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Pathology > Peripheral Vascular Disease > Flashcards

Peripheral Vascular Disease Flashcards

1
Q

What are peripheral vascular diseases?

A

Atherosclerotic disease of non-cardiac,

arteries

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2
Q

What are peripheral vascular disease risk factors the same as?
Except for what? (2)

A

same as for CAD,

except that cigarette smoking
and diabetes mellitus appear to
increase the risk of PVD

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3
Q

Peripheral vascular disease can effect what locations? 4

A

GI tract, GU tract, brain,

extremities

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4
Q

What is pathogenesis in peripheral vascular disease?

A

vessel occlusion by atherosclerotic plaques
with “downstream” ischemia and
necrosis

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5
Q

GI involvement in peripheral vascular disease can occur with what? (2)

A
  1. occlusive atherosclerosis of the celiac or mesenteric arteries
  2. atherosclerotic emboli from the aorta (cholesterol emboli)
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6
Q

If you have occlusion in GI, where and what changes do you see?

A

ischemic changes and/or infarction
of the bowel “downstream” from the
occlusion

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7
Q

Ischemic changes in the colon can lead to what?

3 symptoms

A

ischemic colitis

  1. atrophy of surface epithelium,
  2. hyalinization/fibrosis of the lamina propria
  3. diarrhea that can be bloody
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8
Q

What people should you look for PVD causing ischemic colitis?

A

Elderly with athersclerosis factors

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9
Q

Infarction of the bowel can cause what?

A
  1. ileus
  2. severe abdominal pain
  3. bloody diarrhea
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10
Q

Can infarction of bowel by fatal?

Why?

A

Yes

Bacterial overgrowth

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11
Q

How do you recognize infarction of bowel? (3)

A
  1. High level of suspicion
  2. Abomdinal pain out of proportion to physical exam
  3. Metabolic acidosis
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12
Q

What GU organs are involved in PVD?

A
  1. kidneys

2. male erectile tissues

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13
Q

3 renal effects of PVD?

A
  1. Occlusion of renal arteries –> Decreased perfusion –> Activate RAS
  2. HTN injuries
  3. Renal infarctions
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14
Q

Effect on male erectile tissue in PVD?

A

Male erectile dysfunction (impotence)

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15
Q

PVD of carotid arteries is a significant caues of what?

A

TIA’s

Strokes (CNS infarcts)

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16
Q

Are TIA’s and strokes associated with emboli or occlusion?

A

Emboli

17
Q

Progressive occlusion can lead to what with carotid arteries?

A

Collateral formation

18
Q

Can a complete occlusion of coronary artery have no effects?

A

yes due to circle of willis

19
Q

Disease similar to coronary arteries in PVD can occur where?

A

Posterior portion of circle of willis via the basilar artery

20
Q

Partial occlusion in carotid arteries have what effects though?

A
  1. Hypotensive

2. Injure CNS in sensitive areas

21
Q

What arteries are most affected by Partial occlusion of carotid arteries?

A

Middle cerebral arteries

22
Q

Treatments of carotid artery PVD? 3

A

Treatment of atherosclerosis in general
Anti-platelet therapy (ASA)
Surgical intervention (carotid endarterectomy)

23
Q

What chronic changes can be seen in PVD in extremities? 6

A

skin atrophy,
fatty replacement of muscle (muscle atrophy),
delayed wound healing,
claudication,
ulceration
eventual necrosis (dry gangrene) with secondary
infection (wet gangrene)

24
Q

Acute occlusion of larger vessels causes what? 2

A

Acute necrosis

Gangrene

25
Q

What is gangrene necrosis?

A

blood supply lost and tissue undergoes coagulative necrosis

26
Q

What is wet gangrene?

A

Superimposed bacterial infection results in coagulative necrosis being altered by liquefactive action of bacteria and attracted leukocytes

27
Q

In PVD, which is affected more, lower or upper extremities?

A

Lower

28
Q

Why are lower extremities affected more?

A

Abdominal atherosclerotic emboli can

shower both lower extremities

29
Q

What increases risk of lower extremity disease with PVD? (2)

A

Cigarette smoking and diabetes mellitus

30
Q

Diagnosis of PVD? 6

A
  1. Claudication
  2. Atrophy of skin and muscles
  3. Diminished pulses
  4. Ulceration
  5. Vascular flow studies
  6. Radiographic studies
31
Q

Treatment of PVD?

A
  1. Treatment of general atherosclerosis
  2. Anti-platelet therapies
  3. Surgical and invasive radiology procedures
32
Q

6 surgeries to repair PVD?

A 
 Angioplasty +/- stents
 ABF bypass
 Fem-pop bypass
 Fem-fem bypass
 Axillary-fem bypass
 Fem-distal bypass

Pathology (36 decks)

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