Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Quarter 2 > PVD Clin Med Final > Flashcards

PVD Clin Med Final Flashcards

1
Q

PAD (arterial)

A

underdiagnosed, undertreated, highly preventable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PAD

A

powerful, independent predictor of mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Atherosclerosis

A

Hardening
development of fatty streaks (thickened intima and accumulation of foam cells)

plaque and such

Vulnerable plaque- burst and trigger a blood clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Atherosclerosis

A

frequently occurs at bifurcations: aortic, iliac, femoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Atherosclerosis affects:

A

more than 85 of adults >50 YO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contributors of Atherosclerosis

A

Endothelial dysfunction, Inflammatory factors, Immunologic factors, Plaque ruptures, Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Endothelial dysfunction

A

HTN, DM, Hypercholesterol, Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute limb ischemia

A

Potential threat to limb viability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic limb ischemia

A

meaning pt came in later than 2 weeks after onset of acute event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Groups at risk for PAD

A 
70 or older
50-69 w hx smoking or DM
40-49 w DM and at least one other risk factor
Leg sx: claudication or pain at rest
Known atherosclerotic at other site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PAD risk factors

A

HTN, DM, Dyslipidemia, Smoking, Age, obesity >30BMI, fam hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Claudication

A

intermittent discomfort in a certain muscle group, worse with exercise and relieved with rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Leriche syndrome

A

Claudication
Absent/diminished femoral pulse
Erectile dysfx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Aortoiliac disease

A

buttock and hip claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Aortoiliac or common femoral artery disease

A

thich claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Superficial femoral artery stenosis

A

upper 2/3 calf claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Popliteal artery stenosis

A

lower 1/2 calf claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tibial or Peroneal artery stenosis

A

foot claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Insufficient flow AT REST

A

Threatened limb!

10% pts w PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ischemic rest pain

A

pain in forefoot/toes WORSE W ELEVATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Critical limb ischemia

A

rest pain
non healing wound/ulcer
Skin discolor/gangrene

pain when elevated, redness when lowered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PAD physical findings

A

blue, pale with elevation, dependent redness, thin, dry, shiny, and hairless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PAD physical findings

A

brittle nails, cool temp, delayed cap refill, diminished pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ABI

A

Ankle-brachial index
Ankle systolic/brachial systolic

ABI 0.90 or less with exertional sx is diagnostic for PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Arterial Duplex Doppler US

A

determine velocity of blood flow

can show site and severity of % stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Contrast arteriography (angiogram)

A

GOLD STANDARD for definitive dx for PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Advanced imaging for PAD

A

CTA and MRA (takes longer, used to plan revascularization procedures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

PAD management

A 
ASA or PLAVIX
stop smoking
Lipid lowering (Statin)
Control sugar and BP
weight loss/diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tx for claudication sx

A

supervised exercise

Cilostazol - phosphodiesterase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

PAD: revascularization

A

Endovascular (first line)

used for CRITICAL limb ischemia (pain at rest, ulcer, gangrene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Endovascular procedure options

A

Angioplasty
Stent
Atherectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Surgical options

A

Bypass graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Acute arterial occlusion

A

leads to limb ischemia

usually d/t thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Atheroembolism

A

cholesterol embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

6 P’s of Acute Arterial Occlusion

A 
Paresthesia
Pain
Pallor
Pulselessness
Poikilothermia-coolness
Paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Management of Acute arterial occlusion

A

Emergency surgical consult

Anticoag: Heparin
Thrombolytic
Thrombectomy
surgical bypass
Amputation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Chronic Venous Disease

A

Telangiectasis 50-60%
Varicose veins 10-30%
Chronic venous infuff 1-5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Chronic venous disease

A

incidene higher in women

39
Q

Risk factors for Chronic Venous Disease

A

age, obesity, smoking, hx of LOWER EXT TRAUMA, PRIOR VENOUS THROMBOSIS, PREGNANCY, family hx of venous disease, STANDING OCCUPATION

40
Q

Cause of Chronic Venous Disease

A

Dysfunction of venous valves d/t venous HTN

failure of the venous pump

41
Q

Sx of chronic venous disease

A

Aching, heaviness, burning

worse with standing.

RELIEVED w ELEVATION

42
Q

Elevate a venous leg

A

makes it better!

43
Q

occasional rupture with local bleeding is characteristic of what

A

chronic venous disease

44
Q

Chronic venous insufficiency

A

d/t valvular incompetence as a result of DVT w RESIDUAL DAMAGE TO VEIN

lumen reestablishes itself all funky after DVT

Post thrombotic syndrome develops

45
Q

chronic venous insuff

A

rigid and thick walls

More advanced signs: sig edema, skin changes, ulcers

46
Q

Hemosiderin staining

A

pigmented byproduct of hemoglobin

chronic venous insuff

47
Q

Lipodermatosclerosis

A

inflammation of fat under epidermis, subQ fibrosis and hardening of skin

chronic venous insuff

48
Q

Venous duplex doppler US

A

used to determind velocity of BF

49
Q

Venography

A

rarely needed but GOLD STANDARD. invasive and expensive

50
Q

Stasis dermatitis

A

Aka Stasis eczema

51
Q

Stasis dermatitis

A

erythema, inflamm, pruritis, scaling, vesicles form

medial ankle usually

Tx: emollients, barrier creams, topical steroids

52
Q

Chronic venous disease tx

A

exercise, wt loss, elevate legs 30 min 4-3 x per day, compression

53
Q

wound care for chronic venous disease

A

Unna boot: zinc paste impregnated bandage

occlusive hdrocolloidal or gel

54
Q

Sclerotherapy

A

option for small surface veins

55
Q

Surgical venous

A

vein stripping if significant

skin grafting also option for some ulcers

56
Q

Arterial disease

A

pain with walking, resolves with rest

57
Q

Venous disease

A

pain standing, resolves with elevation

58
Q

Arterial ulcers

A

toe joints, malleoli, anterior shin, base of heel

pressure points

base: dry, pale/necrotic

arterial pulse: no

skin: atrophy, shint, taut, loss hair

59
Q

Venous ulcer

A

malleoli above bony prominence, POSTERIOR calf, may be large, circumferential

base: pink with yellow fibrinous tissue, exudate

Arterial pulse is present

Skin: red, edema, dry, varicosities

60
Q

M:F ratio for AAA

A

4:1

61
Q

Cause of Aortic Aneurysms

A

Atherosclerosis most common

Also: conn tissue disorders (Marfans, Ehlers Danlos), Trauma

62
Q

Aneurysm

A

usually 1.5-2x normal size

63
Q

Dissection

A

tear in vessel wall creating true and false lumen

64
Q

Type A Dissection

A

Worse prognosis

Arch proximal to L subclavian artery

65
Q

Type B dissection

A

Descending thoracic aorta (just beyond L subclavian)

66
Q

Aortic Dissection sx

A

severe CP radiates to back, SUDDEN ONSET

syncope

CVA like sx

AMS

Paresthesia

67
Q

Aortic Dissection physical findings

A

HTN, can be hypo if in shock, neuro deficitits
and
Horner’s syndrome: ptosis, miosis, anhidrosis

68
Q

Aortic Dissection test of choice

A

CT chest and abdomen

69
Q

Aortic Dissection tx

A

Immediate control of BP with beta blockers (labetolol)

urgent surgical intervention (all type As)

70
Q

Thoracic aneursym

A

<10 % of aortic aneursyms. more rare. bleeding rarely contained, no time for emergent repair

71
Q

Sx of Thoracic AA

A

(most are asympto)

substernal back or neck pain, dyspnea, stridor, cough, edema in neck and arms, distended neck veins, hoarseness

72
Q

TAA test of chocie

A

CT scan

73
Q

AAA most common site

A

Infrarenal abdominal aorta

74
Q

AAA clinical findings

A

5 cm or greater in 80% patients

most are asymptomatic until they rupture

75
Q

AAA sx

A

back or abdominal pain with tenderness may proceed rupture

76
Q

AA rupture

A

assoc w/high mortality

50% bleed out prior to making it to hospital

IF they do make it to hospital, only 50% make it out of surgery

77
Q

AA rupture sx

A

EXCRUCIATING abdominal pain radiating into back, pulsatile abdominal pulse, tenderness, hypotension

78
Q

AAA diagnostic

A

Abdominal US is screening diagnostic study of choice*

79
Q

One time screening Abdominal US recommended for:

A

65-75 current or past smokers

65-75 who have never smoked but have 1st deg relative who required AAA repair or died from ruptured

80
Q

When should CT scan be done for screening

A

when aneurysm nears diameter threshold for tx: 5.5 cm

81
Q

AAA management

A

Risk factor modify, routine f/u

Refer to vascular specialist when 4 cm or greater

82
Q

When to repair AAA

A

> 5.5 cm in diamter or rapid expansion! >0.5 cm in 6 months

83
Q

Carotid artery stenosis

A

can result in cerebral infarction

84
Q

Carotid artery stenosis

A

TIA transient ischemic attacks

Focal neural sx:
Amaurosis Fugax: transient one eyed blindness

85
Q

Amaurosis Fugax (robert had this)

A

transient monocular blindness

Ophthalmic artery

86
Q

other sx of Carotid Artery Stenosis

A

contralateral weakness/numbness of extremity or face
dysarthria
aphasia

87
Q

Phys ex findings of carotid artery stenosis

A

Carotid bruit
Absent pupillary light response
Fundoscopic exam: arterial occlusion or ischmemic damage to retina

88
Q

Carotid duplex US (perform this first!!)

A

detects blood flow

89
Q

Cerebral angiography

A

GOLD standard for Carotid artery stenosis

evaluates entire carotid system but invasive and expensive

90
Q

Degree of stenosis - carotid artery stenosis

A

Severe is 70% or greater of lumen diameter

Moderate is 50-69% of lumen

91
Q

Carotid artery stenosis screening

A

not recommended UNLESS

Bruit noted, other vascular sx, or 2 or more risk factors for atherosclerotic disease

92
Q

Asympto Carotid atherosclerosis

A

Marker of increased risk for MI & vascular death

considered a risk equivalent for coronary heart disease

93
Q

Tx for Carotid Artery stenosis

A

if Asympto: controversial

if Sx: Revascularization (carotid endarterectomy, carotid artery stenting (short term)

Quarter 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions