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Vascular 2 > Peripheral Arterial Disease > Flashcards

Peripheral Arterial Disease Flashcards

1
Q

Risk factors

A 
Diabetic 
Hypertension
Hyperlipidemia 
CAD
Previous hx of CVA or MI 
Smoking 
Age
FHx
Male
Obesity 
Sedentary lifestyle 
Elevated levels of homocysteine 
Excessive levels of C-reactive protein 
Hx of radiation
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2
Q

What are the physical signs

A

Skin changes
Palpitations
Auscultation
Limb pressures

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3
Q

What are the different skin changes that can occur

A 
Pallor 
Rubor
Dependant rubor
Cyanosis 
Temperature 
Ulcers
Gangrene 
Trophic changes 
Capillary refill time
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4
Q

What is pallor

A

Pale colour secondary to deficient blood supply

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5
Q

What is rubor

A

Dark reddish colour or discolouration from dilated or damaged vessels

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6
Q

What is dependant rubor

A

When limbs take on pallor when elevated but becomes abnormally red when hanging dependant

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7
Q

What is cyanosis

A

Bluish colour of the skin and mucous membranes that results from a concentration of deoxygenated hemoglobin

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8
Q

What will the temperature of the skin feel like when there is skin changes

A

Cool to the touch

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9
Q

What are arterial ulcers

A

Deep,irregular shaped areas over the tibial area and are very painful

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10
Q

What does gangrene result from

A

Death of tissue from absent blood supply

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11
Q

What are trophic changes due to

A

The lack of nourishment

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12
Q

What does trick changes include

A

Shiny, scaly skin
Thick toenails
Loss of hair

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13
Q

What is capillary refill time

A

When pressure is applied to an area of the skin and released, colour return should be immediate

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14
Q

What does an increase in capillary refill time mean

A

Indication of poor arterial supply

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15
Q

Pulses are graded how

A

From 0-4+

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16
Q

What is a grade of 0 for a pulse

A

No pulse

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17
Q

What is a grade of 4+ for a pulse

A

Bounding pulse

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18
Q

For pulses what should always be done

A

Compare the sides

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19
Q

Diminished or absent pulses suggest what

A

Arterial insufficiency

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20
Q

Aneurysms have what

A

Bounding pulses

21
Q

Bruits are

A

Abnormal low frequency sounds that can be caused by a significant stenosis

22
Q

How are bruits graded

A

1+ - 3+ (mild to severe)

23
Q

In a stenosis >90% is a bruit heard

A

No, it is not

24
Q

Difference in limb pressures side to side may indicate what

A

Disease

25
Q

What is the difference of limb pressure in the upper and lower extremity that is considered abnormal

A

20mmHg

26
Q

Claudication (intermittent) is what

A

A symptom from the patient

27
Q

What is intermittent claudication

A

Muscle pain that occurs during excessive but subsides at rest

28
Q

What is intermittent claudication caused by

A

A lack of blood supply to a group of muscles

29
Q

Is intermittent claudication reproducible

A

Yes

30
Q

What are the common sites of intermittent claudication

A

Hip
Thigh
Buttock
Calf

31
Q

The site of disease is always what

A

Proximal to the muscle group

32
Q

What does buttock claudication suggest

A

Distal aortoiliac disease

33
Q

Thigh claudication suggest what

A

Distal external iliac/CFA disease

34
Q

Calf claudication suggests what

A

Femoral/popliteal disease

35
Q

What are common symptoms that the patient presents with

A

Claudication (intermittent)
Ischemic rest pain
Necrosis
Pseudo claudication

36
Q

Ischemic rest pain is always an indicator of what

A

Advanced multi-segment disease

37
Q

What is ischemic rest pain a precursor to

A

Limb loss unless medically or surgically treated

38
Q

What does the pain feel like in cases of ischemic rest pain

A

Severe and constant

39
Q

Where does ischemic rest pain usually affect

A

The dorsum of the foot and toes

40
Q

Early onset of ischemic rest pain usually occurs when

A

Only at night when the limb is not in a dependant position

41
Q

How can early onset of ischemic rest pain be relieved

A

By lowering the foot to mildly excerising

42
Q

Does rest relieve the pain caused by ischemic rest pain

A

No

43
Q

Necrosis is

A

Tissue death at the end stage of absent blood supply and is the most severe symptom

44
Q

Pseudoclaudication is what

A

Pain caused by other factors

45
Q

What are the common factors that can cause pseudoclaudication

A

Joint disease
Spinal stenosis
Herniated discs

46
Q

Is pseudoclaudication pain reproducible with exercise testing

A

No

47
Q

What is a common patient hx

A 
Excerise related claudication
Rest pain
Paralysis 
Paresthesia
Poikilothermia 
Previous ulceration/gangrene of feet/toes
Previous therapeutic vascular procedure
48
Q

What are the mechanisms of disease

A

Atherosclerosis
Embolism
Aneurysm

Vascular 2 (1 decks)

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