Peripheral arterial and venous disease

Question 1

what is the main etiology of peripheral arterial disease?

Answer 1

atherosclerosis

Question 2

what are the two main risk factors for peripheral arterial disease?

Answer 2

tobacco use

diabetes mellitus

Question 3

what is the most common symptom / clinical clue of peripheral arterial disease?

Answer 3

intermittent claudication - cramping

Question 4

what is the pathology of peripheral arterial disease?

Answer 4

segmental lesions causing stenosis or occlusion are usually localized to small and medium-sized vessels

Question 5

peripheral arterial disease usually involves what vessels?

Answer 5

AA / iliac arteries
femoral and popliteal
distal vessels - tibial, peroneal

Question 6

an ABI ratio (ankle to brachial) greater than 1 indicates:

Answer 6

normal

Question 7

an ABI ratio (ankle to brachial) less than 1 indicates:

Answer 7

occlusive disease

Question 8

an ABI ratio (ankle to brachial) less than 0.5 indicates:

Answer 8

severe ischemia

Question 9

definition: fibromuscular dysplasia

Answer 9

hyperplastic disorder affecting small and medium sized renal arteries

Question 10

who is the classic fibromuscular dysplasia patient?

Answer 10

young active female with BP problems

Question 11

what is the treatment for fibromuscular dysplasia?

Answer 11

PTA and surgical reconstruction

Question 12

definition: thromboangiitis obliterans (buerger’s disease)

Answer 12

inflammatory disease of the small and medium sized arteries and veins of the extremities

Question 13

who is the classic patient for buerger’s disease (thromboangiitis obliterans)?

Answer 13

young male who smokes

Question 14

young active female with BP issues - what is the likely condition?

Answer 14

fibromuscular dysplasia

Question 15

young male smoker with peripheral vascular problem (hands) - what is the likely condition?

Answer 15

buerger’s disease (thromboangiitis obliterans)

Question 16

definition: atheroembolism

Answer 16

subset of acute arterial occlusion - multiple small deposites of fibrin, platelets, and cholesterol debris embolizing downstream

Question 17

definition: raynaud’s disease

Answer 17

syndrome manifested by attacks of pallor and cyanosis of the digits in response to cold or emotion

Question 18

definition: livido reticularis

Answer 18

localized areas on the extremities develop a reddish blue rete or net like appearance

Question 19

virchow’s triad

what is the significance

Answer 19

1. stasis
2. vascular damage
3. hypercoagulability

predisposing factors to venous thrombosis

Question 20

what is homan’s sign? what is it used for?

Answer 20

increased resistance or pain during forced plantarflexion

DVT

Question 21

what are the gold standards for DVT diagnosis?

Answer 21

1. ascending contrast enography

2. doppler

Question 22

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

Answer 22

normal

Question 23

if there ARE findings seen on CXR, they are:

Answer 23

hamptom’s hump

Question 24

what test is used to diagnose PE?

Answer 24

pulmonary angiography

Question 25

what are the treatments for PE?

Answer 25

heparin 
warfarin 
thrombolytics 
filter 
surgical removal