PAD Flashcards
Signs of Acute Limb Ischemia include:
Pulseless (all classes)
Pain
Pallor
Paresthesia
Paralysis
Typical clinical picture of Chronic Limb Ischemia […]
Intermittent claudication
Relieved by rest
[…] is the first sign in all classes of ALI
Absent pulse
ALI classes:
Class 1 : […]
Class 2 : […]
Class 3 : […]
1: Moderate pain
2: Severe pain, paresthesia
3: No pain, paralyzed limb
[…] is a common cause of ALI in cardiac patient (recent MI / A fib)
Arterial Emboli
Most appropriate first step in management of ALI is […]
Heparin
💚💉
Best confirmatory test for Acute Limb Ischemia […]
Angiography
…
ALI= Angio
Best confirmatory test for Chronic Limb Ischemia […]
CT-A = DSA
…
CLI= CTA
Steps in the approach of ALI:
Heparin -» […] -» […] -» Angiography
Heparin - Duplex US - CTA - Angio
Definitive first line treatment of ALI is […] unless in cardiac cause or A fib where […] is indicated
Catheter thrombolysis
Unless cardiac » Embolectomy
Choose Amputation in ALI case if :
- Acute on chronic
- Class III with irreversible paralysis
Most common risk factor for a venous ulcer is […]
Venous hypertension
Followed by age
In foot ulcer with absent pulse indicating […] issue. […] is most appropriate for diagnosis
Arterial
Arterial US
In foot ulcer with intact pulse & dark skin discoloration, indicating […] issue. […] is most appropriate for diagnosis
Venous
Venous US
Patient with PAD, how to improve walking distance?
Supervised exercise program
Elderly smoker with DM comes for ulcer on the tip of three of his toes, diminished dorsalis pedis bilaterally but intact popliteal pulse. Best initial management:
Debridement
If not present : Diet & lifestyle modifications
Diabetic patient with pseudo-hyperepithelizstion in situ
What should you do?
Repeat biopsy
To role out SCC
For patient with AAA
Who is asymptomatic and stable
Next step : […]
US (screening)
For patient with AAA
Who is symptomatic but stable
Next step : […]
CTA
For patient known case AAA
Who is unstable
Next step : […]
Immediate laparotomy
For patient present with AAA symptoms (unknown case)
Who is currently unstable
Next step : […]
US
During lap chole you found AAA 4.5 cm
What you will do?
Do the surgery and follow up with US
Screen for AAA in heavy smokers at age […]
65
Which electrolyte disturbance is seen after AAA repair?
HypoMg
67 yo male diagnosed with PAD. Best way to prevent cardiovascular event:
A. Warfarin
B. Heparin
C. Aspirin
D. Clopidogrel
C. Aspirin
65 yo male present to ER with acute left LL pain for 3 hours associated with numbness & absent pulse. ECG: atrial fibrillation. Best next step:
A. Heparin
B. CT angio
C. Arteriography
D. US doppler
A. Heparin
Absent pulse » confirm with ABI
1. Start heparin
2. CT angio
3. Angiography with revascularization
