Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology > Medical Management of Peripheral Vascular Disease > Flashcards

Medical Management of Peripheral Vascular Disease Flashcards

1
Q

Aims of Medical Management of PVD

A

Relieve Symptoms
Improve walking distance/QOL
Limit progression of the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk Factors for PVD

A

Age
Smoking
Diabetes
HIgh BP, Cholesterol and homocyteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatments of PVD

A

Risk factor modification
Drug therapies (anti-platelets, etc)
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Smoking Cessation

A

Slow progression of disease/progression to CLI
Reduces risk of death from other cardiovascular causes
Does not improve walking distance/claudication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treating High cholesterol

A

Statins reduce serum cholesterol and improve endothelial function
Reduces risk of death from other cardiovascular causes
No direct effect on PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diabetic control

A

Prevents microvascular complications (nephropathy, retinopathy, neuropathy)
Not clear if effective on Macrovascular complications
Does not affect amputation risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treating Hypertension

A

Not clear if effective at slowing disease progression.

Effective at preventing strokes/ other cardiovascular death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Calcium Channel Blockers in PVD

A

Act as vasodilators
May increase flow by decreasing small vessel resistance
Can reduce systemic blood pressure reducing flow to limb
Proven to help in Raynaud’s
Not clear if helpful in PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Reducing homocysteine levels

A

Can use B vits and folate to reduce serum homocysteine

But no evidence it has any effect in coronary or PVD patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anti-platelet Therapy

A

V effective at reducing cardiovascular/ischemic deaths

maintains graft patency and reduces thrombotic complications of PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Exercise Therapy

A

Improves functional capacity by development of collaterals
Gives comparable benefit to bypass surgery
Requires motivation and supervision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Exercise therapy is best if

A

sessions > 30 mins
>3 sessions a week
>6 months of sessions
Benefits start after four weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anti-platelet agents used in PVD

A

Asprin routinely given
Clopidegrel given instead if allergic to aspirin
Both given if high risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Use of Anti-hypertensive Agents in PVD

A

Vasodilating B-blocker (nebivolol, carvedilol) ok in moderate but not severe disease
ACEi/ARBs must be used cautiously due to risk of renal disease in PVD patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug Rx of Claudication: Cilostazol

A

PDE3 inhibitor - anti-platelet, vasodilator, inhibits VSMC proliferation
Small increase in ABI and HDL
Found to improve walking distance/QOL indicators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Problems with Cilstazol

A

Side effects- headache, diarrhoea, palpitations, dizziness
Contraindicated in heart failure
Not currently endorsed by NICE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Drug Rx of Claudication: Naftidrofuryl

A

5HT2 receptor blocker
Improves painfree but not max walking distance
NICE endorses its use in appropriate patients

18
Q

Drug Rx of Claudication: Levocarnitine

A

May improve metabolism and performance in ischemic skeletal muscle
Possible positive effect on walking distance and QOL
Not currently licensed

19
Q

Drug Rx of Claudication: Prostaglandins

A

PGE1/beraprost (synthetic analogue) improve walking distance/QOL
Mainly studied for treating CLI
Can cause headache, flushing and GI side-effects

20
Q

Claudication

A

Leg pain on exertion due to insufficient oxygen supply - Occurs in 15-40% of PVD patients

21
Q

Critical Leg Ischemia

A

Ischemic pain at rest due to terminal lack of supply to leg - mortality 25%

22
Q

Risk Factors for PVD

A

Age
Smoking
Diabetes
HIgh BP, Cholesterol and homocyteine

23
Q

Treatments of PVD

A

Risk factor modification
Drug therapies (anti-platelets, etc)
Surgery

24
Q

Smoking Cessation

A

Slow progression of disease/progression to CLI
Reduces risk of death from other cardiovascular causes
Does not improve walking distance/claudication.

25
Q

Treating High cholesterol

A

Statins reduce serum cholesterol and improve endothelial function
Reduces risk of death from other cardiovascular causes
No direct effect on PVD

26
Q

Diabetic control

A

Prevents microvascular complications (nephropathy, retinopathy, neuropathy)
Not clear if effective on Macrovascular complications
Does not affect amputation risk

27
Q

Treating Hypertension

A

Not clear if effective at slowing disease progression.

Effective at preventing strokes/ other cardiovascular death

28
Q

Calcium Channel Blockers in PVD

A

Act as vasodilators
May increase flow by decreasing small vessel resistance
Can reduce systemic blood pressure reducing flow to limb
Proven to help in Raynaud’s
Not clear if helpful in PVD

29
Q

Reducing homocysteine levels

A

Can use B vits and folate to reduce serum homocysteine

But no evidence it has any effect in coronary or PVD patients.

30
Q

Anti-platelet Therapy

A

V effective at reducing cardiovascular/ischemic deaths

maintains graft patency and reduces thrombotic complications of PVD

31
Q

Exercise Therapy

A

Improves functional capacity by development of collaterals
Gives comparable benefit to bypass surgery
Requires motivation and supervision

32
Q

Exercise therapy is best if

A

sessions > 30 mins
>3 sessions a week
>6 months of sessions
Benefits start after four weeks

33
Q

Anti-platelet agents used in PVD

A

Asprin routinely given
Clopidegrel given instead if allergic to aspirin
Both given if high risk

34
Q

Use of Anti-hypertensive Agents in PVD

A

Vasodilating B-blocker (nebivolol, carvedilol) ok in moderate but not severe disease
ACEi/ARBs must be used cautiously due to risk of renal disease in PVD patients

35
Q

Drug Rx of Claudication: Cilostazol

A

PDE3 inhibitor - anti-platelet, vasodilator, inhibits VSMC proliferation
Small increase in ABI and HDL
Found to improve walking distance/QOL indicators

36
Q

Problems with Cilstazol

A

Side effects- headache, diarrhoea, palpitations, dizziness
Contraindicated in heart failure
Not currently endorsed by NICE

37
Q

Drug Rx of Claudication: Naftidrofuryl

A

5HT2 receptor blocker
Improves painfree but not max walking distance
NICE endorses its use in appropriate patients

38
Q

Drug Rx of Claudication: Levocarnitine

A

May improve metabolism and performance in ischemic skeletal muscle
Possible positive effect on walking distance and QOL
Not currently licensed

39
Q

Drug Rx of Claudication: Prostaglandins

A

PGE1/beraprost (synthetic analogue) improve walking distance/QOL
Mainly studied for treating CLI
Can cause headache, flushing and GI side-effects

40
Q

Blood profile monitoring in statins

A

Lipid screen: before, 12 weeks after start, every year after
LFTs: as lipids (look out for ASTs)
CK: before therapy, repeat if muscle pain

41
Q

Site of action of LWMH

A

Activates antithrombin III

Inhibits factor Xa

Cardiology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions