peripheral arterial disease

Question 1

chronic venous insufficiency

Answer 1

incompetent venous valves blood remains in veins and then you get dilated. and increased venous hydrostatic pressure (edema)

Question 2

signs of chronic venous insufficiency

Answer 2

hemosiderin- stasis dermatitis: medial mallelous: improves with decreased venous hydrostatic pressure

Question 3

what are the complications of chronic venous insufficiency

Answer 3

venous ulcer- proximal to ankle

Question 4

vircow triad

Answer 4

venous stasis, endothelial damage, hypercoaguability

Question 5

homan sign

Answer 5

dorsiflex the foot, pain in the calf

Question 6

complication of the DVT

Answer 6

pulmonary embolus

Question 7

migratory superficial thromboplhebitis

Answer 7

superifical venous thrombus- classically associated with malignancy, recurring with multiple sites. hypercoagubility.

Question 8

Which are the veins affected in peripheral venous disease

Answer 8

great saphenous
small saphenous

both are superficial

Question 9

factors that improve peripheral venous disease

Answer 9

leg elevation, ambulation, and compression stockings.

Question 10

venous ulcer pain improves and worsens with what?

Answer 10

exertion - improves
rest- worst

Question 11

where do venous ulcers appear

Answer 11

above the lateral and medial alleoli

Question 12

complication of chronic venous insufficiency

Answer 12

venous ulcer- increased venous hydrostatic pressure forces leukocytes into the interstitial tissue which leads to free radical formation and capillary damage

Question 13

Which are the arteries affected in PAD?

Answer 13

Femoral Artery, politeal artery, anterior/posterior tibial and fibular arteries.

Question 14

What is the pathophysiology for PAD?

Answer 14

smoking, artherosclerosis, decreased arterial perdusion.

Question 15

What are the signs of peripheral arterial disease?

Answer 15

worse with exertion, improves with rest. weakned pulses (femoral, posterior tibial, dorsalis pedis)

Question 16

What is the treatment for peripheral artery disease?

Answer 16

cilostazol (inhibit PDE3) which inhibits plt aggregation.

definitive management: PCI

Question 17

arterial ulcer

Answer 17

pressure points, lateral malleolus. distal gangrene

Question 18

Leriche syndrome

Answer 18

bilateral hip and thigh claudication, erectile dysfunction, diminished femoral pulses.

Question 19

ankle brachial index
systolic ankle BP/ systolic brachial BP- whats the threshold for peripheral artery disease

Answer 19

<0.9. <0.4= severe
1.4 = calcifications, mockenberg sclerosis

Question 20

how do you improve symptoms in peripheral artery disease

Answer 20

lowering the legs will increase arterial perfusion

Question 21

neuropathic ulcer- where are they found

Answer 21

plantar surface of the foot.
diminished S1 reflex