Peripheral Vascular Disease Flashcards

1
Q

Peripheral Vascular Disease?

A

diseases of arteries and veins except for the heart

any occlusive process that limits blood flow to or from the limbs or to vital organs other than the heart

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2
Q

Atherosclerosis?

A

most common condition affecting the arterial system in the elderly
in the lower extremity is a disease of the elderly

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3
Q

Venous Disease Categories?

A

Deep

Superficial

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4
Q

Deep Vein Disease Risk factors?

A
Injury (Surgery)
Stasis (immobility)
Hypercoagulative state
Obesity
Age
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5
Q

Virchow’s Triad?

A

Injury, Stasis, Hypercoagulable State

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6
Q

DVT often presents with?

A

Classic symptoms of DVT

-pain, edema, warmth is variable, Positive Homan’s Sign

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7
Q

DVT (deep vein thrombosis) Diagnosis?

A

History and Physical
High Index of suspicion
Venous Doppler Study (ultrasound)

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8
Q

DVT treatment?

A

anticoagulant, warm moist packs, elevate, invasive-thrombectomy, thpmbolytics, inferior vena cava filter (especially with 2nd)

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9
Q

DVT sequale?

A

most important
PE- pulmonary embolism
life threatening, don’t want to miss

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10
Q

PE signs and symptoms?

A

Chest pain, shortness of breath, anxiety, tachycardia, respiratory distress, shock, death

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11
Q

Superficial Venous Disease?

A

Not so dramatic as DVT
Chronic
Can be a real mess:
-varicose veins, superficial phlebitis, stasis dematitis, venous ulcers

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12
Q

Superficial phlebitis?

A

bad varicose veins, feel warmth

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13
Q

Superficial Venous Disease Risk factors?

A

Sedentary, Obesity, Varicose veins, poor hygiene, age

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14
Q

Superficial Venous Disease Signs and Symptoms?

A

Ache, Edema, Rash, Inflammation, Ulcers(feet)

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15
Q

Peripheral Arterial Occlusive Disease?

A

Hardening of the arteries

most common arterial disease of the elderly

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16
Q

Peripheral Arterial Occlusive Disease Risk Factors?

A

Smoking, Hypertension, Hyperlipidemia, Diabetes, Sendentary Lifestyle, Age, Family History

17
Q

Treatable risk factors of Peripheral Arterial Occlusive Disease?

A

Smoking, Hypertension, Hyperlipidemia, Diabetes, Sendentary Lifestyle

18
Q

Peripheral Arterial Occlusive Disease Signs and Symptoms?

A

Ache/Pain, Claudication, Loss of hair, numbness, coolness, pallor and cyanosis, absent pulse

19
Q

Claudication?

A

pain in legs on walking relieved by rest

20
Q

Peripheral arterial disease?

A

reduced blood flow and oxygen delivery to tissues

this causes pain with walking (increase oxygen demand of skeletal muscle)

21
Q

Pain in peripheral arterial disease vs DVT?

A

DVT pain never goes away

peripheral arterial pain gets better with rest

22
Q

The anatomy of Claudication? (what arteries it affects in different locations)

A

Buttock and Hip= Aortoilliac arteries

Thigh= Common Femoral Artery

Calf(upper 2/3)= Superficial Femoral Artery

Calf (lower 1/3)= Poplitial artery

Foot- Tibial or Peroneal artery (fibular artery)

23
Q

Treatment/ modify risk factors Peripheral arterial disease?

A

Stop smoking, control hypertension, lower lipids, control diabetes, exercise

24
Q

Peripheral arterial disease medicines?

A

Anti-platelet agents
-Aspirin, Clopidogrel, Cilostazol, Pentoxyfylline
Lipid lowering agents
ACE inhibitors

25
Clopidogrel?
irrversibly binds to P2Y12 adenosine diphosphate receptors, reducing platelet activation and aggregation
26
Aspirin?
irreversible inhibits cyclooxygenase, reducing prostalgandin and thromboxane A2 synthesis, reducing platelet aggregation
27
Phentoxyifylline?
increase erythrocyte flexibility, decrease plasma fibrinogen (decrease blood viscosity), increase blood flow, tissue oxygenation
28
Cliostazol?
increase cAMP, decrease platelet aggregation and cause femoral vasodilation platelets- decrease platelet aggegation, decrease claudication vasculature- vasodilate, decrease claudication
29
First line?
Cilostazol | more effective than pentoxyifylline
30
Pentoxyifylline?
used as an alternative to cilostazol | mixed results in clinical trials
31
What are you treating with meds?
Claudication symtoms
32
Cilostazol adverse reactions?
Headache, diarrhea, palpitation, dizziness, contraindicated in heart failure
33
Pentoxyfylline adverse reactions?
nausea, vomiting, diarrhea, dizziness, headache
34
Arterial embolism?
medical emergency acute and dangerous fortunately far less common than chrome Peripheral Arterial disease
35
Acute arterial occlusion signs and symptoms?
pain, pallor, parathesis, paralysis, pulseless
36
Acute occlusion diagnosis?
History and physical | imaging studies
37
Acure occlusion treatment?
Thrombolytic/ anticoagulant surgery (surgical bypass) intravacular procedures
38
what happens with peripheral artery disease?
plague buildup in artery causes reduced pressure and flow of blood distal to the atheroma endothelial dysfunction distal to the atheroma which causes reduced production of NO RBCs deform when passing through capillaries and align themselves in planar manner reduce viscosity and enables them to pass smoothly through capillaries
39
Chronic tissue ischemia and hypoxia causes?
decreased ability of RBCs to deform increased platelet aggregation and activation of clotting factors these events increase blood viscosity and further inhibit blood flow and oxygen delivery to tissues