Peripheral Vasculature Disease - Dr. Miller Flashcards
DX DVT
US ( and look when you compress the Vein ) after D- dimer is +
After 2nd DVT how long do you take anticoagulants
Lifetime
Acute and management tx DVT
ACUTE : Heparin + DOAC
Management : Warfarin + DOAC
What can feel like a DVT
Baker’s Cyst in the synovial fluid behind knee in arthritis = can rupture and go down to calf causing swelling redness and pain
DM neuropathy vs Peripheral artery disease
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
Spinal Stenosis
Improves with no activity, pain down thigh
Peripheral Artery problem DX
ABI Resting : 0.9 or higher is normal
IF NORMAL THEN
Exercise Stress test ABI : should be 0.9 or higher
Peripheral Artery Disease (artery ischemia) TX
ACE and ARBs = antihypertensives that dilate peripheral arteries
Reasons BB or Cliostazol or pentoxifylline is not given in peripheral artery disease
BB = peripheral A constriction
pentoxifylline = make RBCs more flexy so they can squeeze through narrow arteries or veins
Cliostazol : only some vasodilation
TX given PAD
Statin
Anti-plt
Aspirin
3 main SX of PAD
- Rest pain
- Non healing wounds
- Claudication
Chronic Venous Insufficiency SX
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)
Chronic Venous Insufficiency
ORal ABS
Compression Stockings + Daily elevation of legs **
Unmaintained chronic venous insufficiency causing ulcer at medial malleolus
What is the cause
Chronic Venous insufficiency
Venous ulcers locations
Above Medial malleoli
Above lateral malleoli
(Purple + red and superficial ulcer, PAINFUL)
Arterial ulcers locations
Anterior shin Under heel Over toe joints On the malleoli (Deep punched out ulcer, demarcated borders = PAINFUL)
Neuropathic ulcer locations
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)
Tx venous ulcer
Compression and ointments
