PVD & VD <3 - patho E3 Flashcards
risk factors for PVD
smoking
diabetes
high chol
heart disase
stroke
increase age >50
etiology of (PVD) Peripheral Vascular Disease
-atherosclerosis
-a thrombus
-inflammation (thromboangitis obliterans)
-vasospasm (raynauds)
clinical manifestations of PVD
-pain (calf & buttock)
-numb, burning, intermittent claudication
-wounds that do not heal
-diminished sensation in the extremities
-trophic skin changes (shiny, thick toenails, loss of leg hair, diminished pulses, pallor/cyanosis, red legs when they hang, erectile dysfunction)
intermittant claudication
consistent pain precipitated by consistent level of exercise
always when walking & stops w/ rest
5 P’s of PAD
-pain
-pulselessness
-palpable coolness
-paresthesias
-paresis
how to dx PVD
ankle - brachial index: BP in leg vs arm, normal is >1
PAD S/s
-intermittent claudication pain
-no edema
-no pulse
-no drainage
-round, smooth sores on toes & feet
-black eschar
PVD S/s
-dull, achy pain
-lower leg edema
-pulse present
-drainage
-sores w/ irregular borders on ankles
-yellow slough or ruddy skin
CVI causes & treatment
blood to pool or collect in veins -> venous stasis
treat w/ anti platelets & coags, thrombolytics & lipid lowering agents
CVI s/s
lower extremity edema
achiness or tiredness in legs
leathery looking skin
stasis ulcer on ankles
flaking or itching skin
new varicose veins
pharm treatment of PVD/PAD
-anti platelet (aspirin)
-anti coag (warfarin)
-antiilipemics
-antihtn
the AV valves are
tricuspid & mitral
open during systole & close w/ diastole
the ventricular valve are
pulmonic & aortic
valve abnormalities: pannus
failure to for the valve leaflets to close all the way
endocarditis usually leads to what
a valve replacement
what valve is most commonly effected by stenosis
aortic
what valve is most commonly effected by regurgitation
mitral valve -> causes blood flow to go backwards instead of forward into the body
aortic stenosis
blood is unable to flow freely from the left ventricle to the aorta during aortic stenosis
what are the most common symptoms of aortic stenosis
syncope
light headedness
chest pain
+ pulm edema -> will hear rhonchi & crackles, cough and pulm congestion
mitral regurgitation symptoms
fatigue bc not getting the amount of blood they body needs
SOB
treatment for mitral regurgitation
most likely a valve replacement
infective endocarditis
vegetations on the heart valves
infected mass which impede the opening and closing of valves
the vegetations can break off and spread through the body or lungs
what valve does infective endocarditis most often affect
the tricuspid valve
risk factors for infective endocarditis
1) prosthetic valve
2) pacemaker
3) IV drug abuse
if you have a prosthetic valve, what should you do before going to dentist
take prophylactic antibiotic
infective endocarditis symptoms
very sick
fever, chills, anorexia, weight loss, myalgias, arthralgias, heart murmur
what do people with infective endocarditis usually present to the hospital with
sign of ischemia or infarction of the extremities, spleen, kidney, bowel or brain (stroke)
cerebral emboli caused by infective endocarditis
septic emboli that lodged in a cerebral artery or arteriole and cause an ischemic stroke -> pt may present w/ meningitis, seizures, encephalopathy or abscesses of the brain
patho of septic emboli
microorganisms travel into the heart, adhere to damaged endothelial tissue & attract WBCs and platelets that release cytokines & coagulation factors -> coagulation cascade results in fibrin disposition & development of vegetation
clinical manifestations of a septic emboli
petechiae
splinter hemorrhages
janeway lesions
osler’s nodes
roth spots (spots in eyes)
