PVD/PAD Flashcards

1
Q

List some occlusive diseases

A
  • PAD
  • atherosclerosis
  • thrombosis/embolism
  • vasculitis (Buerger’s, Raynauds, giant cell arteritis)
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2
Q

Define claudication

A

pain with exertion that resolves with rest

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3
Q

which medication can be used to improve symptoms & increase pain-free walking distances in patients with lower extremity PAD

A

Cilostazol

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4
Q

What is normal ABI?

A

1+

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5
Q

What are the most common areas of involvement for PAD

A

lower extremities or subclavian

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6
Q

What are some risk factors for VTE

A

immobility, damage to veins/valves, pregnancy, medications (OCP), genetic clotting disorders, surgery, malignancy, travel

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7
Q

What is the diagnostic gold standard for PE?

A

helical CT chest with contrast

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8
Q

Does superficial thrombophlebitis become PE?

A

No because it is superficial

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9
Q

Describe the etiology of PAD

A

Atherosclerotic plaque buildup narrows an artery causing ischemia to peripheral tissues & development of collateral vessels

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10
Q

What are the MC signs & symptoms of PAD

A

Symptoms: 20-50% asymptomatic (especially in those with DM), intermittent claudication, ischemic rest pain, non-healing ulcers, erectile dysfunction

Signs: diminished pulse pressure, bruits, pallor of foot on elevation, reactive hyperemia & dependent rubor, coolness, ulcers, hair loss, reduced/absent pulses

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11
Q

What is the gold standard test for PAD and a normal value

A

ankle-brachial index (Normal = 1+)

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12
Q

Describe the etiology of critical limb ischemia

A

Can be a presentation of PAD pts

Significant ischemia that threatens the limb, insufficient arterial flow d/t thrombosis of atherosclerotic artery

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13
Q

List the 6 P’s of critical limb ischemia

A

Pain, paresthesia, pallor, paralysis, pulselessness, poikilothermia (cold)

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14
Q

Describe the etiology & RFs of venous thromboembolism

A

Virchow’s Triad:
- alterations in blood flow (venous stasis)
- vascular endothelial injury
- alterations in blood constituents (inherited/acquired hypercoagulable state)

RF: immobility, damage to veins/valves, pregnancy, medications (OCP), genetic clotting disorders, surgery, malignancy, travel

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15
Q

Describe the gold standard diagnostics for a DVT and PE

A

DVT: duplex US of LE

PE: helical CT chest w/ contrast

(D-dimer high negative predictive value)

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16
Q

Describe the treatment for venous thromboembolism

A

warfarin (INR goal 2-3) and SQ lovenox BID until warfarin is therapeutic

then DOACs to prevent clot from getting bigger/reduce risk/recurrence

17
Q

Describe the RF and etiology of thromboangiitis obliternas (Buerger’s)

A

MC young men, smoking

Inflammation of small-med size vessels in extremities, not atherosclerotic

18
Q

Describe the etiology & RFs for Raynaud’s

A

Finger & toe artery vasospasm

MC in F, young

Primary: symptoms occur without assoc disorder, bilateral, early onset, short episodes

19
Q

Describe the etiology of giant cell arteritis

A

vasculitis of med-large vessels (MC temporal arteritis)

20
Q

Describe the etiology of varicose veins

A

Dilated, tortuous superficial veins, usually bilateral LE (MC great & small saphenous)

Incompetent valves, blood pooling, more pressure on competent valves - May indicate underlying venous insufficiency

MC F, onset in 40s

21
Q

Describe the etiology of chronic venous insufficiency

A

MC cause of chronic LE edema

Pathophys: incompetent veins, extravasation of plasma, RBCs, plasma proteins, deposition of hemosiderin from lysed RBCs, scarring/fibrosis of subQ

Chronic elevation of venous pressure, valvular reflux d/t incompetence, blood pools in LE

Assoc with chronic disability, diminished quality of life, high healthcare cost

Hereditary or from trauma

22
Q

Describe the clinical presentation of chronic venous insufficiency

A

Common to have LE pain, discomfort that worsens with standing/sitting, better with elevation/walking, abnormal venous dilation (reticular, varicosity), edema, inflammation, erythema, stasis dermatitis, ulceration, eczema, lipodermatosclerosis

23
Q

Describe the main differences between arterial & venous insufficiency

A