukopenia, hemolytic anemia
Anesthetic management - Wegeners Granulomatosis
Avoid airway trauma with DL
Have 1-2 size smaller ETT (stenotic airway)
supplemental steroids
