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CPR Exam 1 > PAD > Flashcards

PAD Flashcards

1
Q

what is a TIA?

A

reversible ischemia in the brain
collateral flow reestablishes perfusion
increased risk of stroke

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2
Q

what is the clinical presentation of carotid stenosis?

A

amaurosis fugax (vision loss)
TIAs
ischemic stroke on the same side as the lesion

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3
Q

what are risk factors for CAS?

A 
HTN
heart disease
age
smoking
male
HLD
DM
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4
Q

when should you screen a patient for CAS?

A

cervical bruit
OR
known atherosclerotic disease

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5
Q

what is the best imaging tool to diagnose CAS?

A

US

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6
Q

what is an abdominal aortic aneurysm?

A

aorta with diameter > 3 cm

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7
Q

at what diameter is an AAA likely to rupture?

A

> 5 cm

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8
Q

where are AAA most likely to occur?

A

below the renal arteries

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9
Q

what else is commonly involved in AAA?

A

aortic bifurcation

iliac arteries

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10
Q

HY: what is AAA most often associated with?

A

atherosclerosis

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11
Q

HY: what is aortic dissection most often associated with?

A

HTN

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12
Q

what is the clinical presentation of a ruptured AAA?

A

abdominal pain that radiates to the back
hypertension before rupture
hypotension after rupture

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13
Q

what is the clinical presentation of symptomatic AAA?

A

mild to severe abdominal pain that may radiate to lower back
constant or intermittent
exacerbated by gentle pressure on the aneurysm sack

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14
Q

what are inflammatory aneurysms?

A

inflammatory peel that surrounds the aneurysm and encases adjacent retroperitoneal structures

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15
Q

what lab findings are associated with a ruptured aneurysm?

A

normal hct

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16
Q

what is the best imaging tool to diagnose a ruptured AAA?

A

abd US

17
Q

what is the treatment for a ruptured AAA?

A

emergency repair

18
Q

when is surgery contraindicated in an AAA?

A

an inflammatory aneurysm is present

*unless retroperitoneal structures are compressed

19
Q

what is the best imaging tool to diagnose an AAA?

A

CT with or without contrast

20
Q

what peripheral artery is most often occluded by atherosclerosis?

A

superficial femoral artery

21
Q

when does claudication occur?

A

2-4 blocks when there is occlusion or stenosis of the superficial femoral artery with good collaterals

22
Q

what is claudication?

A

pain during exercise due to ischemia of peripheral muscles

23
Q

besides angiography, what diagnostic tool can predict the presence of PAD?

A

ankle-branchial index

< 0.9 = PAD

24
Q

what does an ABI < 0.4 indicate?

A

chronic limb-threatening ischemia

25
Q

when can is ABI contraindicated?

A

patients with DM, CKD and older adults where vessels may be calcified

26
Q

what should be used instead of ABI when it is contraindicated?

A

toe-branchial index

< 0.7 = PAD

27
Q

what is the treatment for PAD?

A

statin

lifestyle changes

28
Q

when is surgery indicated for PAD?

A

claudication is progressive, incapacitating or interferes with daily activities

mandatory for ischemic rest pain or ischemic ulcers

29
Q

what surgeries can be utilized to treat PAD?

A

fem-pop bypass
angioplasty
stenting
thromboendarterectomy

30
Q

what medications can treat PAD?

A 
statins 
anti-HTN
insulin for DM
ASA
clopidogrel
cilostazol
31
Q

what are the risk factors for PAD?

A

50-69 with hx of smoking or DM

< 50 with DM + HTN/HLD/smoking
> 65
abnormal LE pulses
known atherosclerosis

32
Q

what are the screening steps for suspected PAD?

A
  1. screen with ABI

2. if negative and still suspicious –> exercise stress test with post-exercise ABI

33
Q

what is the most common cause of chronic venous insufficiency?

A

venous HTN secondary to venprogressive superficial venous reflux

34
Q

what are common clinical of venous insufficiency?

A 
pitting edema of LE
brawny skin hyperpigmentation 
subcutaneous lipodermatosclerosis
large ulcerations at or above the medial ankle
varicose veins
cellulitis
35
Q

what are common clinical complaints of venous insufficiency?

A

itching
dull discomfort made worse by standing long periods
ulcers

36
Q

what imaging is used to diagnose venous insufficiency?

A

duplex US

37
Q

what is the first-line treatment for venous insufficiency?

A

fitted, graduated compression stockings
intermittent elevation of the legs
sleeping with legs above the heart

38
Q

what is the treatment for severe venous reflux or obstruction?

A

venous stenting

CPR Exam 1 (19 decks)

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