T2: PVD and PE Flashcards
What is Well’s Criteria?
The Wells criteria for pulmonary embolism is a risk stratification score and clinical decision rule to estimate the probability for acute pulmonary embolism (PE) in patients in which history and examination suggests acute PE is a diagnostic possibility.
What are the underlying pathological mechanisms of PVD?
PVD, also known as arteriosclerosis obliterans, is primarily the result of atherosclerosis. The atheroma consists of a core of cholesterol joined to proteins with a fibrous intravascular covering. The atherosclerotic process may gradually progress to complete occlusion of medium-sized and large arteries. It can cause perisperhal arteries (hence why its is also called PAD) to narrow, block or spasm.
Underlying this is atherosclerosis.
What factors predispose to venous thrombosis?
Predisposing factors include age, BMI and smoking.
Give symptoms of PAD.
- Swelling
- An obstruction to an artery is a blockage in the inflow to the tissues. There is a reduced flow of materials to the tissues. The limb pale, dry and the muscle is often wasted.
- Hair loss on your legs and feet
- Numbness or weakness in the legs
- Brittle, slow-growing toenails
- Ulcers (open sores) on feet and legs, which do not heal
- Changingskin colouron legs, such asturning pale or blue
- Shiny skin
- In men, erectile dysfunction
The muscles in your legs shrinking (wasting)
Give differences between venous and arterial blockages.
Venous blockage:
- Swelling, darkening and tender peripheral tissues
- Can lead to a PE
- Leads to collaterals opening up
Arterial blockage:
- Leads to atrophy, pallor (pale) and pain
- Can affect peripheries and can lead to gangrene
- Causes collaterals to open up
What often happens to small PEs?
Small thrombi that do not cause clinical problems, start to resolve. They fibrous and recanalize. This is often what happens when an individual has a lot of small PEs they do not know about.
What are the underlying pathological mechanisms of PE?
Usually DVT
