Peripheral Vasculature Disease - Dr. Miller

Question 1

DX DVT

Answer 1

US ( and look when you compress the Vein ) after D- dimer is +

Question 2

After 2nd DVT how long do you take anticoagulants

Answer 2

Lifetime

Question 3

Acute and management tx DVT

Answer 3

ACUTE : Heparin + DOAC

Management : Warfarin + DOAC

Question 4

What can feel like a DVT

Answer 4

Baker’s Cyst in the synovial fluid behind knee in arthritis = can rupture and go down to calf causing swelling redness and pain

Question 5

DM neuropathy vs Peripheral artery disease

Answer 5

DM neuropathy : starts distal extremities then travels up , numbness, tingling
Peripheral artery disease : usually higher up extremities, ache cramps pain, improves with rest and worse with activity
= hangs leg down improves sx

Question 6

Spinal Stenosis

Answer 6

Improves with no activity, pain down thigh

Question 7

Peripheral Artery problem DX

Answer 7

ABI Resting : 0.9 or higher is normal
IF NORMAL THEN

Exercise Stress test ABI : should be 0.9 or higher

Question 8

Peripheral Artery Disease (artery ischemia) TX

Answer 8

ACE and ARBs = antihypertensives that dilate peripheral arteries

Question 9

Reasons BB or Cliostazol or pentoxifylline is not given in peripheral artery disease

Answer 9

BB = peripheral A constriction
pentoxifylline = make RBCs more flexy so they can squeeze through narrow arteries or veins
Cliostazol : only some vasodilation

Question 10

TX given PAD

Answer 10

Statin
Anti-plt
Aspirin

Question 11

3 main SX of PAD

Answer 11

1. Rest pain
2. Non healing wounds
3. Claudication

Question 12

Chronic Venous Insufficiency SX

Answer 12

Bilateral redness and swollen and edema in lower legs,
Legs are warm
Legs are tender to palpate on and lower pulse bilaterally
= hemosiderin stain noted (brown skin change)

Question 13

Chronic Venous Insufficiency

Answer 13

ORal ABS

Compression Stockings + Daily elevation of legs **

Question 14

Unmaintained chronic venous insufficiency causing ulcer at medial malleolus
What is the cause

Answer 14

Chronic Venous insufficiency

Question 15

Venous ulcers locations

Answer 15

Above Medial malleoli
Above lateral malleoli
(Purple + red and superficial ulcer, PAINFUL)

Question 16

Arterial ulcers locations

Answer 16

Anterior shin
Under heel
Over toe joints
On the malleoli
(Deep punched out ulcer, demarcated borders = PAINFUL)

Question 17

Neuropathic ulcer locations

Answer 17

AT PRESSURE POINTS
Over toe joints
Under metatarsal heads
Under heel
On malleoli 
Inner side of 1st metatarsal (toe) head
(White and red in the middle deep punched out = NOT PAINFUL)

Question 18

Tx venous ulcer

Answer 18

Compression and ointments