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Specific Systems > Peripheral Vascular Disease > Flashcards

Peripheral Vascular Disease Flashcards

1
Q

PVD

Limb pain upon exertion is a symptom of PAD and is termed

A

intermittent claudication

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2
Q

PVD

PVD is also known as arteriosclerosis obliterans, is primarily the result of _______.

A

atherosclerosis

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3
Q

PVD

Peripheral Vascular Disease AKA

A

Peripheral Arterial Disease

or Peripheral Arterial Occlusive Disease

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4
Q

PVD

Up to ___ million people affected in US

A

12

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5
Q

PVD

___% of people over 55 suffer from PVD

A

10% - 25%

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6
Q

PVD

Despite PVD prevalence and complications, only ___% of those affected are receiving treatment.

A

25

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7
Q

PVD

Pt with PVD have ____ times increased risk of stroke and MI

A

4-5

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8
Q

PVD

______ increases the risk of atherosclerosis by approximately threefold

A

smoking

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9
Q

PVD

adults over ___ are at increased risk of PAD

A

55

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10
Q

PVD

PAD more frequent in older adults, with a ___ to ____ increase in risk for every 10-year increase in age

A

1.5 to twofold

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11
Q

PVD

PVD Risk Factors

A
  • >55 (2x)
  • Smoker, 20 pack year (2-3x)
  • DM (3x)
  • Dyslipidemia
  • Hypertension (>130)
  • A-fib (medical emergency)
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12
Q

PVD

other pathologies for developig PVD include

A
  • Autoimmune disease (RA)
  • Systematic Lupus
    • Malar (BuLerfly) rash on face
  • Trauma, surgery
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13
Q

PVD

when do symptoms of PVD start?

A

70% occlusion

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14
Q

PVD

developement of occlusion (atheroma) can start as early as

A

the teen years

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15
Q

PVD

the atheroma (occlusion) is made of

A

a chore of cholesterol (fat) joined to proteins

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16
Q

PVD

90% of occlusion =

A

pain at rest

(night pain)

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17
Q

PVD

what happens when te plaque within an artery ruptures?

A

platelets aggregation at the site → form a clot (thrombus) that further occludes the vessel

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18
Q

PVD

thromboses occur more in the _________ extremities than in the _______ extremities

A

lower > upper

19
Q

PVD

PVD manifest more acutely when

A

thrombi, emboli, or acute trauma compromises perfussion

(A-fib?)

20
Q

PVD

the most common cause of sudden ischemia

A

emboli

(can be of cardiac origin 80%, or from proximal atheroma)

21
Q

PVD

`emboli tend to lodge at artery bifurcations.
Which artery is the most common site of emboli lodge?

A

femoral artery, then iliac artery, then aorta, and the popliteal arteries

22
Q

PVD

emboli tend to carry higher comorbidity because

A

the extremity has not had the time to develop collateral circulation

23
Q

PVD

symptoms/signs of PVD; acute limb ischemia

A
  • Pain (ischemic pain is the worse pain)
  • Paresthesias (numbness)
  • Poikilothermia (cold)
  • Pallor
  • Paralysis
  • Pulseless
24
Q

PVD

most common manifestation of PVD

A

claudication (ischemic pain with exercice)

25
Q

PVD

aortoiliac disease manifest as pain in

A

the thigh and buttock

26
Q

PVD

with popliteal occlusion, the ischemic pain will be at

A

the foot

27
Q

PVD

femoral-popliteal disease manifests as pain in ____

A

calf

(most typical type of pain)

28
Q

PVD

true or false: claudication may also present as the hip or leg “giving out” after a certain period of exertion and may not demonstrate the typical symptoms of pain on exertion

A

true

29
Q

PVD

Distal extremity color change with position is a sign of PVD. Skin rubor when leg dependent. Skin pallor when leg elevated > 1-minute. If color takes more than 40 seconds to return it means…

A

severe ischemia

30
Q

PVD

Skin signs of PVD

A
  • Cold to touch
  • Dry, scaly, shiny atrophic skin
  • Hairless over lower extremity
  • Dystrophic toenails
  • Non-healing ulcers
31
Q

PVD

An ankle-brachial ratio of > 0.95 - 1.2

A

normal

32
Q

PVD

An ankle-brachial ratio of < 0.95

A

Peripheral Vascular Disease

33
Q

PVD

An ankle-brachial ratio of < 0.6

A

Intermittent Claudication

34
Q

PVD

An ankle-brachial ratio of < 0.26

A

Resting Ischemic Pain

35
Q

PVD

An ankle-brachial ratio of < 0.2

A

Gangrenous Extremity

36
Q

PVD

an excellent noninvasive confirmatory test of PVD

A

Duplex Arterial US

37
Q

PVD

Check Pulses, skin → ABI → Duplex Arterial US →

A

angiogram (gold standard)

38
Q

PVD

criterion standard for diagnosis of PVD

A

Angiogram

39
Q

PVD

PVD mgmt

A
  • Smoke cessation
  • Cholesterol mgmt
  • Hypertension mgmt
  • Exercise program
40
Q

PVD

Exercise dosage in PVD that has been shown to increase pain-free walking by 179% and max walking time by 122%

A
  • start with 3-5 sessions/week for 30 min per time
    • Increase by 5 min until 50-60 min.
  • 30-45 minutes
  • minimum 12 weeks
  • Continue indefinetly
41
Q

PVD

medication mgmt of PVD

A
  • Aspirin
  • Coumadin
  • heparin
42
Q

PVD

Cilostazol, also know as Pletal is a medication used in the

A

alleviation of intermittent claudication in individuals with PVD

43
Q

PVD

surgical mgmt of PVD (when 90% occlusion has been achieved)

A
  • Angioplasty (catheter with dye, ballon/stent inserted)
  • Vascular bypass
44
Q

PVD

complications of PVD

A

gangrene

amputations

Specific Systems (9 decks)

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