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CSI Exam 4 > PVD > Flashcards

PVD Flashcards

1
Q

Unhealing lesion on extremity

A

chronic disease, with progressive decrease in blood flow

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2
Q

PVD typically involves the

A

Lower extremities

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3
Q

Pain w/ PVD occurs when

A

blood flow cannot keep up w/ O2 demand, pain w/ exercise

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4
Q

Claudication

A

cramping primarily in the calf muscles

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5
Q

Intermittent claudication

A

cramping, weakness, limb fatigue after exercise/standing/walking

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6
Q

What other Sx might be associated w/ PVD

A

Erectile dysfunction

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7
Q

Ankle Brachial Index

A

ratio of systolic BP at the ankle compared to the brachial a.

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8
Q

Normal Ankle Brachial Index

A

1.0-1.2

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9
Q

What is a pathological value for Ankle Brachial Index

A

< 0.9

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10
Q

CT andiography/MRA for PVD can determine

A

anatomic location of disease w/o invasive angiogram procedure, angiogram is reserved for concurrent intervention

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11
Q

Treatment for PVD - Management

A

smoking cessation, weight los, exercise

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12
Q

Treatment for PVD - Pharmaceutical

A

Phosphodiesterase inhibitors (Cilostazol) - relieves claudication

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13
Q

Treatment for PVD - Procedures

A

angioplasty/stenting

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14
Q

Treatment for PVD - Surgical Intervention

A

Bypass graft

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15
Q

Unilateral cold foot

A

small clot blocks off stenotic vessel - occlusive disease

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16
Q

Sx of Occlusive disease

A

worse claudication, skin breakdown, larger non-healing ulcers, gangrene, muscle atrophy, loss of hair on LEs, diminished pulses of LEs

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17
Q

ABI of Occlusive disease

A

< 0.5

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18
Q

Most common artery involved in LE PVD

A

superficial femoral a.

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19
Q

Treatment for PVD Occlusive Disease - Surgical Intervention

A

Bypass, Angioplasty/Stenting, Thromboendarterectomy

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20
Q

Dry Gangrene toe

A

chronic or acutely evolved

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21
Q

Wet Gangrene toe

A

Some blood supply + infection

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22
Q

Treatment for Gangrene toe

A

amputation, surgical procedures to open up blood supply, ABX prophylaxis

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23
Q

Buerger Disease (thromboangiitis obliterates)

A

severe distal extremity ischemia - tissue and limb loss

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24
Q

Patients w/ Buerger Disease

A

Young, male, cigarette smoker

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25
Q

Charcteristics of Buerger Disease

A

segmental, , inflammatory, thrombotic process of distal arteries and arterioles
Pain at rest, no claudication

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26
Q

DM, paradoxical Afib, sudden, sharp pain in her LLE, whole leg feels “asleep”

A

Acute Arterial Disease

27
Q

Acute Arterial Disease

A

large embolic events almost always originate from the heart (AFib)

28
Q

Sx in Acute Arterial Disease

A

Hx of claudication + acute sharp, sudden pain

29
Q

Diagnosis of Acute Arterial Disease

A

dopplers, angiogram/MRA show abrupt cutoff of blood supply

30
Q

Labs of Acute Arterial Disease pts may be

A

acidotic

31
Q

Tx for Acute Arterial Disease

A 
Immediate revascularization (irreversible if tx w/in 6hrs) -
Heparin, TPA to clot if no neuro compromise
32
Q

Why might sepsis ensue following revascularization in Acute Arterial Disease

A

Blood supply to dying tissue, if dying tissue has already began a bacterial process, spreads bacteria to remainder of body

33
Q

Pancreatic cancer, weight loss, postprandial, abdominal pain, nausea -> pancreatic cancer is worrisome bc

A

pancreatic cancer is risk for clot/stroke

34
Q

Cramping after eating in pt w/ pancreatic cancer

A

increases pressure in intraabdominal pressure, mesenteric claudication

35
Q

Acute Mesenteric Vein Occlusion

A

Pancreatic cancer increases risk

36
Q

Tx for Acute Mesenteric Vein Occlusion

A

Surgical revascularization, Thrombolytics

37
Q

High cholesterol, HTN, Hx of MI, CHF, abdominal pain after eating may indicate

A

Acute intestinal ischemia, Chronic intestinal ischemia, ischemic colitis

38
Q

Sx of Acute intestinal ischemia

A

periumbilical pain, epigastric discomfort, high WBC, lactic acidosis, hypotension, and distention

39
Q

Sx of Chronic intestinal ischemia

A

Atherosclerosis, weight loss, anorexia

40
Q

Sx of ischemic colitis

A

LLQ pain, tenderness, abd cramping, bloody stools

41
Q

Imaging for suspected intestinal ischemia

A

CT or MRA shows narrowing of visceral vessels

Angiogram showing block

42
Q

Colonoscopy in intestinal ischemia may show

A

segmental changes, often at the splenic flexure or rectosigmoid junction, perforation risk

43
Q

Treatment for Acute intestinal ischemia

A

bypass, bowel resection

44
Q

Treatment for Chronic intestinal ischemia

A

Angioplasty/Stenting is first line, bypass may be needed

45
Q

Treatment for Ischemic colitis

A

rest, supportive care, blood pressure control

46
Q

Abdominal pain radiating to back, pain worse w/ palpation, acute onset of pain and hypotension

A

ruptured AAA

47
Q

AAA

A

Dilation of the infrarenal aorta is a normal part of aging

48
Q

Aneursym is considered a diameter of

A

3cm

49
Q

Normal diameter of abdominal aorta

A

2cm

50
Q

Risk for rupture of AAA when diameter exceeds

A

5cm

51
Q

Early Sx of AAA

A

midabdominal discomfort, increased pain w/ palpation

52
Q

Late Sx of AAA

A

sharp pain, sudden escape of blood into the peritoneal space, hypotension, death

53
Q

Treatment of AAA

A

elective repair when diameter > 5.5cm of increased >0.5cm in 6mo, or pain and tenderness Sx

54
Q

Treatment of AAA rupture

A

if rupture is contained in the retroperitoneum, pt may survive until graft suture can occur

55
Q

Crushing substernal chest pain, often death shortly after

A

Aortic Dissection

56
Q

Aortic Dissection

A

spontaneous intimal tear develops and blood dissects into the media of the aorta creating a “false lumen”

57
Q

Type A Aortic Dissection

A

involves the arch of the aorta proximal to the left subclavian artery

58
Q

Type B Aortic Dissection

A

involves the proximal descending thoracic aorta, usually just beyond the left subclavian artery

59
Q

Increased risks of dissection include:

A

Pregnancy, bicuspid aortic valve, coarctation of the aorta

60
Q

Sx of Aortic Dissection

A

Severe, persistent chest pain radiating into the anterior chest and down the back, syncope, hemiplegia, paralysis

61
Q

Aortic Dissection is typically associated w/

A

HTN

62
Q

Pharmacological Treatment of Aortic Dissection

A

b-Blocker, Labetolol, Nitroprusside, morphine (lower BP)

63
Q

Surgical Treatment of Aortic Dissection

A

Urgent surgery for ALL type A, and surgery for type B IF aortic branch compromise occurs or malperfusion is a concern

CSI Exam 4 (11 decks)

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