General

Question 1

usually refers to

Answer 1

chronic atherosclerotic occlusive disease of large and medium arteries, primarily of the legs

Question 2

epidemiology

Answer 2

common
elderly
men
risk factors same as for CAD

Question 3

Atherosclerotic luminal narrowing decreases blood flow…

Answer 3

in inverse proportion to length of stenosis and blood viscosity

in proportion to radius to the fourth power

**Poiseuille’s eqn.

Question 4

What is important in determining the amount of blood flow?

Answer 4

radius of the lumen

Question 5

if radius is reduced to half, flow is….

Answer 5

reduced to 1/16

Question 6

Symptoms

Answer 6

intermittent claudication

Question 7

intermittent claudication

Answer 7

pain brought on by exercise, relieved by rest

Question 8

Where is the pain most common?

Answer 8

calf muscles when disease in femoral or popliteal arteries (the usual site) causes it

Question 9

What are indicators of severe disease?

Answer 9

pain at rest

ulcers

Question 10

Signs

Answer 10

diminished or lost distal pulses
brits
pallor or cyanosis
skin atrophy muscle atrophy
ulcerations
necrosis (gangrene)

Question 11

bruits

Answer 11

swishing sounds auscultated over lesions with turbulent flow

Question 12

Diagnosis

Answer 12

made by Hx and physical exam!!!

Question 13

Physical exam useful for diagnosis

Answer 13

measure BP in arm and lower leg w/ pt supine...
if ratio ("ankle/brachial ratio") is <.9, no further diagnostic tests are necessary

Question 14

First line treatment

Answer 14

exercise (esp walking)
–helps develop collaterals

cilostazol (vasodilates)
penoxifylline (decreases blood viscosity)
angioplasty
surgery (bypass, amputation)

Question 15

claudication

Answer 15

ischemic pain of periphery, usually legs, usually calves, usually intermittent, usually brought on by exertion and relieved by rest