PVD & VTE

Question 0

pallor w/ raised extremity, hair loss on leg/foot, atrophic skin, delayed cap refill, cyanosis

Answer 0

PAD

Question 1

walking impairment, claudication, ischemic rest pain, erectile dysfunction, non-healing wounds could indicate?

Answer 1

arterial & venous PVD

Question 2

Leriche Syndrome (3)

Answer 2

decreased femoral pulses
impotence
butt & thigh claudication

Question 3

amaurosis fugax is associated with?

Answer 3

Carotid artery disease

Question 4

asymptomatic carotid artery disease treatment

Answer 4

tx HTN, hyperlipidemia, DM, smoking cessation, aspirin

Question 5

pain in chest, neck, back

swelling of head, neck, arms

Answer 5

thoracic ascending aneurysm

Question 6

wheezing, SOB, hemoptysis, hoarseness, dysphagia, chest/back pain

Answer 6

aortic arch or descending aortic aneurysm

Question 7

indication for surgery of thoracic aortic aneurysm

Answer 7

5-6 cm

4.5-5 cm in Marfan’s

Question 8

treatment of thoracic aneurysm (5)

Answer 8

B-blockers
Ang II receptor blockers
statins
smoking cessation
BP goal < 140/90

Question 9

intima tears, blood penetrates into the media, splitting it longitudinally- false channel created

Answer 9

aortic dissection

Question 10

Type A Aortic dissection symptom

Answer 10

chest pain

Question 11

Type B aortic aneurysm symptom

Answer 11

Back pain

Question 12

TX for type A thoracic aortic dissection

Answer 12

surgery

Question 13

tx for type b thoracic aortic dissection

Answer 13

reduce BP- B-blockers, then vasodilators

Question 14

abd pain, pulsatile abd mass, tenderness, hypotension

Answer 14

ruptured AAA

Question 15

AA dissection tx

Answer 15

surgery for > 5.5 cm or symptoms of rapid expansion

Question 16

most common complaint w/ abdominal aortic dissection?

Answer 16

back pain

Question 17

narrowing at bifurcation, presents w/ chronic lower limb ischemia

Answer 17

Aorto-Iliac Occlusive Disease

Question 18

typical aorto-iliac occlusive disease pt?

Answer 18

younger, female, smoker, hyperlipidemia, small infrarenal aorta

Question 19

TX for aorto-iliac occlusive disease

Answer 19

aortic bypass surgery, endovascular angioplasty w/ or w/o stenting

Question 20

venous thrombosis, varicose veins, chronic venous insufficiency

Answer 20

peripheral venous disease

Question 21

commonly seen after reperfusion of ischemic limb, typically calf
compression of nerves, veins, and arterial inflow

Answer 21

Compartment syndrome

Question 22

Tx for arterial disease (4)

Answer 22

walking
cholesterol therapy
aspirin
surgical intervention to remove plaque

Question 23

tx for venous disease (3)

Answer 23

walking, limb elevation, compression therapy

Question 24

Virchow's triad

Answer 24

stasis vessel wall injury hypercoaguability

Question 25

asymptomatic; otherwise swelling, pain, warmth, redness

Answer 25

DVT

Question 26

DVT tx

Answer 26

prevent clot propagation, prevent PE

Question 27

UE DVT tx

Answer 27

anticoagulant thrombolysis surgical decompression

Question 28

superficial thrombophlebitis tx

Answer 28

local heat, NSAIDs | should resolve 1-2 wks

Question 29

veins visible on surface following injury, like venous cath/PICC, IV tx

Answer 29

superficial thrombophlebitis

Question 30

obstruction of the pulmonary a. or one of its branches by material that originated elsewhere in the body

Answer 30

PE

Question 31

sustained hypotension, pulselessness, bradycardia | resulting in right ventricular failure and possible death

Answer 31

massive PE

Question 32

RV dysfxn or myocardial necrosis w/o systemic hypertension

Answer 32

submassive PE

Question 33

dyspnea, tachypnea, pleuritic pain, calf/thigh pain

Answer 33

PE

Question 34

EKG prognostic finding w/ PE

Answer 34

S1Q3T3

Question 35

gold standard for diagnosing PE

Answer 35

Pulmonary angiography

Question 36

how long should heparin therapy go?

Answer 36

at least 5 days

Question 37

VTE tx (5)

Answer 37

``` anticoag meds thrombolytics thrombo/embolectomy IVC filter prophylactic measures ```

Question 38

anti coag medicine for long term tx of VTE?

Answer 38

warfarin (coumadin)

Question 39

initial tx of VTE

Answer 39

IV unfractionated heparin

Question 40

outpt tx of VTE, stable PE for at least 5 days

Answer 40

LMW heparin

Question 41

Factor Xa inhibitors? (3)

Answer 41

Fondaparinux (Arixtra) Rivaroxaban (Xarelto) Apixaban (Eliquis)

Question 42

acute tx of VTE as "bridge" to warfarin

Answer 42

arixtra

Question 43

acute tx & secondary prevention of VTE (2)

Answer 43

Xarelto, Eliquis

Question 44

antidote for heparin

Answer 44

protamine

Question 45

direct thrombin inhibitor, acute tx and secondary prevention

Answer 45

Dabigatran (Pradaxa)

Question 46

duration of anticoag therapy for transient risk factor

Answer 46

3 mo

Question 47

duration of anticoag therapy w/ cancer

Answer 47

3 mo. or for the duration of the cancer

Question 48

duration of anticoag therapy for unprovoked thrombosis

Answer 48

3 mo., consider indefinite

Question 49

duration of anticoag therapy for underlying thrombophilia

Answer 49

indefinite

Question 50

activate plasminogen to form plasmin, resulting in accelerated lysis of thrombi

Answer 50

thrombolytics

Question 51

thrombolytic tx recommended for?

Answer 51

for unstable (hypoxia risk) pts w/ PE

Question 52

indication for thrombolectomy

Answer 52

unstable PE

Question 53

IVC filter

Answer 53

prevents DVT from propagating to lungs

Question 54

IVC filter indications/contraindications

Answer 54

indicated for: recurrent PE despite adequate anticoag | contraindicated for: coags (acute bleeding)

Question 55

outpt tx for VTE is indicated for? (4)

Answer 55

no indication of PE pain controlled good pt compliance can pay for it

Question 56

otpt tx of VTE is contraindicated if

Answer 56

DVT of IVC, common femoral, or UE recent surgery noncompliant PT