Peripheral Arterial Disease (Arterial Disease)

Question 1

Cause of PAD (Arterial Insufficiency)

Answer 1

1. Lack of bloodflow
2. Occluded by atherosclerosis
3. Vasculitis (inflamed blood vessels)
4. Cryoglobulinemia
5. Polyarteritis

Question 1

It referes to a lack of adequate blood flow to a region or regions of the body.

Answer 1

Peripheral Arterial Disease (Arterial Insufficiency)

Question 2

It is commonly present with symptoms of intermittent claudication or critical limb ischemia.

Answer 2

PAD or Arterial Insufficiency

Question 3

It is a general term used to describe any disorder that interferes with
arterial or venous blood flow of the lower extremities than upper exteremities. Commonly seen in Males than Females.

Answer 3

Peripheral Vascular Disease

Question 4

Risk Factors for PAD or Arterial Insufficiency

Answer 4

1. Diabetes Mellitus
2. HTN
3. Abnormal Platelet Activation
4. Smoking
5. Hyperlipidemia
6. Older age
7. Metabolic Disease with abnormal fat and serum cholesterol

Question 5

Precipitation of Immunoglobulins when exposed to cold temperatures; separation of immunoglobulins when heated

Answer 5

Cryoglobulinemia

Question 6

1. ■ an acute necrotizing vasculitis that affects primarily medium-sized and small arteries
   ■ a systemic disorder that may involve the kidneys, joints, skin, nerves, and various other
   tissues (organ failure); systemic vasculitis
2. Other name of this condition?

Answer 6

1. Polyarteritis
2. Polyarteritis Nodosa

Question 7

Disorders that occur with abnormal arterial blood flow:

Answer 7

1. Ateriosclerosis
2. Atherosclerosis
3. Arteriosclerosis Obliterans
4. Thromboangiitis Obliiterans
5. Raynaud’s Disease
6. Ulceration

Question 8

thickening, hardening, and loss of elasticity of arterial walls

Answer 8

Arteriosclerosis

Question 9

The most common form of arteriosclerosis, associated with damage to the
endothelial lining of the vessels and the formation of lipid deposits, eventually leading to plaque formation.

Answer 9

Atherosclerosis

Question 10

A peripheral manifestation of atherosclerosis characterized by
intermittent claudication, rest pain, and trophic changes
■ the arterial disease most likely to lead to ulceration
■ Known risk factors for development of the disease are smoking, diabetes mellitus,
hypertension, hyperlipidemia, and hyperhomocysteinemia

Answer 10

Arteriosclerosis Obliterans

Question 11

It is an inflammation leads to arterial occlusion and
tissue ischemia, especially in young men who smoke.

Answer 11

Thromboangiitis Obliterans (Buerger’s disease)

Question 12

A vasomotor disease of small arteries and arterioles that is most often characterized by pallor and cyanosis of the fingers

Answer 12

Raynaud’s Disease

Question 13

A peripheral sign of a long-standing disease process; by definition, arterial ulcers are
associated with arterial insufficiency

Answer 13

Ulceration

Question 14

How many percentage does your LE ulcers which are caused by arterial disease.

Answer 14

10-25%

Question 15

Clinical Manifestations of Peripheral Arterial Disease

Answer 15

○ unilateral/bilateral LBP, hip, buttock, groin, or leg pain - palpate the pulses
○ Intermittent Claudication (due to occlusion → pain with minimal motion)
○ Trophic changes of affected LE (ulceration, dependent erythema or rubor, gangrene)

Question 16

Clinical Presentation of PAD

Answer 16

○ Wounds will most frequently be located on the LEs: lateral malleoli, dorsum of feet, toes.
○ When wounds are present on an ischemic limb, atherosclerotic occlusion of the peripheral
vasculature is almost always present.
○ The majority of patients with arterial insufficiency also have diabetes.
○ Trophic changes are present and include abnormal nail growth, decreased leg and foot hair, and
dry skin.
○ Skin is cool on palpation.
○ Wounds are painful and patients may also describe pain in the legs and/or feet
○ Wound base is usually necrotic and pale, lacking granulation tissue.
○ Skin around the wound may be black, mummified (dry gangrene).
○ Other signs of arterial insufficiency will be evident: decreased pulses, pallor on leg elevation, and
rubor when dependent.

Question 17

Clinical Signs and Symptoms of PAD

Answer 17

○ Intermittent claudication: For chronic cases: this is the most important
○ Burning, ischemic pain at rest
○ Rest pain aggravated by elevating the extremity; relieved by hanging the foot over the side of the
bed or chair
○ Change in color, temperature, skin, nail beds
○ Decreased skin temperature
○ Dry, scaly, or shiny skin: First to occur s/sx
○ Poor nail and hair growth
○ Possible ulcerations and gangrene on weight-bearing surfaces (e.g., toes, heel)
○ Change in vision (diabetic atherosclerosis)
○ Fatigue upon exertion (diabetic atherosclerosis)

Question 18

1st sign of vascular occlusive disease

Answer 18

Loss of hair on the toes (dorsum) - worst case is ulcerations

Question 19

2nd most important symptoms of chronic arterial disease

Answer 19

○ Intermittent Claudication
○ Ischemic Resting Pain

Question 20

Location of Pain dependent on the site of Major Arterial Occlusion

Answer 20

MC: Superficial Femoral Artery

Question 21

Course of Arterial Disease

Answer 21

1. In advanced cases; red or cyanotic extremity is dependent in advanced cases
2. Ulceration and Gangrene are common complications of arterial diseases