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7442 Cardio Test 3 > PAD > Flashcards

PAD Flashcards

1
Q

Non-modifiable risk factors:

A

age
sex
race/ethnicity
FH of CVD

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2
Q

Modifiable risk factors:

A 
smoking
DLD
DM
HTN
microalbuminuria
obesity/overweight
alcohol
stress
physical inactivity
poor diet/nutrition
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3
Q

What age is the main marker for ASCVD risk?

A

> 40

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4
Q

What diagnostic is used for PAD?

A

ankle-brachial index (ABI)

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5
Q

> 50% occlusion

A

intermittent claudication

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6
Q

> 80% occlusion

A

critical limb ischemia (CLI)

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7
Q

Fontaine PAD classification stage I

A

reduced pulses

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8
Q

Fontaine PAD classification stage II

A

intermittent claudication

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9
Q

Fontaine PAD classification stage III

A

pain even when resting

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10
Q

Fontaine PAD classification stage IV

A

ulcers

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11
Q

What age is high risk?

A

> = 65 yrs

should be tested

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12
Q

What age is high risk with risk factors for atherosclerosis (DM, DLD, HTN, smoking)?

A

50-64

should be tested

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13
Q

What age is high risk with DM + 1 additional ASCVD risk factor?

A

<= 50

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14
Q

non compressible ABI?

A

> 1.40

requires further diagnostics

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15
Q

mild to moderate ABI?

A

0.41-0.90

abnormal

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16
Q

severe PAD?

A

<= 0.40

abnormal

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17
Q

Used to establish PAD Dx in symptomatic pts when resting ABI is normal-borderline?

A

exercise ABI testing

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18
Q

Used to establish PAD Dx in pts wit non compressible arteries (ABI > 1.40)?

A

toe-brachial intex (TBI)

19
Q

What is most important modifiable risk factor?

A

smoking cessation

advise them to quit at every visit

20
Q

Exercise prescription?

A

30-45mins/session 3 or more times/week for 12 or more weeks

walk at incline/speed to produce IC Sx within 3-5mins

21
Q

High intensity statin therapy?

A

lower LDL by >= 5o%

atorvastatin 40-80mg
rosuvastatin 200-40mg

22
Q

BP goal?

A

< 130/80

ACEi or ARB

23
Q

HbA1c goal?

A

< 7 %

24
Q

Preferred diabetes meds?

A

SGLT2i and GLP1 receptor agonists

added after metformin

25
Q

antiplatelet therapy is reasonable in what pts?

A

asymptomatic with ABI < 0.90

aspirin 75-325mg PO QD
clopidogrel 75mg PO QD

26
Q

antiplatelet therapy is recommended in what pts?

A

symptomatic with ABI < 0.90

aspirin 75-325mg PO QD
clopidogrel 75mg PO QD

27
Q

When may dual antiplatelet therapy be reasonable?

A

after lower extremity revascularization

28
Q

The clinical benefit of what agent added to existing antiplatelet therapy is uncertain?

A

vorapaxar

used in addition to aspirin and/or clopidogrel

29
Q

Preferred first line PAD antiplatets?

A

aspirin or clopidogrel

30
Q

Should anticoagulants be used in pts with PAD?

A

no

no benefit and increased bleeding risk with warfarin + antiplatelet therapy

31
Q

What is an effective therapy to improve Sx and increase walking distance in pts with claudication?

A

cilostazol

FDA approved in combo with antiplatelet therapy

32
Q

Cilostazol is contraindicated when?

A

HF of any severity

33
Q

Is pentoxifylline recommended for treatment of claudication?

A

no

34
Q

How often is ABI monitored?

A

q 3-6 months

Measurements to assess ASCVD:

  • fasting lipid panel
  • HbA1c
  • BP
35
Q

How often is treadmill testing done in pts with IC?

A

q 3-6months

36
Q

Exercise

Sx improvement?
ASCVD risk reduction?

A

Sx improvement: yes

ASCVD: no

37
Q

smoking cessation

Sx improvement?
ASCVD risk reduction?

A

Sx: yes
ASCVD: yes

38
Q

statins

Sx improvement?
ASCVD risk reduction?

A

Sx: yes
ASCVD: yes

39
Q

BP control

Sx improvement?
ASCVD risk reduction?

A

Sx: no
ASCVD: yes

40
Q

ACEi and/or ARB

Sx improvement?
ASCVD risk reduction?

A

Sx: yes
ASCVD: yes

41
Q

glycemic control

Sx improvement?
ASCVD risk reduction?

A

Sx: no
ASCVD: yes

42
Q

antiplatelets

Sx improvement?
ASCVD risk reduction?

A

Sx: no
ASCVD: yes

43
Q

cilostazol

Sx improvement?
ASCVD risk reduction?

A

Sx: yes
ASCVD: no

7442 Cardio Test 3 (6 decks)

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