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Clin Med I Disease Key Notes > Hem/Imm (Final Exam) > Flashcards

Hem/Imm (Final Exam) Flashcards

1
Q

What is considered anemia in men? In women?

A
  • Men: Hb <14

- Women: Hb <12

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2
Q

What is the normal Hb:Hct ratio?

A

Hb:Hct = 1:3

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3
Q

What are the three likely causes of anemia if there is decreased RBC production?

A
  • Nutritional deficiencies (iron, B12/folate)

- Chronic disease

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4
Q

What is the likely cause of anemia if there is increased RBC destruction?

A

Hemolysis

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5
Q

What are the three likely causes of anemia if there is blood loss?

A
  • Menstruation
  • GI
  • Trauma
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6
Q

What are four signs of anemia?

A
  • Pallor
  • Heme in stool
  • Orthostatic changes
  • Tachycardia
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7
Q

What are six symptoms of anemia?

A
  • Fatigue
  • Weakness
  • Headache
  • Dizziness
  • Dyspnea
  • Palpitations
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8
Q

What are the three causes of microcytic anemia?

A
  • Iron deficiency anemia
  • Thalassemia anemia
  • Sideroblastic anemia
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9
Q

What are the three causes of normocytic anemia?

A
  • Chronic disease
  • Hypothyroidism
  • Liver disease
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10
Q

What are the two causes of macrocytic anemia?

A
  • Folate deficiency

- Vitamin B12 deficiency

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11
Q

What is the most common cause of anemia worldwide?

A

Iron Deficiency Anemia (IDA)

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12
Q

What is the most common cause of Iron Deficiency Anemia (IDA) in adults?

A

Blood loss

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13
Q

What type of anemia involves atrophic glossitis, angular cheilitis, koilonychia; pica?

A

Iron Deficiency Anemia (IDA)

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14
Q

What type of anemia has labs that show:

  • Low MCV (low RBCs, Hb, Hct)
  • Low Serum Fe
  • High TIBC
  • Low Ferritin
  • High RDW
A

Iron Deficiency Anemia (IDA)

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15
Q

What type of anemia has a peripheral smear that shows Microcytic, hypochromic RBCs; anisocytosis, poikilocytosis?

A

Iron Deficiency Anemia (IDA)

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16
Q

What is the recommended treatment for Iron Deficiency Anemia (IDA)?

A

Oral ferrous sulfate 325 mg TID daily

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17
Q

What type anemia can lead to ineffective erythropoiesis and hemolysis (low RBC production and high RBC destruction) and then bone changes, impaired growth, iron overload?

A

Thalassemia Anemia

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18
Q

What type of anemia shows:

  • VERY low MCV
  • Normal/high Serum Fe
  • Normal/low TIBC
  • Normal/high Ferritin
  • Normal RDW
A

Thalassemia Anemia

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19
Q

What type of anemia uses Hemoglobin Electrophoresis to help with diagnosis?

A

Thalassemia Anemia

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20
Q

What type of anemia involves ONE beta-globin chain dysfunction; asymptomatic?

A

Beta Thalassemia Minor

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21
Q

What type of anemia involves BOTH beta-globin chains dysfunction, but less severe?

A

Beta Thalassemia Intermedia

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22
Q

What type of anemia involves BOTH beta-globin chains dysfunction but more severe?

A

Beta Thalassemia Major

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23
Q

What type of anemia involves severe hemolytic anemia and is transfusion-dependent?

A

Beta Thalassemia Major

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24
Q

What type of anemia is acquired more common in adults; often a variant of myelodysplastic syndrome (MDS)?

A

Sideroblastic Anemia

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25
Q

What type of anemia involves Bone Marrow Aspirate that shows ring sideroblasts?

A

Sideroblastic Anemia

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26
Q

What type of anemia involves systemic iron overload?

A

Sideroblastic Anemia

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27
Q

What is the second most common cause of anemia worldwide?

A

Anemia of Chronic Anemia (ACD)

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28
Q

What type of anemia involves hepcidin-induced alterations of iron metabolism?

A

Anemia of Chronic Anemia (ACD)

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29
Q

What type of anemia shows:

  • Normal MCV
  • Normal/low Serum Fe – low due to inflammation
  • Normal/low TIBC – low due to inflammation
  • Normal/high Ferritin
A

Anemia of Chronic Anemia (ACD)

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30
Q

If reticulocyte count is HIGH with macrocytic anemia, what two causes should be considered?

A
  • Hemorrhage

- Hemolysis

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31
Q

If reticulocyte count is LOW with macrocytic anemia, what two causes should be considered?

A

Megaloblastic:

  • B12 deficiency
  • Folate deficiency
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32
Q

What type of anemia involves anemia-related symptoms plus glossitis, vague GI (NO neuro issues)?

A

Folic Acid Deficiency Anemia

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33
Q

What type of anemia shows:

  • High MCV
  • Low serum folate level
  • High homocysteine
  • Normal serum MMA
A

Folic Acid Deficiency Anemia

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34
Q

What TWO types of anemia shows macro-ovalocytes, hypersegmented neutrophils on peripheral smear?

A
  • Folic Acid Deficiency Anemia

- Vitamin B12 Deficiency Anemia

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35
Q

What should ALWAYS be ruled out with Folic Acid Deficiency Anemia?

A

RULE OUT CO-EXISTING B12 DEFICIENCY

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36
Q

What is the most common cause of Vitamin B12 Deficiency Anemia?

A

Pernicious Anemia

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37
Q

Where is folate absorbed in the body? Where is B12 absorbed in the body?

A
  • Folate: jejunum

- Vitamin B12: ileum

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38
Q

What type of anemia can be caused by decreased intake (vegan), medications (Metformin), malabsorption (elderly)?

A

Vitamin B12 Deficiency Anemia

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39
Q

What type of anemia involves anemia-related symptoms plus glossitis, vague GI, atrophic glossitis; NEURO?

A

Vitamin B12 Deficiency Anemia

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40
Q

What type of anemia is associated with increased risk of gastric cancer?

A

Vitamin B12 Deficiency Anemia

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41
Q

What are the neuro symptoms in Vitamin B12 Deficiency Anemia caused by?

A

Defective myelin synthesis in CNS

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42
Q

What type of anemia shows:

  • High MCV
  • Low serum B12 level
  • High homocysteine
  • High MMA
A

Vitamin B12 Deficiency Anemia

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43
Q

Why can’t you treat B12 deficiency with folic acid only?

A

If B12 is not ALSO replaced, patient can develop serious, possibly irreversible neuro damage

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44
Q

What group of anemias involve anemia-related plus jaundice, gallstones, dark urine?

A

Hemolytic Anemias

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45
Q

What type of anemias show:

  • High reticulocyte count
  • High unconjugated bilirubin
  • High LDH
  • Low haptoglobin
A

Hemolytic Anemias

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46
Q

What type of anemias shows immature RBCs (reticulocytes), nucleated RBCs, fragmented RBCs on peripheral smear?

A

Hemolytic Anemias

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47
Q

What is the difference between Extravascular Hemolysis and Intravascular Hemolysis (think location)?

What is another name of Intravascular Hemolysis?

A
  • Extravascular Hemolysis: RBC destruction in reticuloendothelial system (spleen)
  • Intravascular Hemolysis aka “Footstrike Hemolysis”: destruction of RBCs within blood stream
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48
Q

What type of anemia involves pain crisis, acute chest syndrome?

A

Sickle Cell Anemia, (Hemolytic Anemia, EXTRA)

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49
Q

What type of anemia involves o aplastic crisis associated with Parvovirus 19 infections (Fifth Disease)?

A

Sickle Cell Anemia, (Hemolytic Anemia, EXTRA)

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50
Q

What type of anemia involves Howell-Jolly bodies?

A

Sickle Cell Anemia (Hemolytic Anemia, EXTRA)

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51
Q

What type of anemia involves IgM (“cold” agglutinins) vs. IgG (“warm” agglutinins)?

A

Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)

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52
Q

What type of anemia can be caused by SLE, CLL, Mycoplasma, EBV?

A

Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)

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53
Q

What type of anemia involves a Positive Coombs Test (DAT)?

A

Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)

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54
Q

How does treatment differ between “cold” and “warm” Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)? What can both be treated with?

A

Both: Rituximab

  • Cold: avoid cold
  • Warm: STEROIDS
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55
Q

What symptom is most often associated with Hemolytic Transfusion Reaction (Hemolytic Anemia, INTRA)?

A

Fever

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56
Q

What type of anemia involves pallor, jaundice, splenomegaly, dark urine at night/early morning?

A

Paroxysmal Nocturnal Hemoglobinuria (Hemolytic Anemia, INTRA)

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57
Q

What two pharmacologic treatments can often help Hemolytic Anemia? What type of surgery is often advised with Hemolytic Anemia?

A
  • Tx: steroids can help, Folic Acid supplements

- Surgery: splenectomy

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58
Q

What type of anemia uses the Osmotic Fragility Test diagnostically?

A

Hereditary Spherocytosis (Hemolytic Anemia, EXTRA)

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59
Q

What type of anemia is often asymptomatic; may have mild jaundice/icterus, pigmented black gallstones, splenomegaly?

A

Hereditary Spherocytosis (Hemolytic Anemia, EXTRA)

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60
Q

What type of anemia often shows pancytopenia (anemia/reticulocytopenia + leukopenia + thrombocytopenia)?

A

Aplastic Anemias

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61
Q

What type of anemia involves bone marrow that lacks precursor platelets, RBCs and WBCs?

A

Aplastic Anemias

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62
Q

What is often the recommended treatment for Aplastic Anemias?

A

Bone marrow transplant

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63
Q

What condition involves Virchow’s Triad? What are the three components?

A

Venous Thromboembolism

  • Stasis
  • Hypercoagulability
  • Vessel wall injury
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64
Q

What condition is associated with Factor V Leiden mutation; Prothrombin gene mutation?

A

Venous Thromboembolism

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65
Q

For a DVT, what should be ordered next if there is a high Wells score? Moderate/low Wells score?

A
  • If high Wells: order compression ultrasound

- If moderate/low Wells: order D-Dimer

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66
Q

For a DVT or PE, if D-Dimer was negative, what’s next? What if D-Dimer was positive?

A
  • If D-Dimer is negative, testing STOPS (<500 ng/mL)

- If D-Dimer is positive, order US for DVT, or CPTA for PE

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67
Q

What is considered a POSITIVE D-Dimer test?

A

> 500 ng/mL

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68
Q

What is one of the most common risk factors for a DVT?

A

Previous thrombotic event

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69
Q

What are the two most common symptoms associated with a PE?

A
  • SOB

- Pleuritic pain

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70
Q

For a PE, what should be ordered next if there is a high Wells score? Moderate/low Wells score?

A
  • If high Wells: order CTPA

- If moderate/low Wells: apply PERC

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71
Q

For a PE, what should be ordered next if there is a positive PERC score? Negative PERC score?

A
  • If PERC positive, order D-Dimer

- If PERC is negative, testing STOPS

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72
Q

What is the treatment for a patient with PE that has severe renal failure, a hemodynamically unstable PE, or has a massive iliofemoral DVT?

A

UFH (IV unfractionated heparin)

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73
Q

For a patient with PE that is pregnant or has active cancer, what is the DOC?

A

Lovenox (LMWH)

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74
Q

What is typically used for long-term anticoagulation therapy? What must be considered?

A

Warfarin

- Must monitor PT and INR

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75
Q

To avoid the burden of PT/INR monitoring, what two groups of medications can be considered?

A
  • Oral Factor Xa inhibitors

- Oral thrombin inhibitors

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76
Q

What is the recommended course of treatment for a DVT?PE that was provoked? Unprovoked?

A
  • Provoked (i.e. surgery): 3 months

- Unprovoked: consider longer therapy (6-12 months)

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77
Q

What course of treatment would be considered for 1st or recurrent episode of unprovoked proximal PE/symptomatic PE, or if underlying thrombophilia or active malignancy?

A

Lifelong treatment

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78
Q

What is the one Anticoagulation Reversal Therapy we discussed in class?

A

aPCC

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79
Q

What are the “clot busters” for DVT/PE and when are they used?

A

Thrombolytics

- Used for unstable PE patients

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80
Q

What two treatments are used for unstable PE patients?

A
  • Thrombolytics

- Thrombectomy/Embolectomy

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81
Q

Under what four conditions might a patient now be considered for discharge home after diagnosis or DVT/PE?

A
  • Pain controlled
  • Compliant/reliable
  • Capable of administering injections if subQ tx
  • Pay for injectable agents while transitioning to oral Warfarin
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82
Q

What type of immune system is the first line of defense, rapid response (minutes/hours), non-specific defense, no memory?

A

Innate Immune System

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83
Q

What type of immune system is the second line of defense, more sophisticated response, highly specific, long-lasting response, develops memory with each exposure?

A

Acquired Immune System

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84
Q

What are the five steps associated with the complement system? What immune system is the complement system associated with?

A

Innate Immune System

  1. Activation via classical pathway
  2. Formation of enzyme C3 Convertase
  3. Opsonization and phagocytosis
  4. Inflammation
  5. Membrane Attack Complex (MAC) formation and lysis
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85
Q

What is the distribution of WBCs from most numerous → least (think of the mnemonic)?

A

Neutrophils → Lymphocytes → Monocytes → Eosinophils → Basophils

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86
Q

What type of WBC is the first responder, most active against bacteria?

A

Neutrophils

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87
Q

What type of WBC is associated with a “left shift”, and what does this indicate?

A

Neutrophils

- “Left shift” on CBC = sign of acute bacterial infection

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88
Q

What does Neutrophilia often indicate? Neutropenia?

A
  • Neutrophilia: high neutrophils = bacterial infection

- Neutropenia: low neutrophils = viral infection

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89
Q

What type of WBC is the largest?

A

Monocytes

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90
Q

What type of WBC become tissue resident macrophages or dendritic cells; found in blood and SPLEEN?

A

Monocytes

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91
Q

What type of WBC is most active against large parasites; found in mucous membranes?

A

Eosinophils

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92
Q

What two types of WBCs release histamines?

A
  • Basophils

- Mast cells

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93
Q

What two types of WBCs are involved in the allergy response?

A
  • Eosinophils

- Basophils

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94
Q

What type of WBCs are involves in anaphylaxis reactions?

A

Mast cells

95
Q

What lymphatic organ hosts B cell maturation?

A

Bone marrow (primary)

96
Q

What lymphatic organ hosts T cell maturation?

A

Thymus (primary)

97
Q

What lymphatic organ is largest; removes old RBCs, stores RBCs and recycles iron; synthesizes antibodies?

A

Spleen (secondary)

98
Q

What lymphatic organ has increased susceptibility to encapsulated bacteria (like Strep pneumoniae, H. influenzae and N. meningitidis)?

A

Spleen (secondary)

99
Q

What lymphatic organ filters foreign molecules and cancer cells?

A

Lymph nodes (secondary)

100
Q

What lymphatic organ is the 1st line of defense against ingested/inhaled pathogens; combats common cold?

A

Tonsils/Adenoids (secondary)

101
Q

What lymphatic organ attacks antigens passing through mucosal epithelium?

A

MALT (secondary)

102
Q

What are the two types of adaptive immunity?

A
  • Humoral

- Cell-Mediated

103
Q

What type of adaptive immunity involves antibody-mediated, B-lymphocyte cells, extracellular pathogens?

A

Humoral (Adaptive Immunity)

104
Q

What type of adaptive immunity involves direct cell-to-cell contact, T-lymphocyte cells, intracellular pathogens?

A

Cell-Mediated (Adaptive Immunity)

105
Q

What type of Adaptive Immunity involves ONE step activation? Which involves TWO step activation?

A
  • ONE: Humoral

- TWO: Cell-Mediated

106
Q

What type of antibody is the first responder, activates complement system, LARGE; NOT cross placenta?

A

IgM

107
Q

What type of antibody is the second responder; most abundant and longest half-life; good at opsonization?

A

IgG

108
Q

What type of antibody is found primarily in mucosal membranes?

A

IgA

109
Q

What type of antibody binds to mast cells → release of histamine?

A

IgE

110
Q

What type of immunity is obtained via breastfeeding or infusion?

A

Passive immunity

111
Q

What type of immunity is obtained via exposure to antigen OR vaccine?

A

Active immunity

112
Q

What is the growth pathway by which B cells and T cells progress (3 steps)?

A
  1. Immature (bone marrow)
  2. Mature naïve (bone marrow OR thymus)
  3. Activated (secondary lymph organs)
113
Q

Which type of cell is activated via TCR binds to MHC-antigen complex of antigen-presenting cell (APC), THEN TCR CD28 binds with B7, located on the APC?

A

T cells

114
Q

What type of T cell has CD4+ surface receptors; binds to MHC II?

A

Helper T cells

115
Q

What type of T cell has CD8+ surface receptors; binds to MHC I?

A

Cytotoxic T cells

116
Q

What type of T cell distinguish self vs. non-self?

A

Suppressor T cells

117
Q

What type of T cell recognizes antigens from previous exposures?

A

Memory T cells

118
Q

What type of cell are Antigen-Presenting Cells (APCs)?

A

ANY nucleated cell in body

119
Q

What is found on surface of ALL nucleated cells?

A

MHC I

120
Q

What surface complex presents to cytotoxic T-cells (which contain CD8+ receptors)?

A

MHC I

121
Q

What surface complex presents to helper T-cells (which contain CD4+ receptors)?

A

MHC II

122
Q

What is found only on surface of B-cells, dendritic cells, macrophages?

A

MHC II

123
Q

What are the three B symptoms?

A
  • Weight loss
  • Fever
  • Night sweats
124
Q

What is the most common acute leukemia in ADULTS (age 65 years)?

A

Acute Myeloid Leukemia (AML)

125
Q

What is CA of bone marrow and lymphatic system?

A

Leukemia (4 types: AML, CML, ALL, CLL)

126
Q

What type of CA is associated with chemical exposure/radiation or myelodysplastic syndrome (MDS)?

A

Acute Myeloid Leukemia (AML)

127
Q

What type of CA involves pancytopenia (reduced production of RBCs, WBCs, platelets); elevated LDH?

A

Acute Myeloid Leukemia (AML)

128
Q

What type of CA involves Auer rods; leukemic blasts (>20% on bone marrow aspiration and biopsy)?

A

Acute Myeloid Leukemia (AML)

129
Q

What condition involves risk for progression to AML?

A

Myelodysplastic Syndrome (MDS)

130
Q

What two conditions are often asymptomatic/found routinely on CBC?

A
  • Myelodysplastic Syndrome (MDS)

- Chronic Myeloid Leukemia (CML)

131
Q

What condition involves a tx of donor bone marrow transplant = only possible cure?

A

Myelodysplastic Syndrome (MDS)

132
Q

What condition is a oncologic emergency (high mortality)?

A

Tumor Lysis Syndrome

133
Q

What condition is often caused by chemotherapy initiation (<1 day); can be spontaneous?

A

Tumor Lysis Syndrome

134
Q

What type of CA is associated with BCR-ABL1/Philadelphia chromosome?

A

Chronic Myeloid Leukemia (CML)

135
Q

What type of CA involves ionizing radiation as a risk factor?

A

Chronic Myeloid Leukemia (CML)

136
Q

What is the most common phase of Chronic Myeloid Leukemia (CML)?

A

Chronic phase: most common

137
Q

What type of CA involves a tx of donor stem cell transplant = only possible cure?

A

Chronic Myeloid Leukemia (CML)

138
Q

What type of CA involves complications of tumor lysis syndrome; hyperviscosity syndrome; hyperleukocytosis = emergency?

A

Chronic Myeloid Leukemia (CML)

139
Q

What is the most common cancer in children/teens (age 2-5 years)?

A

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

140
Q

What type of ALL is most cases of childhood ALL?

A

Precursor B-cell ALL

141
Q

What type of ALL involves older age/mostly males; very high WBC count at dx?

A

T-cell ALL

142
Q

What type of ALL is also called Burkitt cell; favorable prognosis?

A

Mature B-cell ALL

143
Q

What type of CA involves LAD, hepatosplenomegaly, pallor, bone/MSK pain, fever?

A

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

144
Q

What type of CA shows lymphoblasts on peripheral smear and on bone marrow or tissue biopsy?

A

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

145
Q

What two conditions indicate a better diagnosis for Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

A
  • Child

- B-cell ALL

146
Q

What is the ONLY adult leukemia (age 70 years)?

A

Chronic Lymphocytic Leukemia (CLL)

147
Q

What type of CA involves B-cell lymphocytosis?

A

Chronic Lymphocytic Leukemia (CLL)

148
Q

How can you differentiate the two stages of Chronic Lymphocytic Leukemia (CLL)?

A
  • Indolent stage: often asymptomatic

- Advanced stage/Terminal phase: inclusion of B symptoms

149
Q

What type of CA involves organomegaly (lymph, spleen, liver); skin involvement?

A

Chronic Lymphocytic Leukemia (CLL)

150
Q

What is the only cancer that involves a tx of observation (that we discussed)? Under what conditions would this be considered?

A

Asymptomatic or early stage 1 Chronic Lymphocytic Leukemia (CLL)

151
Q

What is the recommended treatment for symptomatic or advanced stage Chronic Lymphocytic Leukemia (CLL)?

A

Rituximab/other monoclonal antibodies

152
Q

What type of CA begins in lymphocytes (lymph nodes, spleen, thymus, bone marrow, tonsils/adenoids)?

A

Lymphoma

153
Q

What three symptoms present with both types of Lymphoma?

A
  • Painless LAD
  • Mediastinal mass
  • B symptoms
154
Q

What type of CA is associated with EBV as a risk factor?

A

Hodgkin Lymphoma (HL)

155
Q

In what age group is Hodgkin Lymphoma (HL) more common/ What about for Non-Hodgkin Lymphoma (NHL)?

A
  • Hodgkin Lymphoma (HL): 15-34 years

- Non-Hodgkin Lymphoma (NHL): 66 years

156
Q

What type of CA involves painless LAD, mediastinal mass, severe pain after alcohol, B symptoms, fatigue, pruritis/no rash?

A

Hodgkin Lymphoma (HL)

157
Q

What type of CA shows Reed-Sternberg cells (“popcorn” cells) on peripheral smear?

A

Hodgkin Lymphoma (HL)

158
Q

What type of CA can lead to other cancer or heart disease?

A

Hodgkin Lymphoma (HL)

159
Q

What type of CA has a worse prognosis if bilateral LAD, bulky disease, distant spread?

A

Hodgkin Lymphoma (HL)

160
Q

What type of CA involves extra lymph sites, painless LAD, mediastinal mass, B symptoms?

A

Non-Hodgkin Lymphoma (NHL)

161
Q

What type of CA is diagnosed by biopsy (prefer 2+ cm lymph nodes); CT/PET scan; bone marrow aspiration and biopsy (specifically discussed)?

A

Non-Hodgkin Lymphoma (NHL)

162
Q

What type of CA involves malignancy of plasma cells?

A

Multiple Myeloma (MM)

163
Q

In what population is Multiple Myeloma (MM) more common?

A

African Americans

164
Q

What type of CA involves back pain, neurologic changes, bone pain, fatigue?

A

Multiple Myeloma (MM)

165
Q

What type of CA shows paraproteins on Protein Electrophoresis?

A

Multiple Myeloma (MM)

166
Q

What type of CA involves an M spike? What does this indicate?

A 
Multiple Myeloma (MM)
- Early indication of malignancy
167
Q

What type of CA involves anemia (Rouleaux formation)?

A

Multiple Myeloma (MM)

168
Q

What type of CA involves Bence-Jones proteins in urine?

A

Multiple Myeloma (MM)

169
Q

What type of CA involves lytic lesions and generalized osteoporosis on axial skeleton x-ray?

A

Multiple Myeloma (MM)

170
Q

What type of CA involves CRAB (diagnostically), and what does each letter stand for?

A

Multiple Myeloma (MM)

  • Calcium
  • Renal
  • Anemia
  • Bony lesions
171
Q

What type of CA is associated with hyperviscosity syndrome?

A

Multiple Myeloma (MM)

172
Q

What is the treatment for Multiple Myeloma (MM)?

A

IV bisphosphonates

173
Q

What is the primary cause of Atherosclerosis?

A

Endothelial dysfunction

174
Q

What are the steps in Atherosclerosis?

A
  1. Fatty streak
  2. Fibrous plaque
  3. Atherosclerotic plaque (calcification)
  4. Plaque rupture/fissure with thrombosis
175
Q

What condition involves insufficient blood flow/O2 to meet metabolic demand due to thrombus or embolus?

A

Ischemia

176
Q

What condition is underdiagnosed but highly prevalent?

A

Peripheral Artery Disease (PAD)

177
Q

What condition is an independent mortality predictor?

A

Peripheral Artery Disease (PAD)

178
Q

What is the most common etiology of Peripheral Artery Disease (PAD)?

A

Atherosclerosis of LE

179
Q

What are the seven most common risk factors of Peripheral Artery Disease (PAD)?

A
  • HTN
  • DM
  • Dyslipidemia
  • Smoking
  • Age
  • Obesity
  • FH
180
Q

What condition involves a relationship between HBA1c and risk for amputation?

A

Peripheral Artery Disease (PAD)

181
Q

What condition involves claudication in calf (worse with exercise, better with rest; pain worse with elevation?

A

Peripheral Artery Disease (PAD)

182
Q

What condition involves Leriche syndrome? What are the three aspects of this syndrome?

A

Peripheral Artery Disease (PAD)

  • Claudication
  • Absent/diminished femoral pulses
  • ED
183
Q

What condition involves pallor with foot elevation, rubor when lowered; hairless skin; ulcers; diminished/absent pulses?

A

Peripheral Artery Disease (PAD)

184
Q

What condition uses Ankle-Brachial Index/ABI diagnostically? What is an abnormal result?

A

Peripheral Artery Disease (PAD)

- <0.90 with exertional symptoms

185
Q

What is the gold standard diagnostic test for Peripheral Artery Disease (PAD)?

A

CTA or MRA (MRA is more expensive/longer but better)

186
Q

What is the primary treatment for Peripheral Artery Disease (PAD)?

A

Lifestyle modifications and aggressive risk factor reduction

187
Q

What is the recommended treatment for claudication?

A

WALK (creates collateral blood flow)

188
Q

What condition involves possible treatment of endovascular (PTA +/- stents, atherectomy) or surgery (bypass graft)?

A

Peripheral Artery Disease (PAD)

189
Q

What two conditions are an EMERGENCY due to threatened limb?

A
  • Critical Limb Ischemia

- Acute Arterial Occlusion

190
Q

What condition involves ischemic rest pain: pain forefoot/toes aggravated by elevation (hang legs over side of bed); non-healing wounds/ulcers; gangrene?

A

Critical Limb Ischemia

191
Q

What is the recommended tx for Critical Limb Ischemia?

A

Endovascular vs. surgery urgently

192
Q

What is the most common cause of Acute Arterial Occlusion?

A

Thromboembolism

193
Q

What condition involves the 6 P’s, and what are they?

A

Acute Arterial Occlusion

  • Paresthesia
  • Pain (distal)
  • Pallor
  • Pulselessness
  • Poikilothermia/coolness
  • Paralysis
194
Q

What condition is caused by valvular incompetence OR DVT with residual vein damage?

A

Chronic Venous Insufficiency

195
Q

What condition involves late stage symptoms of significant edema, skin changes, ulcers?

A

Chronic Venous Insufficiency

196
Q

What condition involves telangiectasias, prominent superficial veins; stasis dermatitis; ulcerations; edema?

A

Chronic Venous Disease (CVD)

197
Q

What condition involves risk factors of older age, obesity, smoking, prior DVT, pregnancy, prior trauma, FH, standing occupation?

A

Chronic Venous Disease (CVD)

198
Q

What condition involves venous HTN → dysfunction of venous valves, failure of “venous pump”?

A

Chronic Venous Disease (CVD)

199
Q

What is pigmentation due to Hb byproduct? What condition is it associated with?

A

Hemosiderin staining

- Chronic Venous Disease (CVD)

200
Q

What condition involves lipodermatosclerosis and stasis dermatitis?

A

Chronic Venous Disease (CVD)

201
Q

What is inflammation, scaling, pruritis (commonly medial ankle)?

A

Stasis dermatitis

202
Q

For all peripheral vascular diseases, what diagnostic tool is often used in office, if available?

A

Doppler US

203
Q

What is the gold standard diagnostic tool for Chronic Venous Disease (CVD)?

A

Venography

204
Q

What condition involves recommended tx of elevate legs; compression therapy? What MUST be ruled out before beginning compression therapy (3)?

A

Chronic Venous Disease (CVD)

- Only if arterial disease/DVT/cellulitis ruled out

205
Q

What condition involves recommended tx of ablations; sclerotherapy; surgery (vein stripping/grafting)?

A

Chronic Venous Disease (CVD)

206
Q

Is pain upon walking, resolves with rest associated with arterial PVD or venous PVD?

A

Arterial

207
Q

Is cramping associated with arterial PVD or venous PVD?

A

Arterial

208
Q

Is worsening pain when leg is elevated associated with arterial PVD or venous PVD?

A

Arterial

209
Q

Is relief of pain in dependent position associated with arterial PVD or venous PVD?

A

Arterial

210
Q

Is pain worse with standing associated with arterial PVD or venous PVD?

A

Venous

211
Q

Is tired, heavy legs associated with arterial PVD or venous PVD?

A

Venous

212
Q

Is relief of pain with leg elevation associated with arterial PVD or venous PVD?

A

Venous

213
Q

Is increased discomfort with limb dependency associated with arterial PVD or venous PVD?

A

Venous

214
Q

Are ulcers of the toe joints, malleoli, anterior shin, base of heel or pressure points associated with arterial PVD or venous PVD?

A

Arterial

215
Q

Are ulcers with a dry, often pale/necrotic base associated with arterial PVD or venous PVD?

A

Arterial

216
Q

Are ulcers WITHOUT a pulse associated with arterial PVD or venous PVD?

A

Arterial

217
Q

Is skin with atrophy, shiny, taut, loss of hair associated with arterial PVD or venous PVD?

A

Arterial

218
Q

Are ulcers of the malleoli above bony prominences, posterior calf, large/circumferential associated with arterial PVD or venous PVD?

A

Venous

219
Q

Are ulcers with a pulse associated with arterial PVD or venous PVD?

A

Venous

220
Q

Are ulcers with a pink/red, yellow, exudate base associated with arterial PVD or venous PVD?

A

Venous

221
Q

Is skin with erythema, hyperpigmentation, edema, dry, varicosities associated with arterial PVD or venous PVD?

A

Venous

222
Q

What is the most common cause of aortic disease?

A

Atherosclerosis

223
Q

What type of aortic dissection has the worst prognosis?

A

Type A

224
Q

What condition involves sudden onset severe/persistent chest pain, that radiates to back; syncope; CVA-like symptoms; Hypertensive → Hypotensive/Shock?

A

Aortic disease

225
Q

What is the test of choice for Aortic disease?

A

CT chest/abdomen

226
Q

What might a CXR for Aortic disease show?

A

Widened mediastinum

227
Q

What type of Aortic disease is catastrophic (no time for emergent repair)?

A

Thoracic Aortic Aneurysm (TAA) that RUPTURES

228
Q

What is the most common site for an Abdominal Aortic Aneurysm (AAA)?

A

Infrarenal abdominal aorta

229
Q

What condition involves excruciating abdominal pain radiation to back just before rupture?

A

Abdominal Aortic Aneurysm (AAA)

230
Q

What is the test of choice for Abdominal Aortic Aneurysm (AAA) SCREENING?

A

Abdominal US

231
Q

What condition involves TIA; Amaurosis fugax (transient blindness)?

A

Cerebrovascular Disease: Carotid Artery Stenosis

232
Q

What condition involves carotid bruit, absent pupillary light reflex?

A

Cerebrovascular Disease: Carotid Artery Stenosis

233
Q

What diagnostic tool should be considered first with Cerebrovascular Disease: Carotid Artery Stenosis?

A

Carotid duplex

234
Q

What is the gold standard diagnostic test for Cerebrovascular Disease: Carotid Artery Stenosis?

A

Cerebral angiography

Clin Med I Disease Key Notes (4 decks)

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