Peripheral Arterial and Venous Disease

Question 1

Peripheral arterial disease - definition;

Answer 1

-clinical disorder in which there is a stenosis or occlusion in the aorta or arteries of the lmibs

Question 2

Major cause of PAD?

Answer 2

-ATHEROSCLEROSIS**

OTHERS:

• thrombosis
• embolism

Question 3

Risk factors for atherosclerosis:

Answer 3

• tabacco

- DM

Question 4

Most common symptom of PAD?

Answer 4

INTERMITTENT CLAUDICATION (Cramping in calf, thigh or butt)

Question 5

Severe PAD symptoms?

Answer 5

• hair loss
• thick nails
• smooth shiny skin
• reduced skin temp
• pallor
• cyanosis
• ulcers/gangrene
• pain at rest
• 50% asymptomatic

Question 6

Pathology of PAD:

Answer 6

-segmental lesions causingstenosis or occlusion in large and med sized vessels

Question 7

Vessels usually involved in PAD:

Answer 7

• abdominal aorta and illiac arteries
• *** FEMORAL AND POPLITEAL - most common
• others…

Question 8

Best way to non-invasively test/screen for PAD?

Answer 8

• H and P!!!!***

- other stuff like US, stress testing, MRA,… shit

Question 9

Diagnosis of PAD?

Answer 9

• contrast enhanced MRA

- ABI (anke brachial indices) - not expensive very sensitive and speicific

Question 10

ABI ratio >1 means

ABI ratio < 0.5 means:

Answer 10

• Normal!
• occlusive disease!
• severe ischemia

Question 11

Treatment for PAD:

Answer 11

• Tx hyperlipidemia, HTN, and DM wiht drugs
• drugs that inh platelet clumping (aspirin n stuff)
• exercise!!!
• stop smoking!!!

Question 12

What is fibromuscular dysplasia:

Answer 12

• hyperplastic disorder affecting medum sized and small arteries
• diagnosed secondary to HTN
• usually involved renal and carotid arteries

Question 13

Gender prevalence for fibromuscular dysplasia?

Answer 13

FEMALE

Question 14

26 yo F with headaches and HTN - differential??

Answer 14

-fibromuscular dysplasia!

Question 15

Thromboangiitis obliterans (Buergers disease)

• gender prevalence
• age range?
• directly related to?
• Tx?

Answer 15

• MALES
• young 20-30s
• directly related to smoking
• stop smoking

Question 16

Atheroembolism:

Answer 16

-suaully when someone went to cath lab had a clot broken up and some little fragments got away and lodged in small capillaries of toes or whatever

Question 17

RAynauds

• gender prevalence
• onset age?
• definition?

Answer 17

• FEMALE
• 20-40s
• syndrome manifested by attacks of pallor and cyanosis of the digits in response to cold or emotion –> looks like pink hand but fingers are white

Question 18

Virchows Triad - predisposing factors:

Answer 18

• stasis
• vascular damage
• hypercoaguability

Question 19

venous thrombosis - definition:

Answer 19

presence of a thrombus within a superficial or deep vein and the accompanying inflammatory response in the vessel wall

Question 20

gold standard for DVT? (deep vein throm..)

Answer 20

-ascending contrast venography

Question 21

Risk factors for Acute pulmonary embolus:

Answer 21

• Surgery
• *HTN
• *prior hist of DVT
• *prolonged anesthesia
• *hypercoaguable state
• *estrogen (NOT PROGESTERONE)

Question 22

Clinical symptoms DVT:

Answer 22

• tachypnea
• coarse or diminished lung soudns
• chest pain/pleurisy
• hemoptysis

Question 23

What is the most common finding on CXR of a patient with known PE?

If there are findings youll see?

Answer 23

• NORMAL!!!!!

- SEE: hamptons hump - wedge sign (shadow on X-ray)

Question 24

Dx of PE?

Answer 24

-nothing on x-ray

• DO H&P FIRST!
• THEN do Pulmonary angiography