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Cardiology Med-Study > Lecture 7: PAD, Carotid, Vasospastic > Flashcards

Lecture 7: PAD, Carotid, Vasospastic Flashcards

1
Q

ABI > 1:40

next step

A

non-compressible

toe-brachial

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2
Q

ABI 1-1.4

A

normal

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3
Q

ABI 0.91-0.99

A

borderline

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4
Q

ABI < 0.90

A

abnormal

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5
Q

indications for exercize aBI

A

if exertional symptoms

borderline ABI 0.91-0.99

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6
Q

positive result excerize ABI

A

20% decrease in excerize or > 30 mmHg drop in ankle pressure

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7
Q

positive TOE

A

PAD is diagnosed if
1. < 0.70
OR
SBP < 40

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8
Q

definition of critical limb ischemia

A

ABI < 0.4 with flat waveform

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9
Q

how to differ from lumbar spinal stensosi

A
  • LBS - relieved by flexing spine, walking while leaning.
  • worse with especially dowhill
    (AUGUSTE)
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10
Q

Dx of lumbar stenosis

A

MRI of lumbar spine

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11
Q

BP goal in PAD

A

< 130/80

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12
Q

medication RX for risk manangmeent

A
  • ASA or clopidrogel monotherapy

- high intensity statin

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13
Q

tx PAD, 1st line

A

supervisized excercize program

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14
Q

tx PAD, 2nd line

A

cilastozol, PDE inhibitor only in normal LV function

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15
Q

main contraindication of cilastazol

A

needs to have normal LV function

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16
Q

6 P of critical ischemia

A 
Pain
Pallor
Pulsenessess
Parasthesia
Poikothermia
Paralysis
17
Q

TX critical ischemia

A

< 3 hours- catheter directed thrombolysis with angioplasty (muscle strength normal)
> 3 hours (or gangrene, paralysis) - limb amputation

18
Q

post intervention on PAD to look for

A

cholesterol emboli and compartment syndrome

19
Q

screening for PAD may be reasonable –>

A

screening may be reasonable in persons with one of the following characteristics that signify increased risk: (1) age 65 years and older, (2) age 50 to 64 years with risk factors for atherosclerosis or family history of PAD, (3) age younger than 50 years with diabetes mellitus and one additional risk factor for atherosclerosis, or (4) known atherosclerotic disease in another vascular bed (coronary, carotid, subclavian, renal, or mesenteric artery stenosis, or abdominal aortic aneurysm).

20
Q

how to calculate ABI

A

the ABI is calculated by dividing the ankle pressure (dorsalis pedis (DP) and the posterior tibial (PT) arteries, and the higher of the two is used as the ankle pressure for that leg) by the higher of the two brachial pressures

21
Q

Buerger’s disease pathophysiology

A

inflammation distal extremity small/medium arteries which causes digital ischemia/ulcers

22
Q

who gets buerger’s

A

male, < 45, smokers

23
Q

tx Buerger’s

A

stop smoking or amputation

24
Q

Takayau disease pathophysiology

A

medium/large upper extremity/heart arteries off the aorta –< thrombosis/inflammation

25
Q

tx Takayau

A

high dose prednisone + immunosuppresants

26
Q

PE Takayasu

A

SBP > 10 mmHg difference between arms

subclavian bruit.

27
Q

who gets Takayasu

A

Asian women below 40

28
Q

who gets Primary Raynaud Syndrome

A

women < 40 y.o,

29
Q

pathophysiology for Raynaud

Mnemonic of PE

A

vasospasm of distal extremity to changes in temperatue or mood.
White–> blue–< red (reactive hyperemia)

30
Q

tx Raynaud

A

CCB, Nitroglycerin

31
Q

features of Prinzmetal angina

A

younger person, vaso-occlusion with transient ST elevations.

32
Q

tx Prinzmetal

A

CCB

33
Q

if carotid ultrasound is positive for stenosis, then next step

A

If the carotid ultrasound shows significant stenosis, the percentage of narrowing and the anatomic location should be confirmed with either CT angiography or MRA without contrast before recommending stenting procedures or other surgery

34
Q

Class I indication for end carotid arterectomy

A

ipsilateral carotid 70% on ultrasound or 50% by catheter angiography with previous history of stroke or TIA within the last 6 months

35
Q

medications to put the patient on if stent carotid

A

ASA + clopidogrel x 1 month

36
Q

if stroke and no other cause is found, which test will help prove etiology

A

30 day holter monitor to look for intermittent atrial fibrillation

37
Q

1st line indication for CEA

A

within 6 months TIA/Stroke and ipsilateral stroke > 70% non-invase and > 50% by cathter angio

Cardiology Med-Study (9 decks)

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