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Patho 1 > Peripheral Vascular disease > Flashcards

Peripheral Vascular disease Flashcards

1
Q

PAD and PVD are…

A

Circulatory diseases

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2
Q

PAD

A

only the arteries are affected

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3
Q

PVD patho

A
  • affects lower extremes (PVD)
  • athero occurs, fills with lipid macrophages in venous walls - plaques - tissue ischemia
  • dec mobility, pain, and dec perfusion
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4
Q

Risks for PVD

A

SMOKE, uncontrolled DM, inc chol, HD, stroke, age 50+

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5
Q

etiologies for PVD

A
  • ATHERO
  • thrombus
  • thromboangiitis obliterans (inflam)
  • permanent occlusion of peripheral arteries
  • vasospasm–Raynaud’s or autoimmune
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6
Q

CM of PVD

A
  • pain in calf or buttock
  • numb/burn
  • heaviness
  • intermittent claudication
  • trophic skin chx (shiny skin, thick nails, lose leg hair)
  • dec pulse
  • pallor, cyanosis
  • reactive hyperemia when legs hang and dependent edema
  • dec sensation in extremities
  • erectile dysfunction
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7
Q

Intermittent claudication

A

consistent pain with exercise, stops at rest, depends on where plaque is built and collateral circ

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8
Q

PAD sx

A
  • often femoral artery, athero, lack circ
  • IC pain
  • dec pulse
  • cool leg
  • leg pallor
  • lose foot sensation
  • ischemia of LL–cell hypoxia
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9
Q

5 Ps of PAD

A
  • paresthesia
  • pain (IC)
  • pulselessness
  • palpable coolness
  • paresis
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10
Q

PVD dx

A
  • ankle-brachial index
  • compare BP in leg and arm
  • ankle ratio is greater than brachial
  • severe PAD index; ABI = 0.5
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11
Q

Chronic venous insufficiency

A

ventricular wall and/or valves no worky
- blood pools in veins - stasis
- 40 of the U.S.??
- chronic

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12
Q

CVI CM

A
  • edema, achy and tired legs, leathery, stasis ulcers, flake/itch, varicose veins
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13
Q

nonpharm tx for peripheral vascular disease

A
  • smoke cessation
  • inc PA
  • dec wt
  • dec stress to dec inflam
  • control DM and HTN
  • if thrombus, balloon shunt
  • if chronic, stent
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14
Q

Pharm tx for vascular diseases

A
  • antiplt
  • anticoag
  • thrombolytics
  • lipid decreasing agents
  • agents that inc blood to extension
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15
Q

What are valves made of?

A

Leaflets; tri, pulm, and aortic have 3, bi have 2

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16
Q

AV nodes

A

bi and tri

17
Q

Ventricular valves

A

atrial and pulmonic

18
Q

Which valves open with systole and close with diastole if the atria

A

tri and bi

19
Q

How can valves get damaged

A
  • wear and tear
  • calcium deposits (calcification)
  • problem with the pannus (leaf not close/open well)
  • endocarditis - valve infx
  • clot formation (thrombus)
  • AV valves –papillary muscle
20
Q

What happens when leaflets are damaged?

A

Can’t close and open all the way

21
Q

Aortic stenosis

A

Leaflets are too tight and hard to get blood thru
- most common
- no sx until severe
syncope, lightheaded, chest pain
- can also get SOB and pulm edema
- blood does not leave the heart so coronary vessels lack BF

22
Q

Mitral regurg

A
  • fatigue and SOB
  • blood backs up to the left atrium so lack oxy blood supply
  • valve is loose
23
Q

aortic stenosis and mitral regurg are both probs of the…

A

Left side

24
Q

dx and tx for valve diseases

A
  • dx with ECHO (transthoracic or transeso)
  • tx with valve replace often bc meds not great
25
Q

Common cause of valve probs

A

genetics or childhood diseases - endothelial diseases

26
Q

Infective endocarditis

A

Infx of the valves that cause vegetations on the valves that can become septic emboli if broken off

27
Q

Which valve is most often affected by infective endocarditis?

A

Tricuspid bc it is the first valve blood goes thru and can lead to a PE

28
Q

Where will a vegetation from the mitral valve go?

A

brain, coronary artery

29
Q

Risks for infective endocarditis

A

prosthetic, pacemaker (wires with bac), IVDU with contaminated needle (esp tricuspid valve)

30
Q

NC for prosthetic valves

A

Take prophylactic abx before a dental procedure to dec risk of infx

31
Q

Sx of infective endocarditis

A

VERY SICK - fever, chills, anorexia, wt loss, myalgia, arthralgia, heart murmur (may not hear)
- many diff based on where vegetations are incl neuro meningitis, sz, enceph, brain abscesses

32
Q

Often the first CM of infective endocarditis?

A

signs of ischemia or infarction of the extremities, spleen, kidney, bowel, or brain based on where vegetations are

33
Q

Septic emboli

A

microorgs to heart, adhere to damaged endothelial tissue and attracts WBCs and plts, release cytokines and coag factors

34
Q

Septic emboli

A
  • microorganisms trigger the coag cascade to make fibrin deposits that develop into vegetations
  • veg often on leaflets and break into circ
  • carried by blood and cause ischemia and infx in remote tissue
35
Q

CM of septic emboli

A

petechiae, splinter hemorrhages, Janeway lesions, osler nodes, Roth spots

36
Q

Tx for infective endocarditis

A
  • replace valves
  • often ppl with rheumatic HD need replacement
  • if blood infx often 24h abx pre-surg
37
Q

What brings ppl with heart failure to the hospital?

A

need for diuretics; heart can’t maintain oncotic pressure

38
Q

First line rate control drugs

A

Beta blockers

Patho 1 (37 decks)

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