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#Phase 2.1: CardioResp > Peripheral Artery Disease > Flashcards

Peripheral Artery Disease Flashcards

1
Q

What is PAD?

A

Narrowing of arteries –> reduced blood supply to limbs

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2
Q

What are the risk factors of PAD? (9 things)

A
  1. Age
  2. FHx
  3. Male
  4. Smoking / Alcohol
  5. Poor diet
  6. Low exercise / sedentary
  7. Obesity
  8. Poor sleep
  9. Stress
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3
Q

What is the pathophysiology of PAD? (5 steps)

A
  1. Atherosclerosis
  2. Plaques
  3. Stiffening of walls + Stenosis
  4. Plaque rupture
  5. Reduced blood supply
  6. Ischaemia
  7. Necrosis
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4
Q

How do PAD patients present? (5 things)

A
  1. Asymptomatic (25%)
  2. Intermittent Claudication
  3. Limb numbness / weakness
  4. Impotence
  5. Critical Limb Ischaemia Symptoms (end stage PAD)
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5
Q

What are the findings @ examination of PAD? (7 things)

A
  1. Poorly healing wounds
  2. Ulcers / gangrene
  3. Discolouration (pale + cyanosis)
  4. Weak / absent pulse
  5. Reduced BP in affected limb
  6. Loss of hair follicles / sweat glands (severe disease)
  7. Smooth + shiny skin (sever disease)
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6
Q

What is Intermittent Claudication a symptom of?

A

Commonest symptom of PAD

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7
Q

How would you describe Intermittent Claudication pain?

A

Crampy achy pain in calf / thigh / buttock

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8
Q

What is Intermittent Claudication associated with?

A

Assoc w muscle fatigue after walking certain distance

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9
Q

When does Intermittent Claudication occur and when is it relieved?

A

Occurs @ exertion

Relieved by rest

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10
Q

What does Critical limb ischaemia suggest about PAD?

A

End stage PAD

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11
Q

What is Criticial limb ischaemia?

A

Inadequate blood supply to limb to function @ rest

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12
Q

What are the features of Critical limb ischaemia? (6 P’s)

A
  1. Pain
  2. Pallor
  3. Pulseless
  4. Paralysis
  5. Paraesthesia (pins and needles)
  6. Perishingly cold
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13
Q

What is the pain like in Critical Limb ischaemia?

A
  1. Burning

2. Worse @ night (bc leg raised so gravity not pulling blood to foot)

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14
Q

What is Leriche Syndrome?

A

A subtype of PAD

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15
Q

What artery occlusion causes Leriche Syndrome?

A

Distal aorta / Prox. Common Iliac Artery

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16
Q

What is the clinical triad of symptoms for Leriche Syndrome? (3 things)

A
  1. Thigh / buttock claudication
  2. Absent femoral pulses
  3. Male impotence
17
Q

What investigations should you do for sus PAD? (3 things)

A
  1. Ankle-brachial pressure index (ABPI)
  2. Duplex US
  3. Angiography (CT / MRI)
18
Q

What is ABPI a ratio of?

A

Systolic BP of ankle compared with Systolic BP of arm

19
Q

What do the different results of an ABPI indicate? (5 classifications)

A

1.3+ = Calcification of arteries
0.9 – 1.3 = normal
0.6 – 0.9 = Mild PAD
0.3 – 0.6 = Moderate – Severe PAD
Less than 0.3 = Severe PAD – Critical Limb Ischaemia

20
Q

What does a Duplex US show?

A

Speed + volume of blood flow

21
Q

What does Angiography show?

A

Uses contrast to highlight arterial circulation

22
Q

What are the CONSERVATIVE management options for Intermittent Claudication? (3 things)

A
  1. X Smoking
  2. Exercise training
  3. Better treatment of co-morbs (e.g DM / HTN)
23
Q

What are the MEDICAL management options for Intermittent Claudication? (3 things)

A
  1. Atorvastatin (80mg)
  2. Clopidogrel (75mg once daily)
  3. Naftidrofuryl oxalate (peripheral vasodilator)
24
Q

What are the SURGICAL management options for Intermittent Claudication? (3 things)

A
  1. Endovascular angioplasty + Stenting
  2. Endarterectomy
  3. Bypass surgery
25
Q

What is Endovascular angioplasty + Stenting? (3 steps)

A
  1. Insert catheter thru arterial system w XR guidance
  2. Inflate balloon @ stenosis site –> dilates lumen
  3. Insert stent
26
Q

What is Endarterectomy?

A

Cutting vessel open + removing atheromatous plaque

27
Q

What is Bypass surgery?

A

Using a graft to bypass the blockage

28
Q

What are the management options for Critical Limb Ischaemia? (4 things)

A
  1. Endovascular angioplasty + Stenting
  2. Endarterectomy
  3. Bypass surgery
  4. Amputation (if not possible to revasc)
29
Q

What are the management options for Acute Limb Ischaemia? (6 things)

A
  1. Endovascular thrombolysis
  2. Endovascular thrombectomy
  3. Surgical thrombectomy
  4. Endarterectomy
  5. Bypass surgery
  6. Amputation
30
Q

What is Endovascular thrombolysis?

A

Inserting a catheter thru arterial system to directly thrombolyse clot

31
Q

What is Endovascular thrombectomy?

A

Inserting a catheter thru arterial system to remove thrombus by aspiration / mechanical devices

32
Q

What is Surgical thrombectomy?

A

Cutting open a vessel + removing thrombus

33
Q

What are the complications of PAD? (3 things)

A
  1. MI
  2. Stroke
  3. Death

#Phase 2.1: CardioResp (28 decks)

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