Lecture 7.2 vasc. more important pts (incl. in 5%)

Question 1

List the 7 red flags for the peripheral vascular system

Answer 1

1) Abdominal AND back pain
2) Pain with eating or “food fear”
3) Intermittent claudication
4) Cold, numbness, pallor, and hair loss in the legs
5) Swelling in the calves, legs, or feet
-May be unilat or bilat
6) Color change in fingertips or toes in cold weather
7) Swelling with redness or tenderness

Question 2

1) What can food fear be a sign of? Why?
2) Describe intermittent claudication and what condition it can be a sign of
3) What can coldness, numbness, pallor, and hair loss in the legs be a sign of?

Answer 2

1) Chronic mesenteric ischemia or other incomplete occlusion; when you eat more, there’s increased blood demand, causing painful incomplete ischemia
2) Peripheral arterial disease; when you flex muscles and move around, tissues need more circulation, hurts bc of ischemia
3) Peripheral arterial disease (chronic ischemia)

Question 3

1) What can swelling in the calves, legs, or feet be a sign of when it’s bilateral?
2) What about when unilateral?

Answer 3

1) Both sides, esp when red and hot = HF
2) One side = DVT

Question 4

Color change in fingertips or toes in cold weather is a sign of what?

Answer 4

Raynaud’s

Question 5

1) Is AAA bad?
2) What may it be on an abdominal exam?
3) What should you not do?

Answer 5

1) A very bad badness
2) May even be pulsatile on abdominal exam
3) Do not compress or deeply palpate a pulsatile abdominal mass

Question 6

1) What are the two types of mesenteric ischemia?
2) When is there pain but not bowel death?
3) What is an associated symptom of this disease?
4) What is necrosis associated with?

Answer 6

1) Acute or chronic
2) In the chronic case
3) “Food fear”
4) An acute disease

Question 7

What is PAD characterized by? (6 things)

Answer 7

1) Claudication
2) Color change (rubor / pallor, particularly with position)
3) Hairlessness of the legs
4) Non-healing [dry] ulcers
5) Poikilothermia
6) Diminished pulses

Question 8

What should you ask about regarding PAD?

Answer 8

Erectile dysfunction

Question 9

Is PAD blanching or non-blanching?

Answer 9

Blanching

Question 10

1) What does venous insufficiency do to lower extremities?
2) What does it do to the skin?
3) What type of laceration can it cause? Over what bone in particular?

Answer 10

1) Swelling in lower extremity
2) Chronic skin changes
3) Distal, nonhealing, wet ulcers (esp. over medial malleolus bc of great saphenous vein)

Question 11

1) What characterizes DVTs?
2) Where can it also occur?
3) What key question should you ask? Why?

Answer 11

1) One-sided redness swelling and pain, usually in the calf
2) Although they can occur in the upper extremity
3) About SOB (bc DVTs turn into PEs)

Question 12

1) What causes Raynaud’s?
2) What causes varicose veins?

Answer 12

1) Peripheral vascular disease impeding circulation
2) Valvular insufficiency

Question 13

What 3 things should you screen regarding peripheral vascular?

Answer 13

1) AAA
2) PAD
3) ABI (test for PAD)

Question 14

1) What demographic is most likely to have AAA?
2) What demographic is most likely to have PAD?
3) What should you obtain when PAD is suspected?

Answer 14

1) 65, male, smoker
2) 65 (*or 50 with smoking or DM)
3) ABI

Question 15

Name 2 characteristics of PAD

Answer 15

1) Leg claudication with exertion
2) Nonhealing (dry) wounds

Question 16

1) What is ABI?
2) What should it be more than?

Answer 16

1) Highest ankle pressure/ highest arm pressure
2) 0.9