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Stage 2: Vascular > Peripheral Arterial and Venous Disease > Flashcards

Peripheral Arterial and Venous Disease Flashcards

1
Q

What causes peripheral arterial stenosis/disease, reducing blood flow to the extremities?

A

Atherosclerosis

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2
Q

What is the biggest risk factor for peripheral arterial disese?

A

Smoking

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3
Q

What are other risk factors for peripheral arterial disease?

A

Diabetes, high BP, high cholesterol

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4
Q

What do 65% of people with PAD also have?

A

Co-morbid cerebral/coronary artery disease

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5
Q

What are the stages of symptoms of PAD?

A

1) Intermittent claudication
2) Ischaemic rest pain (critical ischaemia)
3) Ulceration/gangrene

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6
Q

What is intermittent claudication?

A

Cramping lower limb pain on walking, relieved by rest

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7
Q

How do you diagnose peripheral arterial disease?

A

Ankle-brachial pressure index

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8
Q

What ABPI level indicates PAD?

A

< 1/0.9

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9
Q

What other investigations can you do after ABPI?

A

Colour duplex US ± MR/CT angiography

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10
Q

How do you treat PAD conservatively if someone only has intermittent claudication?

A

Modify risk factors - smoking, BP, cholesterol (statin), clopidogrel, aspirin

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11
Q

How would you treat severe PAD e.g. causing rest pain in someone with viable tissue?

A
  • Percutaneous transluminal angioplasty (PTA)

- Surgical bypass of femoral artery - more invasive, worse choice

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12
Q

What ABPI level indicates severe PAD?

A

< 0.5

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13
Q

What are signs of PAD?

A

Cold, weak/no peripheral pulses, purple

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14
Q

How would you treat severe PAD in someone with unviable tissue?

A

Amputation

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15
Q

What causes chronic venous insufficiency?

A

Valve dysfunction (primary or post-DVT) in veins of lower extremities, reducing blood flow back to the heart

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16
Q

What are risk factors for CVI?

A

Age, family history, smoking, previous DVT

17
Q

What are varicose veins?

A

Long, torturous and dilated superficial veins

18
Q

What are risk factors for varicose veins?

A
  • Prolonged standing
  • Obesity
  • Family history
  • Pregnancy/OCP
19
Q

What causes primary CVI/varicose veins?

A

Mechanical (reflux)

20
Q

What causes secondary CVI/varicose veins?

A
  • Obstruction e.g. DVT
  • AVM
  • Overactive muscle pumps (cyclists)
21
Q

What are signs and symptoms of CVI?

A
  • Leg pain/cramps
  • Leg fatigue
  • Heavy legs (on prolonged standing)
  • Dilated tortuous veins
22
Q

What are complications of CVI?

A

Haemorrhage

Superficial thrombophlebitis

23
Q

What investigations do you do to diagnose chronic venous insufficiency?

A
  • Cough impulse of saphenous vein
  • Doppler colour
  • Duplex US
24
Q

How do you treat CVI?

A

Treat underlying cause and RF modification (also surgical options - see PALS slides)

Stage 2: Vascular (4 decks)

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