PAD large group Flashcards
What is the number one risk factor for PAD?
smoking!
What does a low ABI indicate?
poor blood flow
only 18% of these pts have claudication (too little blood flow during exercise
What are the stages of PAD?
(ABI need to revascularize )
*What percentage of people with PAD are asymptomatic?
40%
symptoms could include: pain with walking, mm atrophy, hair loss, atrophic skin, cool skin, decreased pulses, non-healing ulcers, cold digits
What is the tunica media made of?
smooth mm.
*What is the process of atherosclerosis?
first decade: foam cell=> fatty streak =>
third decade: intermediate lesion=> atheroma =>
(1st–> 3rd decade normally grow through lipid accumulation)
fourth decade: fibrous plaque => complicated lesion/rupture
(4th decade growth through smooth mm and collagen, thrombosis and hematoma)
What is a normal TBI (toe brachial index)?
> .75=normal
<.25=severe PAD
use TBI because not as calcified as ankle AAs
What is the normal transcutaneous oxygen level? impaired healing? ischemic rest pain?
> 55mmHg normal
< 30mmHg impaired
healing
20mmHg predicts ischemic rest pain
What causes an ABI >1.3?
Monckeberg’s medial calcific sclerosis
What makes statins good for PAD?
a very low hazard ratio
What is the treatment for critical limb ischemia?
revascularization
*What is the main presentation of thromboangitis obliterates (Buergers disease)?
Tibial and Radial arteries affected in young men that smoke
hand and foot
–> claudication and gangrene (inflammatory response causes damage)
Where do the majority of arterial emboli originate?
the heart
Left atrium, mural (s/p MI), valves, aneurysms
A fib
What are the 6 Ps of arterial emboli?
pale, pulseless, painful, paralyzed, paresthesia, perishing cold (freezing)
what is the order of color changes in Raynaud’s?
blue==> pale==> red