PVD: Arterial Disease, Venous Disease Flashcards
Arterial Disease:
Occlusive peripheral arterial disease (PAD)
Chronic, occlusive arterial disease of ____ and ____-shed vessels, result of peripheral _____
Medium
Large
Atherosclerosis
Arterial Disease: PAD
Associated with ____ and ____. Pts may also have ____, cerebrovascular disease, _____, metabolic syndrome, and hx of _____.
HTN, hyperlipidemia
CAD, DM, smoking
Arterial Disease: PAD
Diminished blood supply to affected extremities with pulses ____ or ___.
Diminished, absent
Arterial Disease: PAD
Color: ___ on elevation, ____, with dependency
Pale
Dusky red
Arterial Disease: PAD
Early stages: pt exhibits ___ ___. Pain described as burning, searing, aching, tightness, cramping. Occurs ____ and ____ with walking, relieved by ____.
Intermittent claudication
Regularly, predictably
Rest
Arterial Disease: PAD
Late stages: Pts exhibit ___ pain, muscle ____, trophic changes (____, ___ and ____ changes).
Rest
Atrophy
Hair loss, skin, nail
Arterial Disease: PAD
____ ____ ____: Pts exhibit resting or nocturnal pain, skin ulcers, gangrene
Critical stenosis PAD
Arterial Disease: PAD
Affects primarily ____ extremities.
Lower
Arterial Disease:
Chronic, inflammatory vascular occlusive disease of small arteries and also veins.
Thromboangiitis obliterans (Buerger’s disease)
Arterial Disease: Thromboangiitis obliterans (Buerger’s disease)
Common in _____ (age), largely ____ (m/f), who _____.
Young adults
Males
Smoke
Arterial Disease: Thromboangiitis obliterans (Buerger’s disease)
Begins ___ and progresses ____ in both UE and LE.
Distally
Proximally
Arterial Disease: Thromboangiitis obliterans (Buerger’s disease)
Pts exhibit ____ or pain, cyanosis cold extremity, diminished ____ sensation, ____, risk of ___ and ____.
Paresthesias
Temperature
Fatigue
Ulcers and gangrene
Arterial Disease:
An inappropriate elevation of blood glucose levels and accelerated atherosclerosis
Diabetic angiopathy
Arterial Disease: Diabetic angiopathy
____ is a major complication and ____ ___ may lead to gangrene and _____.
Neuropathy
Neurotrophic ulcers
Amputation
Arterial Disease:
Raynaud’s Disease/phenomenon is ___ ___ of ___ arteries and arterioles.
Episodic spasm
Small
Arterial Disease: Raynaud’s
Abnormal ____ reflex exacerbated by exposure to ___ or ____ stress; tips of fingers develop pallor, ____, ____ and tingling. Affects largely ____ (m/f). Is occlusive disease usually a factor?
Vasoconstrictor Cold Emotional Cyanosis, numbness Females Not a factor
Venous Disease:
Distended, swollen, superficial veins; tortuous in appearance
Varicose veins
Venous Disease:
Formation of blood clot in a deep vein that can lead to complications including DVT, PE, or postthrombotic syndrome (PTS)
Venous thromboembolism (VTE)
Venous Disease: VTE
Mortality?
Incidence of 10-30% within 1 month of dx
Venous Disease: VTE
Morbidity?
1/3 experiences another VTE within 10 yrs
Venous Disease: VTE
Can become chronic: ___ can lead to diminished QOL
PTS (postthrombotic syndrome)
Venous Disease:
Clot formation and acute inflammation in a deep vein
Deep vein thrombophlebitis
Venous Disease: Deep vein thrombophlebitis
Usually occurs in _____, associated with forced ____, trauma, ____ and hyperactivity of blood coagulation. Can be unprovoked.
LE
Immobilization
Surgery
Venous Disease: Deep vein thrombophlebitis
S/sx: may be asymptomatic early, progressive _____ with tenderness to palpation; dull ache, tightness, or pain in the ____. Swelling, warmth, redness, or discoloration in LE, prominent _____ _____.
Inflammation
Calf
Superficial veins
Venous Disease: Deep vein thrombophlebitis
Medical management-
Anticoagulation therapy: used to prevent _____, prevent existing clot from ______, and stabilize clot through _______ properties. (Low-molecular-weight heparin [LMWH])
New clots from forming
Getting larger
Anti-inflammatory
Venous Disease: Deep vein thrombophlebitis
Medical management-
LMWH is contraindicated in patients with ________. Patients at high risk are typically treated with _____ _____.
High risk of bleeding Unfractionated heparin (UFH)
Venous Disease: Deep vein thrombophlebitis
Medical management- Both LMWH and UFH are associated with _________ in small percent of patients (2-3%). ___ is associated with paradoxical increased risk for venous and arterial _____.
Heparin-induced thrombocytopenia (HIT)
HIT
Thrombosis
Venous Disease: Deep vein thrombophlebitis
Can also use _______ for medical management. DON’T use _____ to evaluate patients suspected of DVT.
graded compression stockings
Homan’s Sign
Venous Disease:
Presents abruptly with chest pain and dyspnea, diaphoresis, cough, apprehension — requires emergency tx
PE
Venous Disease: PE
Life threatening: 20% with acute PE die _____, 40% die within _____
Almost immediately
3 months
Venous Disease: PE
Can result in ____ ____ ____ _____ with reduced oxygenation and pulmonary HTN.
Chronic thromboembolic pulmonary HTN
Venous Disease: PE
Can lead to ___ heart dysfunction and failure.
RIGHT
Venous Disease:
Combination of clinical signs and symptoms that persist after LE DVT; thrombosis resolution incomplete.
Chronic postthrombotic syndrome (PTS)
Venous Disease: PTS
Symptoms: pain, intractable ___, limb ___, skin _____ changes, leg ____.
Edema
Heaviness
Pigmentation
Ulcers
Venous Disease: PTS
Leads to reduced ____ and ____ ____.
QOL, functional mobility
Venous Disease:
Venous valvular insufficiency
Chronic venous stasis/incompetence
Venous Disease: Chronic venous stasis/incompetence
From fibroelastic degeneration of _____ tissue, venous _____.
Valve
Dilation
Venous Disease: Chronic venous stasis/incompetence
Classification:
Grade I: mild aching, minimal ____, dilated ____ ____.
Grade II: increased ____, multiple ____ veins, changes in skin pigmentation.
Grade III: venous _____, severe ____, cutaneous _____.
Edema, superficial veins
Edema, dilated
Claudication, edema, ulceration