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Cardiovascular 2 > Peripheral Arterial Diseases > Flashcards

Peripheral Arterial Diseases Flashcards

1
Q

True or False: Atherosclerotic Peripheral Arterial Disease (PAD) and Coronary Arterial Disease (CAD) are the same: smoking, diabeetus, dyslipidemia, and HTN.

A

True

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2
Q

What causes the injury in PAD?

A

ischemia from reduced blood flow

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3
Q

Since ischemia can happen in PAD, what is the type of necrosis that can form as a result of ischemia?

A

Gangrene

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4
Q

What is the term when pain that is exeasterbated by walking and relived by rest (a common sign of PAD)?

A

Claudication

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5
Q

Where is the area of claudication if you have stenotic distal aorta or iliac arteries?

A

butt, hips, thighs, or calves

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6
Q

Where is the area of claudication if you have stenotic femoral or popliteal arteries?

A

calves

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7
Q

Where is the area of claudication if you have stenotic subclavian or axillary artieries?

A

arms

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8
Q

What is the first thing you should check if you suspect PAD?

A

Pulses

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9
Q

What is the next vital sign u should take on the arms and ankles?

A

BP

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10
Q

How much lower is the BP from the ankles to the arms to indicate PAD?

A

0.9

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11
Q

What class of drugs can u give for the Tx for PAD?

A

antiplatelets and ASA

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12
Q

What is the drug u can give to increase exercise capacity in PAD?

A

Cilostazol

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13
Q

What is the drug u can give to treat the claudiaction in PAD?

A

Pentoxifylline

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14
Q

This is the condition where emboli or thrombi break off and lodge in an artery somewhere else in the body.

A

Acute arterial occlusion

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15
Q

What are the 5 P’s for the Sx for AAO?

A

Pain, pallor, paralysis, paresthesias, and pulselessness

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16
Q

This is the condition marked by granulomatous vasculitis of medium/larger vessels and weakness in pulses.

A

Takayasu arteritis

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17
Q

Where is the granulomatous vasculitis typically located to cause Takayasu arteritis?

A

aortic arch branch pooints

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18
Q

Who does Takayasu arteritis typically involve?

A

Young asian women

aka ella baek

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19
Q

What is elevated on lab values for takayasu arteritis?

A

ESR

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20
Q

This condition occurs in females > 50, has granulomatous vasculitis, and typically afects the carotid and temportal arteries.

A

Giant cell arteritis

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21
Q

Where is the claudication in giant cell arteritits?

awesome typo. not fixing

A

Jaw

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22
Q

What things must u do to Dx giant cell arteritis?

A

biopsy of a long piece of the vessel and see giant cells with intimal fibrosis

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23
Q

What is a big complication of giant cell artertiis?

A

blindness (opthalmic artery can be involved)

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24
Q

Is the ESR elevated or dperessed in giant cell arteritis?

A

Elevated

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25
Q

This is the condition where there is necorsis of medium vessels, involving gangene, and autoamputation of the fingers and toes.

A

Tromboangiitis Obliterans (Buerger’s disease)

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26
Q

What is the biggest risk factor for Buergers disease?

A

smoking

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27
Q

What is the triad of Sx for Thromboangiitis Obliterans?

A
  1. disteal arterial occlusion
  2. raynauds
  3. migrating superficial bein thrombophlebitis
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28
Q

What is the most important treatment for Buergers disease?

A

Smoking cessation

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29
Q

What is the color change in Raynauds when someone is exposed to stress or cold?

A

white –> blue (cyanosis) –> red (hyperemia)

30
Q

This form of Raynauds is when you women gets vasoconstriction in repsonse to cold or emotional stress, and can sometimes lead to fibrotic changes and mild crap like that.

A

Primary raynauds

31
Q

What conditions give vascular insufficiencies that can leads to raynauds (which is a good warning sign of these diseases)?

A

SLE, scleroderma, Buergers, or atherosclerosis

32
Q

These 2 diseases cause Ag-Ab complexes, which cause vasculitis.

A

SLE and polyarteritis nodosa

33
Q

What type of reaction can cause this same Ab-complement vaculitis?

A

Drug hypersensitivity

34
Q

What class of infections can cause vasculitis?

A

Viral

35
Q

What % of people with polyartertitis nodosa have an underlying hep B infection?

A

30%

remember the HBsAg can cause type III hypersensitivity rxns through immune complexes????

36
Q

These are a group of autoantibodies that are directed against enzymes of neutrophils primary granules, monocyte lysosomes and endothelial cells.

A

ANCAs

37
Q

What does the “p” and “c” mean in p-ANCA and c-ANCA?

A

perinuclear or cytoplasmic

38
Q

Which 2 conditions have a + MPO-ANCAs?

A

microscopic polyangiitis + churg-strauss

39
Q

Wegeners granulomatous has what type of + ANCA?

A

+ PR3-ANCA

40
Q

Which immune cell is the mediator to giant cell arteritis?

A

T cell

41
Q

Which layer of the vessel thickens in giant cell arteritis?

A

intima

42
Q

Thickening of the intima in giant cell arteritis causes what problem with the lumenal diameter?

A

gets smaller

43
Q

What is the DOC for giant cell arteritis?

A

corticosteroids

44
Q

This is the condition where there is systemic vasculitis of small or medium sized muscular arteries, typically in the renal and visceral vessels.

A

Polyarteritis nodosa

45
Q

What is the damage done to the small and medium sized arteries in polyarteritis nodosa?

A

segmental TRANSMURAL necrotizing inflammation

46
Q

Weakening of the arterial walls can lead to what condition as a result of polyarteritis nodosa?

A

aneurysms

47
Q

What type of necrosis is seen with polyarteritis nodosa?

A

fibrinoid

48
Q

What age of people geet polyarteritis nodosa?

A

young adults

49
Q

What are the clinical Sx to polyarteritis nodosa?

A

malaise, fever, wt loss, HTN, abd pain + melena, muscle aches and peripheral neuritis

50
Q

What is the DOC for polyarteritis nodosa?

A

corticosteroids + cyclophosphamide

51
Q

Case: a 3 year old male presents with acute febrile illness, edema of the hands and feet, erythema of the hands, and cervical lymph node enlargement. What type of autoimmune rxn is he having?

A

Kawasaki syndrome (mucocutaneous lymph node syndrome)

52
Q

Which arteries are especially important (and loved) by Kawasaki, which cause an MI by rupture or thrombosis?

A

Coronary arteries

53
Q

How much of the vessel is thickened in Kawasaki syndrome as a result of the pronounced autoimmune inflmamation?

A

The entire vessel

54
Q

What are the 2 drugs u can give for the Tx of Kawasaki syndrome?

A

IVIG + ASA

55
Q

This is the condition where there is necrotizing vasculitis affecting the capillaries, arterioles, and venules.

A

microscopic polyangiitis

56
Q

In microscopic polyangiitis, which ANCA’s are usually implicated?

A

MPO-ANCA’s

57
Q

True or False: in microscopic polyangiitis, most lesions are pauci-immune (do not have immune complexes).

A

True!

58
Q

What type of necrosis forms in microscopic polyangiitis?

A

Fibrinoid

59
Q

true or false: in microscopic polyangiitis, there is usually granulomatous inflammation assocated with the fibrinoid necrosis.

A

FALSE. usually there is no granulomatous inflmmation

60
Q

What are the clinical Sx of microscopic polyangiitis?

A

hemoptysis, hematuria, proteinuria, bowel pain or bleeding, muscle pain or weakness, and palpable cutaneous purpura.

61
Q

What are the 2 drugs u can give for the Tx of microscopic polyangiitis?

A

cyclophosphamide + steroids

62
Q

This is the condition where there is acute necrotizing granulomas of the upper or lower respiratory tract, necrotizing granulomatous vesculitis of the airway, AND focal necrotizing crescentic glomerulonephritis.

A

Wegeners

63
Q

What type of hypersensitivity reaction is Wegeners?

A

T-cell mediated

64
Q

93% of wegeners pts have which + ANCA?

A

PR3-ANCA

65
Q

The granulomas that form in the airways in Wegeners have what pattern of necrosis?

A

Central necrosis with accompanying vasculitis

66
Q

What is the early and late mophology of the renal lesions in Wegeners?

A

Early- focal necrosis with thrombosis

Late- diffuse necrosis + parietal cell proliferation form crescents

67
Q

What are the 3 drugs used to treat Wegeners?

A

Steroids, cylophosphamide and TNF-antagonists

68
Q

What forms in the medium and small vessels in Buergers?

A

Microabscesses

69
Q

This is localized arteritis caused by direct invasion of infectious agents.

A

Infectious vasculitis

70
Q

In infectious vascultiis, the infections can weaken arterial walls and form what type of aneurysms?

A

Mycotic aneurysms (remember??)

Cardiovascular 2 (6 decks)

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