Peripheral Arterial and Venous Disease Flashcards
Peripheral arterial disease - definition;
-clinical disorder in which there is a stenosis or occlusion in the aorta or arteries of the lmibs
Major cause of PAD?
-ATHEROSCLEROSIS**
OTHERS:
- thrombosis
- embolism
Risk factors for atherosclerosis:
- tabacco
- DM
Most common symptom of PAD?
INTERMITTENT CLAUDICATION (Cramping in calf, thigh or butt)
Severe PAD symptoms?
- hair loss
- thick nails
- smooth shiny skin
- reduced skin temp
- pallor
- cyanosis
- ulcers/gangrene
- pain at rest
- 50% asymptomatic
Pathology of PAD:
-segmental lesions causingstenosis or occlusion in large and med sized vessels
Vessels usually involved in PAD:
- abdominal aorta and illiac arteries
- *** FEMORAL AND POPLITEAL - most common
- others…
Best way to non-invasively test/screen for PAD?
- H and P!!!!***
- other stuff like US, stress testing, MRA,… shit
Diagnosis of PAD?
- contrast enhanced MRA
- ABI (anke brachial indices) - not expensive very sensitive and speicific
ABI ratio >1 means
ABI ratio < 0.5 means:
- Normal!
- occlusive disease!
- severe ischemia
Treatment for PAD:
- Tx hyperlipidemia, HTN, and DM wiht drugs
- drugs that inh platelet clumping (aspirin n stuff)
- exercise!!!
- stop smoking!!!
What is fibromuscular dysplasia:
- hyperplastic disorder affecting medum sized and small arteries
- diagnosed secondary to HTN
- usually involved renal and carotid arteries
Gender prevalence for fibromuscular dysplasia?
FEMALE
26 yo F with headaches and HTN - differential??
-fibromuscular dysplasia!
Thromboangiitis obliterans (Buergers disease)
- gender prevalence
- age range?
- directly related to?
- Tx?
- MALES
- young 20-30s
- directly related to smoking
- stop smoking
Atheroembolism:
-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
RAynauds
- gender prevalence
- onset age?
- definition?
- 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
Virchows Triad - predisposing factors:
- stasis
- vascular damage
- hypercoaguability
venous thrombosis - definition:
presence of a thrombus within a superficial or deep vein and the accompanying inflammatory response in the vessel wall
gold standard for DVT? (deep vein throm..)
-ascending contrast venography
Risk factors for Acute pulmonary embolus:
- Surgery
- *HTN
- *prior hist of DVT
- *prolonged anesthesia
- *hypercoaguable state
- *estrogen (NOT PROGESTERONE)
Clinical symptoms DVT:
- tachypnea
- coarse or diminished lung soudns
- chest pain/pleurisy
- hemoptysis
What is the most common finding on CXR of a patient with known PE?
If there are findings youll see?
- NORMAL!!!!!
- SEE: hamptons hump - wedge sign (shadow on X-ray)
Dx of PE?
-nothing on x-ray
- DO H&P FIRST!
- THEN do Pulmonary angiography
