PAD, VTE & Arthritis

Question 1

what are the clinical manifestations of peripheral artery disease?

Answer 1

• intermittent claudication (muscle ache, cramp)
• paraesthesia, decreased cap refill (pins & needle feeling)
• physical appearance (pale when elevated)
• rest pain
• critical ischemia

Question 2

what extremities are most affected by PAD?

Answer 2

the lower extremities

Question 3

how is PAD diagnosed and treated?

Answer 3

• PAD is diagnosed by health history, health exam, pulses, duplex Doppler imaging and ankle-brachial index
• treated by decreasing risk factors and aiding in health promotion, using antiplatelet meds like ASA and Clopidogrel

Question 4

how do you treat venous ulcers?

Answer 4

-compression therapy, adequate nutrition, meds and grafting

Question 5

what is venous thromboembolism?

Answer 5

thrombus form is an area of the inflamed or damaged vein. platelets and fibrin clump together and entrap RBCs, and WBC’s. attaches to wall of vein, when it comes loose it is called an embolism and can travel and get lodged in the lungs, cardiac vessel, or brain

Question 6

what are the three factors (Virchow’s triad) responsible for VTE?

Answer 6

1. venous stasis
2. damaged of endothelium
3. hypercoagulability

Question 7

what is osteoarthritis?

Answer 7

it is the slow, degenerative disorder of articular cartilage. it is more common in women

Question 8

what are some causes of OA?

Answer 8

• meds like corticosteroids, NSAIDs
• other disease such as hemophilia
• inflammation
• joint instability: ligament damage
• mechanical stress
• neurological stress neuropathy
• trauma and skeletal deformities

Question 9

what are the signs and symptoms of osteoarthritis?

Answer 9

pain that worsens with use and relieved by rest, crepitus and grinding, limitations in movement or instability of joints, joint becomes hard and large

Question 10

what drugs are used in OA?

Answer 10

• acetaminophen, topical agents, Voltaren, menthol, NSAIDs, steroid injections, hyaluronic acid

Question 11

what is rheumatoid arthritis?

Answer 11

chronic, systemic, autoimmune disease in synovial joints. peaks between 30 and 50 years of age but can occur in children. there are exacerbations and remissions

Question 12

what are some manifestations of RA?

Answer 12

fatigue, anorexia, weight loss, stiffness, joint deformity and disabiltiy

Question 13

what is the pathophysiology of RA?

Answer 13

it is a combo of genetics and environment. a genetically susceptible person ahs immune response to an antigen that triggers the formation of abnormal immunoglobulin G

• the presence of rheumatoid factor autoantibodies against IgG result in immune complex deposits on articular cartilage and causes inflammation
• neutrophils are attracted to the inflammation and release enzymes which damage cartilage

Question 14

what medications are used for RA?

Answer 14

• methotrexate: can lessen joint erosion
• sulphasalazine or hydroxychloroquine
• tumor necrosis factor inhibitors
• immunosuppressants; corticosteroids