Illness script - week 2 Flashcards by Andy Le

Peripheral vascular disease

Describes a variety of conditions affecting the _____, _____, _____ and _____ in areas such as the _____, _____, and _____

Peripheral vascular disease

Describes a variety of conditions affecting the aorta, arteries, veins and lymphatics in areas such as the neck, abdomen and extremities

How well did you know this?

Not at all

Perfectly

Arterial wall

1) _____: single layer of endothelial cells
2) _____: Elastin, collagen and muscular layer
3) _____: collagen layer

Arterial wall

1) Intima: single layer of endothelial cells
2) Media: Elastin, collagen and muscular layer
3) Adventitia: collagen later

How well did you know this?

Not at all

Perfectly

Aneurysm

Abnormal _____ or _____ in the wall of a blood vessel such as an _____

Aneurysm

Abnormal swelling or bulge in the wall of a blood vessel such as an artery

How well did you know this?

Not at all

Perfectly

Arterial disease

_____ condition in which a narrowed blood vessel reduces blood flow to the _____

Arterial disease

Circulatory condition in which a narrowed blood vessel reduces blood flow to the limbs

How well did you know this?

Not at all

Perfectly

Thrombi

A blood _____ that forms in a blood vessel and _____ there

Thrombi

A blood clot that forms in a blood vessel and remains there

How well did you know this?

Not at all

Perfectly

True aneurysm

Involves all 3 layers of the _____ wall
E.g. _____ disease and _____

True aneurysm

Involves all 3 layers of the arterial wall
E.g. Marfan’s disease and atherosclerosis

How well did you know this?

Not at all

Perfectly

False aneurysm

Not an aneurysm but a _____ _____ which has developed from a disruption to __-__ layers of the arterial wall

False aneurysm

Not an aneurysm but a pulsatile haematoma which has developed from a disruption to 1-2 layers of the arterial wall

How well did you know this?

Not at all

Perfectly

Atherosclerotic aneurysm

Commonly affects the _____ _____ below the _____ _____

Atherosclerotic aneurysm

Common affects the abdominal aorta below renal arteries

How well did you know this?

Not at all

Perfectly

Fusiform

_____ shaped, circumference of artery, usually the _____ _____ _____ (AAA)

Fusiform

Spindle shaped, circumference of artery, usually the abdominal aortic aneurysm (AAA)

How well did you know this?

Not at all

Perfectly

Saccular

_____ out to _____ side

Saccular

Ballooning out to one side

How well did you know this?

Not at all

Perfectly

Medical management of Aneurysms

1) IV cannula
2) _____ cross match, _____, _____, _____ and _____
3) Oxygen
4) _____ (ECG)
5) _____ catheter

Medical management of Aneurysms

1) IV cannula
2) Blood cross match, haemoglobin, coagulation, electrolytes and creatine
3) Oxygen
4) Electrocardiograph (ECG)
5) Urinary catheter

How well did you know this?

Not at all

Perfectly

Surgical intervention of Aneurysms

Incision in the mid line of the _____ and along the _____ length, a _____ is inserted to the un-involved proximal and distal ends of the _____, the wall is closed to prevent the _____ making direct contact with the _____

Surgical intervention of Aneurysms

Incision in the mid line of the abdominal and along the aneurysm length, a graft is inserted to the un-involved proximal and distal ends of the aorta, the wall is closed to prevent the graft making direct contact with the duodenum

How well did you know this?

Not at all

Perfectly

Complications of Aneurysm surgery

1) Arrythmias
2) _____ _____ _____ (AMI)
3) Pulmonary _____
4) _____ and _____ failure
5) Haemorrhage
6) Graft _____
7) _____ _____ and _____ ischaemia
8) Infection

Complications of Aneurysm surgery

1) Arrythmias
2) Acute myocardial infarction (AMI)
3) Pulmonary oedema
4) Renal and respiratory failure
5) Haemorrhage
6) Graft occlusion
7) Spinal cord and mesenteric ischaemia
8) Infection

How well did you know this?

Not at all

Perfectly

Peripheral arterial occulsive diesease

Acute caused by _____ which is a _____ from the heart of aneurysm, aggregate of fat which is commonly found in the _____ or _____

Peripheral arterial occulsive disease

Acute caused by emboli which is a thrombus from the heart or aneurysm which is aggregate of fat commonly found in the lungs or brains

How well did you know this?

Not at all

Perfectly

Vascular trauma

Can be caused from a _____ _____ accident, _____ wound, _____ instruments, _____ injuries and _____

Vascular trauma

Can be caused from a motor vehicle accident, gunshot wound, sharp instruments, crush injuries and fractures

How well did you know this?

Not at all

Perfectly

Classic presentations of arterial occlusive disease - 6Ps

1) _____
2) _____
3) _____
4) _____
5) _____
6) _____

Classic presentations of arterial occlusive disease - 6Ps

1) Pain
2) Pallor
3) Pulselessnesss
4) Parasthesia
5) Paralysis
6) Poikilothermia

Diagnosing of arterial occlusion

1) _____/_____ scan
2) _____ _____ _____: used as a screen only

Diagnosing of arterial occlusion

1) Dupplex/doppler scan
2) Arterial brachial pressure: used as a screen only

Medical management of arterial occlusion

1) IV _____
2) _____/_____
3) _____ agent: _____, _____ _____ _____ activator (r-TPA)
4) Bed rest
5) Oral _____ for long-term therapy: _____

Medical management of arterial occlusion

1) IV heparin
2) Embolectomy/thrombectomy
3) Thrombolytic agent: streptokinase, recombinant tissue plasminogen activator (r-TPA)
4) Bed rest
5) Oral anticoagulants for long-term therapy: Warfarin

Ankle brachial pressure index

<0.5:          \_\_\_\_\_ ulcer
0.5 - 0.7:    \_\_\_\_\_ \_\_\_\_\_ ulcer
0.7 - 0.8:    \_\_\_\_\_ ulcer
>0.9:          \_\_\_\_\_ ulcer
>1.2:           \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_

Ankle brachial pressure index

<0.5:           arterial ulcer
0.5 - 0.7:     mixed arterial ulcer
0.7 - 0.8:     venous ulcer
>0.9:           venous ulcer
>1.2:            possible calcified vessels

Chronic causes of arterial occlusion

1) Progressive _____, _____ and _____ of arteries in the extremities which affect the _____, _____, _____, _____ and _____ vessels
2) Smoking
3) _____ and _____ are the main risk factors
4) _____, _____ and _____ history
5) Common __ - __ year old _____ above the knees, _____ is below the knees

Chronic causes of arterial occlusion

1) Progressive narrowing, degeneration and obstruction of arteries in the extremities which affect the aortoiliac, fermoral, popiteal, tibial and peroneal vessels
2) Smoking
3) Hyperlipidaemia and hypertension are the main risk factors
4) Diaetes, obesity and family history
5) Commonly 60 - 80 year old males above the knees, diabetes is below the knees

Management of Arterial occlusion

1) Health promotion: _____, _____, _____ and _____
2) _____, _____, _____ and _____ (CWMS)
3) _____ pulses
4) _____ care
5) _____ _____ care and mobilsation

Management of arterial occlusion

1) Health promotion: Diet, lifestyle, exercise and footcare
2) Colour, warmth, movements and sensations (CWMS)
3) Peripheral pulses
4) Wound care
5) Pressure area care and mobilsation

Virchow’s triad

_____ stasis, _____ damage and hyper-_____ of _____

Virchow’s triad

Venous stasis, endothelial damage and hyper-coagulability of blood

_____, _____, _____, and _____ from a thrombus, it forms a tail behind the clot

If attached to the _____, the _____ process stops and _____ occurs and becomes an _____

RBCs, WBCs, platelets and fibrin form a thrombus, it forms a tail behind the clot

If attached to the lumen, the thrombotic process stops and lysis occurs and becomes an emboli

Superficial thrombophlebitis

Palpable, firm, _____ cord-like vein, area is tender to touch and has _____ and _____ skin

Superficial thombophlebitis

Palpable, firm, subcutaneous cord-like vein, area is tender to touch and has red and warm skin

Deep vein thrombophlebitis May or may not have unilateral leg _____, _____, _____ skin and calf _____

Deep vein thrombophlebitis May or may not have unilateral leg oedema, pain, warm skin and calf tenderness

Chronic venous insufficiency Common complication that has valvular _____, _____, _____, secondary _____, _____ and limb _____

Chronic venous insufficiency Common complication that has valvular destruction, oedema, pigmentation, secondary varicosities, ulceration and limb cyanosis

Management of thrombophlebitis 1) Mild _____ (_____) and NSAIDs (_____) 2) IV _____ and oral _____: to treat _____ _____ 3) _____ _____ _____ time (APPT) and _____ _____ _____ (INR) for clotting profile 4) _____

Management of thrombophlebitis 1) Mild analgesics (aspirin) and NSAIDs (ibuprofen) 2) IV heparin, and oral warfarin: to treat DVT 3) Activated partial prothrombin time (APPT) and international normalised ration (INR) for clotting profile 4) Embolectomy

Pulmonary embolism A blood clot in an artery which stops blood flow to part of the _____, commonly originates from the right _____, up to the right _____ and into the right _____ __% originates as a _____ from _____ and _____ _____ veins Can also be caused by _____ _____

Pulmonary embolism A blood clot in an artery which stops blood flow to part of the lung, commonly originates from the right leg, up to the right heart and into the right lung 95% originates as a thrombi from calf and deep thigh veins Can also be caused by arterial fibrillation

Diagnosing pulmonary embolism 1) _____ X-ray 2) _____ (ECG) 3) __ and __ changes 4) _____ _____ _____ test (ABG) 5) _____ _____/_____ lung scan

diagnosing pulmonary embolism 1) Chest X-ray 2) Electrocardiograph (ECG) 3) ST and T changes 4) Arterial blood gas test (ABG) 5) Radionuclide ventilation/perfusion lung scan

Symptoms of pulmonary embolism 1) _____ 2) _____ 3) _____ 4) _____ 5) _____ 6) _____

Symptoms of pulmonary embolism 1) Pain 2) Dyspnea 3) Apprehension 4) Cough 5) Haemoptysis 6) Sweats

Signs of pulmonary embolism 1) _____ 2) Accentuated pulmonic S__ and/or _____ rhythm 3) _____ 4) Fever and/or _____ 5) _____ 6) _____ _____

signs of pulmonary embolism 1) Tachypnea 2) Accentuated pulmonic S2 and/or gallop rhythm 3) Tachycardia 4) Fever and/or diaphoresis (sweating) 5) DVT 6) Peripheral oedema

Complications of pulmonary embolism 1) _____ _____ 2) _____ _____

complications of pulmonary embolism 1) Pulmonary infarction 2) Pulmonary hypertension

Comorbidities of pulmonary embolism 1) _____ 2) _____ _____ 3) _____ _____ _____ _____

Comorbidities of pulmonary embolism 1) Immobility 2) Venous damage 3) Chronic obstructive pulmonary disease (COPD)

Management of pulmonary embolism 1) IV _____ 2) Oral _____ 3) _____ agents: _____, _____ _____ _____ _____ (r-TPA) 4) _____ _____: _____ _____ _____ _____ (APPT) and _____ _____ _____ (INR)

management of pulmonary embolism 1) IV herparin 2) Oral warfarin 3) Thrombolytic agents: streptokinase, recombinant tissue plasminogen activator (r-TPA) 4) Clotting profiles: Activated partial prothrombin time APPT and International nationalised ration INR

Chronic venous insufficiency Insufficient blood _____ to the _____ due to _____, _____ dysfunction or _____ retention This can lead to _____ hypertension within the veins and causing an _____ response

Chronic venous insufficiency Insufficient blood return to the heart due to obstruction, valvular dysfunction or fluid retention This can lead to venous hypertension within the veins and causing an inflammatory response

Ulcer types 1) Venous: located from _____ _____ to _____, _____ in colour, highly _____, irregular shape, oedema, _____ edges 2) Arterial: located from _____ and _____, punched out look, painful, shiny, _____ legs, atrophy, blanching, _____ pen woud 3) Diabetes: located from the _____ and _____, mostly _____ in aetiology, _____ _____ or new diagnosis of diabetes

Ulcer types 1) Venous: located from lower leg to ankle, dusky in colour, highly exudating, irregular shape, oedema, macerated edges 2) Arterial: located from foot and ankle, punched out look, painful, shiny, hairless legs, atrophy, blanching, erythmic pen wound 3) Diabetes: Located from the foot and ankle, mostly arterial in aetiology, patient history or new diagnosis of diabetes