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Cardiovascular System > Peripheral Arterial Disease > Flashcards

Peripheral Arterial Disease Flashcards

1
Q

Normal Palpable Pulses (5)

A
  • Aorta
  • Common femoral artery
  • Popliteal artery
  • Posterior tibial pulse
  • Dorsalis pedis pulse
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2
Q

Pathophysiology of CLI

A
  1. atherosclerotic disease of arteries supplying lower limb
  2. vasculitis
  3. Buerger’s Syndrome
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3
Q

Risk Factors of Peripheral Arterial Disease (6)

A 
Male
Age
Smoking
Hypertension
Hyperlipidaemia
Diabetes
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4
Q

How many stages of symptoms are there?

A

4

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5
Q

Stage 1

A

asymptomatic, incomplete blood vessel obstruction

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6
Q

Stage 2

A

Mild claudication
a- greater than 200m travelled
b- less than 200m travelled

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7
Q

Stage 3

A

Rest pain mostly in feet

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8
Q

Stage 4

A

Necrosis and/or gangrene

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9
Q

What stages are considered CLI

A

3 and 4

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10
Q

Diagnosi (History) (8)

A 
Claudication
Rest pain
Tissue loss
Risk factors
PMH
Drug history
Occ.H
Surgical history
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11
Q

Clinical Examination

A

Look for: pallor, hair loss and ulceration
Feel: temepature, capillary refill, peripheral sensation, pulses
Auscultate: doppler (dorsal pedis and posterior tibial pulses)

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12
Q

Special Examination (2)

A

Ankle Brachial Pressure Index

Buerger’s Test

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13
Q

Imaging invetsigations (3)

A
  1. Duplex
  2. CTA/MRA
  3. Digital subtraction angiography
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14
Q

Pros of Duplex

A

Dynamic

Does not use radiation or contrast

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15
Q

Cons of duplex

A

Cannot be used on abdomen
Operator dependent
Time consuming

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16
Q

pros of CTA/MrA

A

Detailed- allows planning for treatment

17
Q

Cons to CTA/MRA

A

Contrast and radiation

can overestimate calcification

18
Q

Conservative management (3)

A
  • Best medical therapy: antiplatelets and statin (inhibits platelet activation and thrombosis, endothelial and inflammation activation, plaque rupture
  • Risk factor controls: BP target (<140/85), smoking cessation, diabetic control
  • Exercise
19
Q

Revascularisation (2)

A 
•	Open surgery
-Bypass and/or
-Endarterectomy 
•	Endovascular intervention
-Balloon angioplasty
-Stent placement
-Atherectomy
20
Q

BASIL Trial (2)

A

Angioplasty is preferred strategy for short term results

Surgery is a better alternative for long term durability and if the patient is in good health

21
Q

Embolus

A

: a blood clot, air bubble, piece of fatty deposit or other object which has been carried in the bloodstream to lodge in a vessel and cause an obstruction

22
Q

Thrombus

A

a blood clot formed in situ within the vascular system of the body impeding blood flow

23
Q

Pathophysiology of Peripheral Artery Disease (5)

A
  • Arterial embolus (MI, AF, proximal atherosclerosis (NOT DVT/PE))
  • Thrombosis
  • Trauma
  • Dissection
  • Acute aneurysm thrombosis i.e. popliteal
24
Q

Clinical presentation of ALI (6)

A 
Pain
Pallor
Pulse deficit
Pins and needles (Paresthesia)
Paralysis
Poikilothermia (cold)
25
Q

What is Compartment Syndrome

A

pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells

26
Q

Consequences of compartment syndrome (2)

A

Renal failure

Creatinine rise

27
Q

Embolectomy

A

Surgical removal of embolus

28
Q

Pathophysiology of Diabetic Foot Disease (6)

A 
Microvascular peripheral artery disease
Peripheral neuropathy
Mechanical imbalance
Foot deformity
Minor trauma Infection
29
Q

Foot care to prevent DFU (5)

A 
Always wear shoes
Check fit of footwear
Check pressure points
Prompt and regular would care of skin breaches
Glycaemic Control
30
Q

Management of DFD

A

Revascularisation (distal stent or bypass)

Amputation

31
Q

Adjunctive Measures (4)

A

Dressings
Debridement
Negative pressure wound closure
Skin grafts

32
Q

Amputation locations (7)

A 
Hip
Above knee
Through knee
Below Knee
Symes
Trans-metatarsal
Digit

Cardiovascular System (42 decks)

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