Trigger - PAD 2

Question 1

6 Ps, what are they and what diagnosis are they for

Answer 1

Pallor
Pain
Paresthesias
Paralysis
Polar
pulselessness

for acute arterial occlusion

Question 2

Imaging of choice is doppler

Answer 2

acute arterial occlusion

Question 3

treated with IV heparin

Answer 3

acute arterial occlusion

if after surgery you determine that the cause was an embolus then you give warfarin for three months

Question 4

MC in males >40 who smoke

think this guy

Answer 4

thomboangittis obilterans (Buerger disease)

Question 5

distal ischemic rest pain or ulceration on toes, feet or fingers

Answer 5

thomboangittis obilterans (Buerger disease)

Question 6

only dianostic studies that are done are to rule out other diseases

Answer 6

thomboangittis obilterans (Buerger disease)

Question 7

tobacco cessation is the only tx

Answer 7

thomboangittis obilterans (Buerger disease)

amputation is frequrntly required:(
NSAIDS or opioids can be given for acute ischemic events

Question 8

is this fusiform or saccular:

circumferential expansion/dilation all around aorta

Answer 8

fusiform!

saccular is outpouching of a segment of the aorta and has higher risk of rupture. (think a sac)

Question 9

abdominal pain radiating to lower back with tenderness to light palpation of the abdomen

Answer 9

AAA

Question 10

hypotension, flank pain, reduced peripheral pulses with bruising on the back

Answer 10

rupture of AAA

Question 11

1st Dx study of choice is abdominal US

Answer 11

AAA

Question 12

when is a CTA used in AAA

Answer 12

to assess need for surgery

Question 13

can be caused by ehlers-danlos syndrome, marfans syndrome or bicuspid aortic valve

Answer 13

thoracic aortic aneurysm

Question 14

can present with superior vena cava syndrome (dyspnea, stidor, distended neck veins, hoarsness)

Answer 14

thoracic aortic aneurysm

also presents with substernal back/neck pain that radiates to jaw and aortic regurg murmur

Question 15

can present with aortic regurg leading to a diastolic murmur

(there is more than one!)

Answer 15

1. thoracic aortic aneurysm
2. aortic dissection

Question 16

presents with substernal back/neck pain that radiates to jaw

Answer 16

thoracic aortic aneurysm

Question 17

shows widened mediastinum on CXR

Answer 17

1. thoracic aortic aneurysm
2. aortic dissection

Question 18

Dx of choice is CT scan w contrast

Answer 18

thoracic aortic aneurysm

can also use MRA or cardiac cath and echo to determine further problems and how its affecting the rest of the arteries

Question 19

Presents as sudden severe and persisten CP radiating to back or neck

Answer 19

aortic dissection

Question 20

Dx of choice is multiplanar CT chest/abdomen

Answer 20

aortic dissection

Question 21

1st line treatment after surgery is labetalol

can use esmolol if unsure how they will react to a BB

Answer 21

aortic dissection BP control

Question 22

morphine is used for pain in this diagnosis

Answer 22

aortic dissection

Question 23

which type of aortic dissection only needs surgery if malperfusion signs are seen

Answer 23

Type B (beyond subclavian0

Type A ALWAYS needs surgery!