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PVD Pharm Flashcards

1
Q

PVD defined

A

disease of blood vessels of extremities and the abdominal cavity organs, primarily the intestines and the kidneys, and disease is of both arterial and venous blood vessels

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2
Q

PVD typically affects what?

A

the lower extremities to a larger degree than upper extremites

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3
Q

PVD is most commonly found as

A

atherosclerosis

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4
Q

What is a common sign with PAD?

A

intermittent claudication

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5
Q

intermittent claudication

A

An aching, crampy, tired, and sometimes burning pain in the legs that comes and goes – it typically occurs with walking and goes away with rest – due to poor circulation of blood in the arteries of the legs.

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6
Q

intermittent claudication is like

A

angina associated w/ CAD

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7
Q

intermittent claudication onset at

A

predictable intensity levels

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8
Q

intermittent claudication improves

A

rapidly with rest

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9
Q

PVD higher among

A

men compared with women

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10
Q

PVD sympoms

A

dependent on the underlying pathology and the regions involved

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11
Q

PVD risk factors

A 
Smoking
hyperlipidemia
HTN
DM
Physical inactivity
obesity
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12
Q

PVD signs

A 
Poor nail growth
Hair Loss
Dry, scaly, atrophic skin
Pallor upon leg elevation after one min
Ischemic tissue ulceration
Absent or diminished femoral or pedal pulses
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13
Q

PVD inflamatory disorders

A

Vasculitis

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14
Q

Vasculitis

A

Group of disorders that share a common pathogenesis regarding inflammation of the arteries or veins
Narrowing or occlusion of the lumen
Formation of aneurysms
Vascular inflammation is common in rheumatoid disorders

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15
Q

Vasculitis can affect

A

vessels of any size, location, or organ system

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16
Q

Vasculitis can be what two things

A

acute of chronic in nature

segmental or encompassing

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17
Q

Vasculitis primary target involvement

A

is most commoy muscles and/or nerves

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18
Q

Vasculitis could have these

A

hypersensitivies in conjuction with thrombovasculitis

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19
Q

Arterial Occlusive Diseases are most commonly from what?

A

atherosclerosis

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20
Q

Arterial Occlusive Disease can be caused by

A

trauma

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21
Q

kinds of AODs

A

Thrombus or embolism, vasculitis, vasomotor disorders, arterial punctures, polycythemia, and chronic mechanical irritation, ischemic colitis or acute intestinal ischemia

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22
Q

Carotid (artery) occlusive disease accounts for what percentage of strokes

A

> 50% of all strokes

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23
Q

Embolims (AOD)

A

Distal block demonstrate signs of pain, numbness, coldness, changes in sensation (pin and needles), skin changes, weakness, and muscle spasm

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24
Q

AOD may result in

A

gangrene may result

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25
Venous diseases
Acute Chronic Thrombus:
26
Chronic venous diseases
(varicose veins and chronic venous insufficiency)
27
acute venous diseases are called this
(thrombophlebitis)
28
thrombus venous disease
Deep or superficial | DVT
29
(DVT) Deep Vein Thrombus
partial or complete occlusion
30
DVT results in
secondary inflammation of the wall of the vein
31
DVT can become
embolized and result in PE, MI, CVA
32
Superficial vein thrombus
Superficial: associated with an indwelling catheter, for the most part
33
DVT is the 3rd most common cause
of CAD affecting 2 million people annually
34
@ 30% - 60% of all people who undergo major general surgery will develop
a DVT up to 4 weeks after the operation
35
what factors are involved venous diseases?
Both genetic and lifestyle factors involved
36
venous disease results from
Results from any trauma to the endothelium of the vein wall which results in platelet accumulation
37
Varicose Veins
abnormal dilation of veins
38
What the most common veins and where are they located?
saphenous veins of of the lower extremities
39
What is the dilation from in varicose veins?
dilation from unstable valves, propensity to thrombus,and twisting of the vessel
40
propensity
an inclination or natural tendency to behave in a particular way
41
who get varicose veins more often?
Women more frequently than men
42
When does the gender difference disapper for more often of having VV?
70
43
VV may be an
inheritied trait
44
Incompetent valves could originate from
defective valves, or a weakness of the vein's wall, could it be a weak media layer
45
8 risk factors involed with varicose veins
``` Periods of high venous pressure associated with heavy lifting Prolonged sitting or standing Hormonal changes pressure associated with prego and obesity HF Hemorrhoids constipation Hepatic cirrhosis ```
46
Varicose V pathophysiology | Blood must flow against
gravity from the lower extremities, most commonly in order to get back to the heart for sufficient cardiac preload. The blood is milked upward with the valves to prevent blood from flowing in the reverse direction
47
VV pathophys | Superficial veins tend to develop
functional insufficiency more so than deep veins
48
Chronic venous insufficency (CVI) is also called
Venous stasis
49
CVI is what?
inadequate venous return over a prolonged period of time
50
CVI follows
most severe cases of DVT, leg trauma, and varicose veins
51
CVI can result in
leg ulcers, and accounting for a majority of vascular ulcers
52
CVI derived from
destroyed venous valves resulting in limited venous return, further resulting in venous stasis
53
CVI usually combined with
limited calf muscle pumping, so an insufficient calf muscle for some reason
54
CVI high ambulatory venous pressure results in the
calf veins
55
What happens in CVI patients with capillaires?
RBC, Proteins, and plasma leak out of the capillaries into the interstitial space, producing edema and a reddish brown pigmentation
56
CVI Results in
poor oxygenation of the regional tissues
57
CVI Tissue death=
ulcers that are more susceptible to infection
58
ulcer
is a discontinuity or break in a bodily membrane that impedes the organ of which that membrane is a part from continuing its normal functions.
59
Vasomotor disease
raynauds
60
Raynaud's disease
Intermittent episodes of small artery or arteriole constriction of the extremities resulting in temporary pallor and cyanosis of the digits, and changes in skin temperature called Raynaud’s phenomenon
61
PVD pharmacologic interventions
``` Vasodilators Diuretics Anti-platelet medication Statins Beta blockers ```
62
Statins drugs
inhibitor of 3-hydroxy-3-methylglutoryl-coenzyme A (HMG-CoA) reducatase lowers cholesterol
63
HMG-CoA reductase cataylzes
he conversion of HMG-CoA to mevolonate, which is the rate limiting step in sterol biosynthesis, namely cholesterol biosynthesis
64
Reductase receptors in liver respond to
LDL oxidation and [ ] by inhibiting LDL/Cholesterol synthesis
65
Statins induce
catabolism of plasma LDL
66
stains are a principle component
in protein synthesis
67
Statins lowers
VLDLs, LDLS, TGs, and apo-Bs
68
statins are associated with
atherosclerosis
69
statins are metabolized in
liver tissue
70
statins excreted in the
bile river
71
STAIN WARNINGS
``` Rhabdomyolysis with acute renal failure secondary to myoglobinuria Myopathy Diffuse myalgias Liver dysfunction/destruction CNS toxicity (Lesions/hemorrhage) ```
72
How can exs help PVD patients?
Increase generalized function Reduce symptoms Prolong survival 24% reduction in cardiovascular mortalities A formal exercise program is the most effective treatment for PAD Demonstrated by over 20 RCTs Exercise increased ambulation capacity better than angioplasty or anti-platelet therapy Increased walking distance by between 150% and 179%
73
Apolipoproteins are proteins that | apo-bs
bind lipids (oil-soluble substances such as fat and cholesterol) to form lipoproteins. They transport the lipids through the lymphatic and circulatory systems.
74
apo-bs are primarily
organizing proteins that help chylomicrons transports LDLS, vldls
75
VLDL
Very-low-density lipoprotein (VLDL) is a type of lipoprotein made by the liver. Enables fats and cholesterol to move within the water-based solution of the bloodstream. VLDL is assembled in the liver from triglycerides, cholesterol, and apolipoproteins
76
segmental vasculitis
portion of extremity
77
all encompasing vasculitis means
whole extremeity
78
Primary target involvement is most commonly muscles and/or nerves in vasculitis
claudication/ neuropathy
79
neuropathy
pain then nerve death and feel nothing at all due to lack of oxygen to the extremity
80
acute
one time
81
chronic
constantly
82
hypersenstivities due to
ischemia
83
thrombovasculitis
thrombi developed that could emboli
84
trauma causes AOD how
swelling, inflamation, clotting
85
AOD vasomotor disease is
reynauds
86
chronic mechanical irritation is due to
thoracic outlet syndrome
87
polycythemia
acculmulation of RBCs
88
muscle spasms occur in AOD why
not getting enough warmth from RBCs

Medical Perspectives 411 (9 decks)

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