PAD & SVC syndrome Flashcards
PAD is most commonly a common condition caused by _
PAD is most commonly a common condition caused by atherosclerosis
Peripheral artery disease is _
Peripheral artery disease is compromised blood flow through the arteries that supply the limbs, leading to tissue ischemia
* Causes pain, weakness, gangrene
The major risk factors for PAD include _
The major risk factors for PAD include smoking, diabetes, HTN, hypercholesterolemia, old age
Acute PAD is recognized by the _
Acute PAD is recognized by the 6 P’s
* Pulseless limb
* Pallor
* Poikilothermia (cool)
* Paralysis
* Pain
* Paresthesia
Normal ankle-brachial index is _ ; PAD may be diagnosed with index of _
Normal ankle-brachial index is 1-1.3 ; PAD may be diagnosed with index of below 0.9
Normal individuals can tolerate raised limb tests; patients with PAD may experience pallor at as little as 15 degrees; this is a positive _ test
Normal individuals can tolerate raised limb tests; patients with PAD may experience pallor at as little as 15 degrees; this is a positive Beurger test
Aside from tobacco cessation and weight loss, one of the most important lifestyle modifications for PAD is _
Aside from tobacco cessation and weight loss, one of the most important lifestyle modifications for PAD is exercise regimen –> develops collateral blood vessels
A patient with PAD was given a medication that suppresses smooth muscle cell proliferation and promotes vasodilation; that drug is a _
A patient with PAD was given a medication that suppresses smooth muscle cell proliferation and promotes vasodilation; that drug is a phosphodiesterase inhibitor, like cilostazol
Carotid stenosis due to atherosclerosis build up in the carotid arteries can predispose individuals to _ , _ , or _
Carotid stenosis due to atherosclerosis build up in the carotid arteries can predispose individuals to transient ischemic attack (< 24 hrs) , artery occlusion (retinal ischemia, blindness), or stroke
Amaurosis fugax is _
Amaurosis fugax is monocular vision loss in a “curtain falling” manner
* This occurs in retinal artery occlusion from carotid stenosis
Retinal artery occlusion results in pale retina with ischemic areas called _
Retinal artery occlusion results in pale retina with ischemic areas called cotton-wool spots
Surgical intervention (angioplasty with stent placement) is indicated when the stenosis is _
Surgical intervention (angioplasty with stent placement) is indicated when the stenosis is > 70%
Signs of thoracic aortic aneurysm:
Signs of thoracic aortic aneurysm:
* Chest pain
* Wheezing
* Hoarseness
* Aortic regugitation (near the aortic bulb)
Signs of abdominal aortic aneurysm:
Signs of abdominal aortic aneurysm:
* Abdominal, flank, back pain
Ascending thoracic aortic aneurysms are most commonly caused by _
Ascending thoracic aortic aneurysms are most commonly caused by cystic medial necrosis
* This is degeneration of the aortic media
* Accumulation of ECM in cyst-like spaces
Risk factors for cystic medial degeneration and ascending thoracic aortic aneurysms:
Risk factors for cystic medial degeneration and ascending thoracic aortic aneurysms:
* HTN
* Age
* Connective tissue disorder
* Bicuspid aortic valve
* Syphylis
* TB
Descending thoracic aortic aneurysms are most commonly caused by _
Descending thoracic aortic aneurysms are most commonly caused by atherosclerosis
* Sometimes by takayasu or giant cell arteritis
The most common aortic aneurysm is _
The most common aortic aneurysm is abdominal aortic aneurysm (AAA)
* Most of these will be infra-renal
Chest x-ray of AAA will show _
Chest x-ray of AAA will show widened mediastinum, enlarged aortic knob, esophageal displacement
Thoracic AA tend to (rupture/dissect)
Thoracic AA tend to dissect
Abdominal AA tend to (rupture/dissect)
Abdominal AA tend to rupture
Consequences of AAs include:
- Rupture or dissection due to progressive weakening of the aortic wall
- Compression of surrounding trachea, esophagus, etc
- Thromboembolism if thrombus forms inside dilated aneurysm
How do we treat aortic aneurysms?
Conservative management
Surgical repair when > 5.5 cm or expanding more than 1 cm/year
Infectious aneurysms are aneurysms with an infected wall; they are also called _
Infectious aneurysms are aneurysms with an infected wall; they are also called mycotic aneurysms
* Infection may come first or aneurysm may come first
* Risk factors: trauma, IV drug use, bacteremia, immunosuppression
The most common pathogens that tend to cause infectious aneurysms (3):
The most common pathogens that tend to cause infectious aneurysms (3):
1. Staph aureus (iv drug use)
2. Staph epidermidis (infected heart valves)
3. Salmonella
Aortic dissection begins with a tear across the _ layer, allowing blood to come in and separate layers of the _
Aortic dissection begins with a tear across the intima layer, allowing blood to come in and separate layers of the media
(Stanford A / Stanford B) are more common and more deadly
Stanford A are more common and more deadly
* They are proximal
Sudden onset of severe ripping or tearing chest pain is likely _ or back pain is likely _
Sudden onset of severe ripping or tearing chest pain is likely Stanford A or back pain is likely Stanford B
Stanford A can result in (hypotension/hypertension)
Stanford A can result in hypotension, also syncope, shock
Stanford B can result in (hypotension/hypertension)
Stanford B can result in hypertension
What are the three D’s of superior vena cava syndrome
Three D’s of superior vena cava syndrome:
1. Dyspnea
2. Distension (facial swelling)
3. Dilated veins
Superior vena cava syndrome is a _
Superior vena cava syndrome is a blockage of the superior vena cava that causes the back up of blood into the veins and upper half of the body
Three categories of causes of superior vena cava syndrome
- Compression from tumors, aneurysms, etc
- Thrombosis from catheters, pacemakers, or spontaneous
- Fibrosing mediastinitis from histoplasma or fungal infection
