Periph. Arterial and Venous Disease Flashcards
What is the appearance of the extremities in Atherosclerosis?
Look like roasted turkey legs.
Darker coloration
Loss of hair growth
What are the Risk factors for Atherosclerosis?
Tobacco Use Diabetes Mellitus Hypertension Advanced Age Dyslipidemia
What are the symptoms of PAD?
Most commonly:
Cramping in Calf, thigh, or buttock
Exacerbated by walking, palliated with rest
Site of claudation is distal to the occlusion
Severe Disease:
Hair loss, thickened nails, smotth and shiny skin, reduced skin temp, and pallor/cyanosis
Ulcers or Gangrene
Pain at rest
What is the procedure for non-invasive testing of PAD?
H and P Digital Pulse Volume Recordings Doppler Flow velocity waveform analysis Duplex Ultrasonography Transcutaneous oximetry Stress Testing MRA Segmental Pressure Measurements
What are ankle Brachial Indices?
Take BP in upper and lower extremities
Should be the same
>1.0 ratio of ankle to brachial
What are the Tx for PAD?
Pharmacologic Tx of HLP, HTN, DM Cilostazol- Phosphodiesterase Inhibitor Phenoxyfylline Platelet inhibitors
Non Pharmacologic Tx for PAD?
Exercise
Foot Care, well fitting shoes, Smoking Cessation
Non-Operative Interventions
-Percutaneous transluminal angioplasty, laser angioplasty, atherotomy, stents
Surgery- Bypass
What is an Embolism vs Thrombus in situ?
Embolism travels from somewhere else
Thrombus stays put
What are the most common sources of an embolus?
heart, aorta and large arteries
A-FIB, Acute Coronary Syndrome, Prosthetic Heart valves, atrial Myxoma, endocarditis
Aortic aneurysms
Large atrial bifurcations
What are the common sources of Thrombus in situ?
Most frequently in Atherosclerosis
Bypass Grafts
Also Polycythemia Vera
Hypercoaguable States
What is Fibromuscluar Dysplasia?
Hyperplastic disorder Affecting med. sized and small renal arteries
Females
Carotid and Renal Arteries
What is the Tx of Fibromuscluar Dysplasia?
PTA and Surgical Reconstruction
What is Thromboangiitis Obliterans? (Buerger’s Disease)
Young People
Men
Directly Related to smoking
Raynaud’s Phenomenon, ulcers and pain are typical
What is the Tx of Thromboangiitis Obliterans? (Buerger’s Disease)
Immediate termination of smoking is critical.
What is the Presentation of Atheroembolism?
Micro-infarcts in the extremities after “roto-rooter” procedure to bust a clot
