Peripheral Vascular Disease

Question 1

PVD

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

Answer 1

intermittent claudication

Question 2

PVD

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

Answer 2

atherosclerosis

Question 3

PVD

Peripheral Vascular Disease AKA

Answer 3

Peripheral Arterial Disease

or Peripheral Arterial Occlusive Disease

Question 4

PVD

Up to ___ million people affected in US

Answer 4

12

Question 5

PVD

___% of people over 55 suffer from PVD

Answer 5

10% - 25%

Question 6

PVD

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

Answer 6

25

Question 7

PVD

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

Answer 7

4-5

Question 8

PVD

______ increases the risk of atherosclerosis by approximately threefold

Answer 8

smoking

Question 9

PVD

adults over ___ are at increased risk of PAD

Answer 9

55

Question 10

PVD

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

Answer 10

1.5 to twofold

Question 11

PVD

PVD Risk Factors

Answer 11

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

Question 12

PVD

other pathologies for developig PVD include

Answer 12

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

Question 13

PVD

when do symptoms of PVD start?

Answer 13

70% occlusion

Question 14

PVD

developement of occlusion (atheroma) can start as early as

Answer 14

the teen years

Question 15

PVD

the atheroma (occlusion) is made of

Answer 15

a chore of cholesterol (fat) joined to proteins

Question 16

PVD

90% of occlusion =

Answer 16

pain at rest

(night pain)

Question 17

PVD

what happens when te plaque within an artery ruptures?

Answer 17

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

Question 18

PVD

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

Answer 18

lower > upper

Question 19

PVD

PVD manifest more acutely when

Answer 19

thrombi, emboli, or acute trauma compromises perfussion

(A-fib?)

Question 20

PVD

the most common cause of sudden ischemia

Answer 20

emboli

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

Question 21

PVD

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

Answer 21

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

Question 22

PVD

emboli tend to carry higher comorbidity because

Answer 22

the extremity has not had the time to develop collateral circulation

Question 23

PVD

symptoms/signs of PVD; acute limb ischemia

Answer 23

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

Question 24

PVD

most common manifestation of PVD

Answer 24

claudication (ischemic pain with exercice)

Question 25

# PVD aortoiliac disease manifest as pain in

Answer 25

the thigh and buttock

Question 26

# PVD with popliteal occlusion, the ischemic pain will be at

Answer 26

the foot

Question 27

# PVD femoral-popliteal disease manifests as pain in \_\_\_\_

Answer 27

calf | (most typical type of pain)

Question 28

# 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

Answer 28

**true**

Question 29

# 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...

Answer 29

severe ischemia

Question 30

# PVD Skin signs of PVD

Answer 30

* Cold to touch * Dry, scaly, shiny atrophic skin * Hairless over lower extremity * Dystrophic toenails * Non-healing ulcers

Question 31

# PVD An ankle-brachial ratio of \> 0.95 - 1.2

Answer 31

normal

Question 32

# PVD An ankle-brachial ratio of \< 0.95

Answer 32

**Peripheral Vascular Disease**

Question 33

# PVD An ankle-brachial ratio of \< 0.6

Answer 33

**Intermittent Claudication**

Question 34

# PVD An ankle-brachial ratio of \< 0.26

Answer 34

**Resting Ischemic Pain**

Question 35

# PVD An ankle-brachial ratio of \< 0.2

Answer 35

**Gangrenous Extremity**

Question 36

# PVD an excellent noninvasive confirmatory test of PVD

Answer 36

Duplex Arterial US

Question 37

# PVD Check Pulses, skin **→** ABI → Duplex Arterial US →

Answer 37

**angiogram** (gold standard)

Question 38

# PVD criterion standard for diagnosis of PVD

Answer 38

Angiogram

Question 39

# PVD PVD mgmt

Answer 39

* Smoke cessation * Cholesterol mgmt * Hypertension mgmt * Exercise program

Question 40

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

Answer 40

* 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

Question 41

# PVD medication mgmt of PVD

Answer 41

* Aspirin * Coumadin * heparin

Question 42

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

Answer 42

alleviation of intermittent claudication in individuals with PVD

Question 43

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

Answer 43

* Angioplasty (catheter with dye, ballon/stent inserted) * Vascular bypass

Question 44

# PVD complications of PVD

Answer 44

gangrene amputations