PVD Vs CVI

Question 1

PVD pathology

Answer 1

Arteriosclerotic narrowing of the lumen of arteries resulting in decreased blood supply to the extremities

Question 2

PVD Causes/Incidence

Answer 2

Usually caused by arthrosclerosis
Similar risk factors for coronary artery disease
Peak incidence 40 to 70 years of age
Hyperlipidemia
Smoking
Diabetes

Question 3

PVD Signs/Symptoms

Answer 3

Usually first symptom: complaint of calf pain (claudication)
Cold/numbness of two extremities
Progresses to pain at rest

Question 4

PVD Physical Findings

Answer 4

Shiny/hairless skin
Dependent Rubor
Pallor
Cyanosis
Ulcerations
Reduced pulses

Question 5

PVD Lab/Diagnostics

Answer 5

Doppler ultrasound to evaluate flow
**ankle brachial index (ABI)
Arteriography: most definitive test

Question 6

PVD Management

Answer 6

Stop smoking and all tobacco use
Exercise: walk one hour per day; stopping during pain and resuming with pain subsides to develop collateral circulation
Cilostazol (pletal)
Weight reduction as needed
Nanas diabetes and hyperlipidemia
Angioplasty
Bypass surgery
Amputation

Question 7

CVI Pathology

Answer 7

Impaired venous return due to the either destruction of valves, changes to the deep thrombophlebitis, leg trauma, or sustained elevation of venous pressure

Question 8

CVI Causes/Incidence

Answer 8

More common in women than men
Maybe genetic predisposition
History of leg trauma; may be associated with varicose veins

Question 9

CVI Signs/Symptoms

Answer 9

Aching of the lower extremities relieved by elevation
Edema after prolong standing
Night cramps of the lower extremities

Question 10

CVI Physical Findings

Answer 10

Trophic changes with brownish discoloration
Stasis legal service
Edema of lower extremities
Dermatitis maybe,
Cool to touch

Question 11

CVI Lab/Diagnostics

Answer 11

Nonspecifically diagnostic of chronic venous insufficiency
Rule out edema due to heart failure and other causes (may Thurner syndrome: compression of left common iliac by overlying right common iliac pain equals LLE DVT)

Question 12

CVI Management

Answer 12

Bedrest with leg elevated to diminish chronic edema
Use of heavy duty elastic support stockings
Weight reduction in the obese
Treat derma Titus or ulcers as indicated
Acute weeping dermatitis
– tap water compresses
– Hydrocolloid dressing
– for less acute dermatitis, hydrocortisone cream