PVD Flashcards
6 P’s of Ischemia
- Pain: earliest sign
- Parasthesias
- Pallor
- Poikilothermia
- Pulslesness
- Paralysis
6 P’s of Ischemia
- Pain: earliest sign
- Parasthesias
- Pallor
- Poikilothermia
- Pulslesness
- Paralysis
Types of primary lymphedema
- Congenital (Milroy’s dz): 35y/o
Rutherford Classification
Stages of PAD
- Grade 0: asymptomatic
- 1: mild claudication pain
- 2: moderate claudication pain
- 3: severe claudication pain
- 4: rest pain
- 5: minor tissue loss (ischemic ulcer)
- 6: major tissue loss (gangrene)
Allen Test
-tests radial or ulnar artery for occlusion
ABI success for healing
> 0.35 = Non-DM
> 0.45 = DM
TBI
-indicated when ABI > 1.3
-
Segmental Pressures
- 30 mmHg difference between adjacent cuffs on same leg
- 20-30 mmHg difference between contralateral leg
TcPO2
Skin Perfusion Pressure (SPP)
MRA v CTA
- CTA gives > image detail
- CTA less accuracy in extensive vessel calcification
MRA v CTA
- CTA gives > image detail
- CTA less accuracy in extensive vessel calcification
Types of primary lymphedema
- Congenital (Milroy’s dz): 35y/o
Rutherford Classification
Stages of PAD
- Grade 0: asymptomatic
- 1: mild claudication pain
- 2: moderate claudication pain
- 3: severe claudication pain
- 4: rest pain
- 5: minor tissue loss (ischemic ulcer)
- 6: major tissue loss (gangrene)
Allen Test
-tests radial or ulnar artery for occlusion
ABI success for healing
> 0.35 = Non-DM
> 0.45 = DM
Blue toe syndrome etiologies
CAVEMAN
- Cardiac catheterization
- A fib
- Valvular dz
- Endocarditis
- MI/mural thrombus
- Aneurysm/AV fistula
- Nothing
Segmental Pressures
- 30 mmHg difference between adjacent cuffs on same leg
- 20-30 mmHg difference between contralateral leg
TcPO2
Skin Perfusion Pressure (SPP)
Contraindications for MRA
- pacemaker
- pregnancy
- implanted defibrillators
- other implanted electronic devices
- aneurysm clip
MRA v CTA
- CTA gives > image detail
- CTA less accuracy in extensive vessel calcification
Risk factors for atherosclerosis
- Modifiable: smoking, DM, HL, HTN
- Predisposing factors: obesity, sedentary, stress (mod); age, male, post-meno, FHx (non-mod)
- Emerging: elevated homocysteine, inflammation
TAO
-AKA Buerger’s Dz
-inflammatory dz of small and medium arteries and veins
-
Sickle Cell Dz
- Homozygous for hemoglobin S
- Contraindication for TQ use
When does irreversible tissue damage occur secondary to ischemia?
6 hours
Risk factors for acute thrombosis
- Hypercoaguable state: protein c/s def, factor V leiden def, etc.
- Thrombophilia
- Malignancy
- Low flow states (i.e. LE immobilization)
- Dehydration
- Hypotension
Blue toe syndrome etiologies
CAVEMAN
- Cardiac catheterization
- A fib
- Valvular dz
- Endocarditis
- MI/mural thrombus
- Aneurysm/AV fistula
- Nothing
PE Testing
- PE likely: spiral CT (positive rules in)
- PE unlikely: D-dimer (negative rules out)
How to reverse coumadin?
- Vitamin K
- FFP (works faster)
How to reverse heparin?
-Protamine sulfate
