PVS

Question 1

MC arteries

Answer 1

-carotid bifurcation
-proximal LAD
-proximal renal arteries
-abdominal aorta
-progress distally
-atherosclerotic

Question 2

homocysteine

Answer 2

-high levels is a risk factor
-high meat diet
-assoc with low levels of B6,B12, folate, and renal ds

Question 3

peripheral venous system

Answer 3

-superficial venous thrombosis poses risks -> 1/3 DVT or PE
-DVT in upper limbs- 10% -> central venous catheters, cardiac pacemakers, defibrillators
-deep veins- 90% of blood
-superficial- great/small saphenous
-anastomotic- connect 2 superficial
-perforating- connect superficial to deep
-1 way valves

Question 4

anatomy of the arteries

Answer 4

-atherosclerosis- chronic inflammation
-LDLs in intima
-atheroma- fatty layer forms

Question 5

venous insufficiency

Answer 5

-varicose veins
-defective valves
-overstretched due to excessive or persistent pressure- venous HTN
-inability to drain blood
-venous stasis- pain
-venous dermatitis
-heavy feeling
-tired legs at end of day
-pulses- normal
-edema
-darkening, hemosiderin deposits
-chronic ulcers

Question 6

lymph

Answer 6

-epitrochlear- medial hand and axilla
-vertical inguinal- leg
-horizontal inguinal- abdomen, butt, genitalia, anus, perianal area, vagina

Question 7

artery with pain

Answer 7

-butt/hip- aortoiliac
-ED- iliac-pudendal
-thigh- common femoral or aortoiliac
-upper calf- superficial femoral
-lower calf- popliteal
-foot- tibial or peroneal
-post prandial- celiac, SMA, IMA

Question 8

leriche’s syndrome

Answer 8

-aortoiliac occlusive disease
-1. claudication
-2. ED
-3. decrease distal pulses

Question 9

PVD

Answer 9

-central venous catheters- discomfort, pain, numb, weak
-virchow’s- hypercoagulability, venous stasis, endothelial injury

Question 10

screening

Answer 10

->65 or > 50 with hx of DM or smoking or leg sx with exertion, non healing wounds
-renal artery ds, AAA
-60% have coexisting CAD or cerebral artery ds
-majority asymptomatic- claudication in only 10%
-ABI
-same CVD risk as MI pts

Question 11

intervention

Answer 11

-supervised exercise programs
-tobacco cessation
-tx of hyperlipidemia
-DM and HTN control
-antiplatelet agents
-meticulous foot care and well fitting shoes
-selected cases revascularization

Question 12

renal artery disease

Answer 12

-higher risk:
-end stage renal ds, CHF, DM, HTN
-fibromuscular dysplasia- women > 40

-suspect in:
-HTN <30
-severe HTN at age of >55
-accelerated/sudden worsening of previous controlled HTN
-resistant- 3 drugs
-malignant HTN- acute end organ damage
-worsening on renal function or after ACE/ARB
-small kidney
-unexplained pulmonary edema, especially with poor renal function

-US, MRA, CTA

Question 13

AAA

Answer 13

-risk- older age, male, smoking, family Hx
-hx of vascular aneurysms, taller, CAD, CVA, atherosclerosis, HTH, dyslipidemia
->3cm
-5.5- risk of rupture

-screen:
-men 65-75 who smoked more than 100 cigs
-also men who dont smoke
-dont screen women who have never smoked
-US

Question 14

ulcer

Answer 14

-arterial- lateral
-venous- medial

Question 15

1+ pulse

Answer 15

-diminished, weaker
-suggest arterial insufficiency

Question 16

edema

Answer 16

-use thumb
-2s
-dorsum of foot
-behind medial malleolus
-over shins

-causes:
-DVT
-chronic venous insufficiency
-lymphedema- unilateral

Question 17

venous thromboembolism (VTE)

Answer 17

-pain
-discoloration
-swelling of leg or lower
-warm
-leg fatigue

Question 18

arterial vs venous

Answer 18

-ARTERIAL
-claudication
-no edema
-no pulse
-round smooth sores- toes, feet
-black
-pain gets better when you dangle, elevation makes it worse
-tx- antiplatelets , femoralpop bypass
-cold

-VENOUS
-dull achy pain
-edema
-pulse is present
-irregular sores
-yellow purple skin
-ankle sores- medial