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Clin med cardiology > PVD > Flashcards

PVD Flashcards

1
Q

What type of aortic aneurysm is most common

A

Abdominal

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2
Q

What is the cause if an aortic aneurysm

A

Weakening of the aortic wall

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3
Q

What is the leading cause of aortic aneurysms

A

atherosclerosis

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4
Q

When do people often become symptomatic with an aortic aneurysm

A

when they dissect / rupture

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5
Q

What symptoms will a patient experience with a thoracic aortic dissection

A

severe tearing back pain
hypotension
shock

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6
Q

What symptoms will a patient experience with an abdominal aortic dissection

A

severe abdominal / flank pain
hypotension
syncope
potential leg ischemia

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7
Q

What is the test of choice for the initial testing / screening for TAA

A

CTA (>4.5cm)

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8
Q

What is the test of choice for initial testing / screening for AAA

A

US (>3cm)

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9
Q

How do you manage AAA

A

Manage modifiable risks (BP/Lipids)
Surveillance of growth

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10
Q

How big does a AAA need to be for surgical management

A

> 5.5cm or rapid growth (+.5cm/year)

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11
Q

What are some risk factors for an aortic dissection

A

Complication of AAA and TAA
Hypertension
+FH

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12
Q

Which gender is at greater risk for aortic dissection

A

men at at 3x greater risk

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13
Q

What layer in the vessel is torn with an aortic dissection

A

the intima
*blood enters the space between the intima and media which created a false lumen

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14
Q

What are the three more common locations for aortic aneurysm

A

aortic root
aortic arch
just distal to subclavian

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15
Q

What does the type A Stanford classification involve

A

Involves the ascending aorta

*Requires surgery

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16
Q

What is a type 1 deBakey classification

A

dissection that originates in the ascending aorta and goes down the descending aorta

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17
Q

What is a type 2 DeBakey classification

A

Confined to the ascending aorta

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18
Q

What is the Type 3 DeBakey classification

A

Starts distal to subclavian
3A: stays thoracic
3B: propagates to abdomen

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19
Q

How will a patient present with an aortic dissection

A

severe ripping chest pain that radiates to the back

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20
Q

How do you workup an aortic dissection

A

EKG and CXR
Echo
CT or TEE (test of choice)

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21
Q

What type of dissections should have medical management before considering surgery

A

Type B

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22
Q

What is the HR and BP goal for dissection management

A

60BPM
100-120 systolic

23
Q

What is the number one risk factor for peripheral artery disease

A

smoking

24
Q

What is the most characteristic symptom of peripheral artery disease

A

intermittent claudication

25
Q

What can improve leg pain with peripheral artery disease

A

hanging foot over the side of things (gravity helps)

26
Q

What makes pain worse with PAD

A

worse with elevation / laying flat (being woken up at night)

27
Q

Where does pain generally originate with PAD

A

Distal metatarsal area

28
Q

What test can help confirm peripheral artery disease

A

ABI

29
Q

What is a normal ABI

A

.9-1.3

30
Q

If a patient as an ABI of <.9 what symptoms will they have

A

intermittent claudication

31
Q

If a patient has an ABI of <.5 what symptoms will they have

A

pain at rest

32
Q

Where will ulcers occur in people with PAD

A

Lateral malleolus

33
Q

Where will ulcers occur in people with venous insufficiency

A

medial malleolus

34
Q

What are treatment options for PAD

A

Smoking cessation
Foot care
exercise
clopidogrel
cilostazol (claudication)
Intervention

35
Q

What is the first line intervention for PAD

A

PTA +/- stenting

36
Q

What are intervention options for PAD

A

Lower leg angio (PTA & stenting)
Endarterectomy
Bypass grafting
Amputation

37
Q

When is amputation done with PAD

A

infection
gangrene
severe pain
limb ischemia

38
Q

What are the 5 Ps of acute arterial occlusion

A

Pain
Pallor (or mottled)
Pulselessness
Polar sensation
paresthesia

39
Q

What is a common example of venous insufficiency

A

Varicose veins

40
Q

What causes varicose veins to form

A

incompetent valves

41
Q

What causes incompetent valves in veins

A

secondary to increased pressure
which causes reflux

42
Q

What is the presentation of venous insufficiency

A

LE pitting edema
pain /achiness
Sx improve w/ rest / elevation
NO CLAUDICATION

43
Q

What is the workup for venous insufficiency

A

Primary a clinical dx
ABI to run out PAD
venous reflux testing

44
Q

What is the top management therapy for venous insufficiency

A

Compression with stockings or bandaging

45
Q

Which patients with venous insufficiency can you not use compression socks in

A

patient sixth co-morbid arterial disease

46
Q

What are some surgical interventions for venous insufficiency

A

sclerotherapy
ablation
vein stripping
valvuloplasty

47
Q

What is one of the most common rectal pathologies

A

Hemorrhoids

48
Q

What is the #1 cause of rectal bleeding

A

hemorrhoids

49
Q

What is hematochezia

A

bright red blood (lower GI bleed)

50
Q

What are risk factors for hemorrhoids

A

straining with defecation
pregnancy
enlarged prostate

51
Q

Which type of hemorrhoid is painful

A

external

52
Q

How can hemorrhoids be dx

A

Mostly clinical
can use digital rectal exam
anoscopy for visualization
lastly a colonoscopy

53
Q

How do you treat hemorrhoids

A

reduce straining
sitz bath
topical cream

54
Q

What are procedural treatments for hemorrhoids

A

rubber band ligation
sclero
photocoagulation

Clin med cardiology (10 decks)

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