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
