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Medical Perspectives 411 > PVD Pharm > Flashcards

PVD Pharm Flashcards

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USMLE® Step 1 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
Q

Venous diseases

A

Acute
Chronic
Thrombus:

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26
Q

Chronic venous diseases

A

(varicose veins and chronic venous insufficiency)

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27
Q

acute venous diseases are called this

A

(thrombophlebitis)

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28
Q

thrombus venous disease

A

Deep or superficial

DVT

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29
Q

(DVT) Deep Vein Thrombus

A

partial or complete occlusion

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30
Q

DVT results in

A

secondary inflammation of the wall of the vein

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31
Q

DVT can become

A

embolized and result in PE, MI, CVA

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32
Q

Superficial vein thrombus

A

Superficial: associated with an indwelling catheter, for the most part

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33
Q

DVT is the 3rd most common cause

A

of CAD affecting 2 million people annually

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34
Q

@ 30% - 60% of all people who undergo major general surgery will develop

A

a DVT up to 4 weeks after the operation

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35
Q

what factors are involved venous diseases?

A

Both genetic and lifestyle factors involved

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36
Q

venous disease results from

A

Results from any trauma to the endothelium of the vein wall which results in platelet accumulation

37
Q

Varicose Veins

A

abnormal dilation of veins

38
Q

What the most common veins and where are they located?

A

saphenous veins of of the lower extremities

39
Q

What is the dilation from in varicose veins?

A

dilation from unstable valves, propensity to thrombus,and twisting of the vessel

40
Q

propensity

A

an inclination or natural tendency to behave in a particular way

41
Q

who get varicose veins more often?

A

Women more frequently than men

42
Q

When does the gender difference disapper for more often of having VV?

A

70

43
Q

VV may be an

A

inheritied trait

44
Q

Incompetent valves could originate from

A

defective valves, or a weakness of the vein’s wall, could it be a weak media layer

45
Q

8 risk factors involed with varicose veins

A 
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
Q

Varicose V pathophysiology

Blood must flow against

A

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
Q

VV pathophys

Superficial veins tend to develop

A

functional insufficiency more so than deep veins

48
Q

Chronic venous insufficency (CVI) is also called

A

Venous stasis

49
Q

CVI is what?

A

inadequate venous return over a prolonged period of time

50
Q

CVI follows

A

most severe cases of DVT, leg trauma, and varicose veins

51
Q

CVI can result in

A

leg ulcers, and accounting for a majority of vascular ulcers

52
Q

CVI derived from

A

destroyed venous valves resulting in limited venous return, further resulting in venous stasis

53
Q

CVI usually combined with

A

limited calf muscle pumping, so an insufficient calf muscle for some reason

54
Q

CVI high ambulatory venous pressure results in the

A

calf veins

55
Q

What happens in CVI patients with capillaires?

A

RBC, Proteins, and plasma leak out of the capillaries into the interstitial space, producing edema and a reddish brown pigmentation

56
Q

CVI Results in

A

poor oxygenation of the regional tissues

57
Q

CVI Tissue death=

A

ulcers that are more susceptible to infection

58
Q

ulcer

A

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
Q

Vasomotor disease

A

raynauds

60
Q

Raynaud’s disease

A

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
Q

PVD pharmacologic interventions

A 
Vasodilators
Diuretics
Anti-platelet medication
Statins
Beta blockers
62
Q

Statins drugs

A

inhibitor of 3-hydroxy-3-methylglutoryl-coenzyme A (HMG-CoA) reducatase
lowers cholesterol

63
Q

HMG-CoA reductase cataylzes

A

he conversion of HMG-CoA to mevolonate, which is the rate limiting step in sterol biosynthesis, namely cholesterol biosynthesis

64
Q

Reductase receptors in liver respond to

A

LDL oxidation and [ ] by inhibiting LDL/Cholesterol synthesis

65
Q

Statins induce

A

catabolism of plasma LDL

66
Q

stains are a principle component

A

in protein synthesis

67
Q

Statins lowers

A

VLDLs, LDLS, TGs, and apo-Bs

68
Q

statins are associated with

A

atherosclerosis

69
Q

statins are metabolized in

A

liver tissue

70
Q

statins excreted in the

A

bile river

71
Q

STAIN WARNINGS

A 
Rhabdomyolysis with acute renal failure secondary to myoglobinuria
Myopathy
Diffuse myalgias
Liver dysfunction/destruction
CNS toxicity (Lesions/hemorrhage)
72
Q

How can exs help PVD patients?

A

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
Q

Apolipoproteins are proteins that

apo-bs

A

bind lipids (oil-soluble substances such as fat and cholesterol) to form lipoproteins. They transport the lipids through the lymphatic and circulatory systems.

74
Q

apo-bs are primarily

A

organizing proteins that help chylomicrons transports LDLS, vldls

75
Q

VLDL

A

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
Q

segmental vasculitis

A

portion of extremity

77
Q

all encompasing vasculitis means

A

whole extremeity

78
Q

Primary target involvement is most commonly muscles and/or nerves in vasculitis

A

claudication/ neuropathy

79
Q

neuropathy

A

pain then nerve death and feel nothing at all due to lack of oxygen to the extremity

80
Q

acute

A

one time

81
Q

chronic

A

constantly

82
Q

hypersenstivities due to

A

ischemia

83
Q

thrombovasculitis

A

thrombi developed that could emboli

84
Q

trauma causes AOD how

A

swelling, inflamation, clotting

85
Q

AOD vasomotor disease is

A

reynauds

86
Q

chronic mechanical irritation is due to

A

thoracic outlet syndrome

87
Q

polycythemia

A

acculmulation of RBCs

88
Q

muscle spasms occur in AOD why

A

not getting enough warmth from RBCs

Medical Perspectives 411 (9 decks)

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