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Cardiovascular > Peripheral Vascular Disease > Flashcards

Peripheral Vascular Disease Flashcards

1
Q

what is DVT

A

thrombus fired anywhere in venous circulation

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2
Q

what is PE

A

thrombus that has embolised and lodged in the pulmonary circulation

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3
Q

what does VTE stand for

A

venous thromboembolic disease

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4
Q

what is virchow’s triad

A

hyper-coagulable state
endothelial injury
circulatory stasis

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5
Q

what is an example of each of the factors of virchow’s triad

A

hyper coagulable state= pregnancy, malignancy
endothelial injury= venous disorders, trauma, atheroma
circulatory state= LV dysfunction, immobility

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6
Q

what does VitK reductase do

A

activates precursors 2,7,9,10 to become active clotting factors 2a,7a,9a,10a

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7
Q

what are risks of virchow’s triad occurring

A

surgery, trauma, acute HF/chronic, adv age, varicose veins, obesity, immobility, cancer, inflammatory disease

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8
Q

what are presenting symptoms of DVT

A

painful swollen red limb, heat and tenderness along vein

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9
Q

what are presenting symptoms of PE

A

sudden SOB, pleuritic pain

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10
Q

what ix is carried out for DVT?

A

pre-test scoring system, USS

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11
Q

what ix is carried out for VTE?

A

d-dimers

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12
Q

what is important to note of d-dimers

A

a +ve result isn’t a diagnosis in itself, -ve result can exclude VTE

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13
Q

what ix is carried out for PE

A

CT pulmonary angiogram, VQ scan, PESI score (1-4)

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14
Q

tx for DVT

A

DOACs

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15
Q

tx for PE

A

thrombosis & DOACs

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16
Q

what is a type of DOAC

A

rivaroxiban

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17
Q

what other anticoagulants can be given for PE

A

VitK antagonists (warfarin), LMWH

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18
Q

length of tx for provoked, provoked with reversible factor, unprovoked VTEs?

A

provoked: 3-6months
provoked w reversible factor: 3-6months
unprovoked: lifelong

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19
Q

what is post-thrombotic syndrome

A

occurs in 1/3 patients that have had idiopathic DVT

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20
Q

how does post-thrombotic syndrome present

A

pain, oedema, hyper pigmentation, eczema

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21
Q

what are the 2 types of stroke

A

haemorrhage, ischaemic (thrombus, embolus, stenosed artery)

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22
Q

what is a stroke

A

acute onset of focal neurological symptoms and signs due to disruption of blood supply

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23
Q

True/False…

Venous strokes lead to strokes

A

False…

Arterial strokes usually do

24
Q

what usually cause strokes

A

non modifiable: age, fhx, gender (male), race, pmhx

modificable: HT, HL, TIAs, smoking, AFib, diabetes, HF, obesity

25
Q

what are rare causes of strokes in young people

A

homocysteinaemia, vasculitis, protein def

26
Q

presenting symptoms of stroke

A

nausea, headache, sweatiness, speech impairment, numbness to face, confusion, visual impairment
BE FAST

27
Q

ix for ischaemic stroke

A

atheroembolism: carotid doppler scan, CT/MRI, angio of aortic arch
cardioembolism: ECG, Echo

28
Q

haemorrhage causes?

A

HT? aneurysm?

if multiple strokes consider vasculitis or Moya Moya disease

29
Q

tx for stroke

A

thrombolysis/thrombectomy

surgical: haematoma evacuation, relief of inter cranial pressure, carotid endarectomy

30
Q

what should be given to prevent another stroke & if stroke is caused by Afib

A

aspirin and if stroke due to Afib give DOACs/warfarin

31
Q

what are TIAs due to

A

occlusion of artery causing temporary stop of blood flow

32
Q

what are TIAs the brain equivalent of?

A

Angina

33
Q

how are TIAs relieved?

A

can self dissolve the clot or angioplasty or clopidogrel/aspirin

34
Q

what are 2 chronic arterial diseases

A

intermittent claudication and critical leg ischaemia

35
Q

what is intermittent claudication

A

muscle ischaemia on exercise

36
Q

what is critical leg ischaemia

A

pain at rest- sudden loss of blood supply to limb

37
Q

what causes chronic arterial disease

A

damage to artery wall causing plaque formation or blockage of artery e.g. embolism, arterial dissection etc

38
Q

what can cause damage to artery wall

A

smoking, HT, diabetes, HL

39
Q

what are presenting symptoms of intermittent claudication

A

pain in limb with exercise

40
Q

what are presenting symptoms of critical leg ischaemia

A

cool to touch, absence of peripheral pulses, pale, poor tissue nutrition, venous guttering, ulcers, gangrene, paraesthesia (pins & needles), paralysis

41
Q

ix for chronic arterial disease

A

non-invasive: duplex USS, ankle brachial pressure index (ABPI)
invasive: MR angio, CT angio, catheter angio

42
Q

what range on ABPI shows claudication

A

0.4-0.85

43
Q

what range on ABPI shows severe claudication

A

0.0-0.4

44
Q

tx for intermittent claudication

A

remove risk factors e.g. smoking cessation, HL meds & anti platelets
walking!
angioplasty if severe

45
Q

tx for CLI?

A

amputation or angioplasty & anticoags

46
Q

what are 3 chronic venous diseases?

A

Varicose veins, chronic venous insufficiency, chronic venous ulceration?

47
Q

what are varicose veins

A

dilated, tortuous veins

48
Q

what is the pathophysiology of varicose veins?

A

due to abnormal transmission of deep venous pressure so blood pools in lower limbs

49
Q

what are common causes of varicose veins?

A

comes on after DVT, age, pregnancy, obesity, fhx

50
Q

what are presenting symptoms & signs of varicose veins?

A

asymptomatic

signs= bleeding, venules, recurrent, thrombophlebitis (inflamed vein)

51
Q

what are signs of chronic venous insufficiency?

A

hemosiderin deposits (browning of skin due to red cell leakage), lipodermatosclerosis occurs (inflammation of layer of skin)

52
Q

what is the main sign of chronic venous ulceration?

A

ulcers

53
Q

what is the ix for chronic venous disease?

A

duplex USS

54
Q

what is tx for chronic venous disease?

A

non-invasive: graduated compression stockings

invasive: foam sclerotherapy or thermal ablation

55
Q

what are possible complications of chronic venous disease?

A

bleeding/ bruising, thrombophlebitis, skin staining, nerve damage

56
Q

what is the difference between a doppler USS and a duplex USS?

A

Doppler: sound waves used that reflect off moving objects e.g. blood to monitor flow
Duplex: sound waves that bounce off of blood vessels

Cardiovascular (12 decks)

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