Vascular 1 Flashcards
From smallest to largest what is the order for the following surgical clamps:
Jake
Hemostat/Snap
Mosquito
Kelly
Jake
Mosquito
Hemostat/Snap
Kelly
What are the 4 etiologies of PAD?
- atherosclerosis
- arterial embolism
- vasculitis
- fibromuscular dysplasia (FMD)
What are the 5 modifiable risk factors for PAD?
- smoking
- hypertension
- diabetes
- hyperlipidemia
- metabolic syndrome
Pain in the lower extremity with walking or physical activity that is relieved with rest is defined as?
intermittent claudication
What physical exam test can distinguish PAD from cellulitis?
Buerger test
- red discoloration that goes away with leg elevation is consistent with PAD
- this does not happen with cellultis!
What type of ulcer is this?
very painful ulcer located on the foot, toes, lateral boarders of the foot, or heel that is pale, yellow, or brown and has sharply defined or “punched out” boarders.
arterial
What type of ulcer is this?
ulcer can be asymptomatic and can occur at any of the pressure points. The color is variable and the borders are punched out with surrounding calloused skin.
neuropathic
What type of ulcer is this?
painful ulcer that is commonly found above medial or lateral malleoli. It is edematous with yellow fibrinous tissue and possible discharge. The borders are irregular with surrounding edema.
venous
Which of the gangrene types can result in auto-amputation?
dry gangrene
wet gangrene needs to go to the OR
T/F: You only need one of the tibial arteries to maintain blood flow to the foot.
True
What is the first line and easiest diagnostic study to do for PAD?
ankle-brachial index (ABI)
higher ankle SBP/higher arm SBP
What ankle-brachial index (ABI) score is diagnostic for PAD?
< 0.9
What ankle-brachial index (ABI) score is considered normal?
0.91-1.30
What ankle-brachial index (ABI) score is considered severe?
< 0.4
What does a ABI score of >1.3 mean?
vessel is non compressible d/t occlusion
need to use another test = toe pressure
PAD diagnosis consists of these 3 criteria.
- symptoms of critical limb ischemia
- ABI < 0.90
- Post-exercise ABI decrease by >20%
If a patient presents complaining of difficulty sleeping d/t lower limb pain that is only relieved when they dangle their leg from the edge of the bed what is this called?
rest pain
For patients with diabetes or ESRD who may have falsely elevated ABIs d/t calcifications what test is more accurate for PAD?
toe pressures or TBI
What are the 3 indications for measuring ABI in asymptomatic patients?
- abnormal or absent pedal pulses
- age > 70 years
- age 50-69 and history of smoking or diabetes
What do the 3 Rutherford Grades correlate with?
- Grade 1 = claudication
- Grade 2 = rest pain
- Grade 3 = tissue loss
What does the AHA Life’s simple 7 consist of?
- not smoking
- being physically active
- having normal BP
- having normal glucose level
- having normal total cholesterol level
- eating a healthy diet
Medical management for PAD always include these 2 medications.
- Aspirin
- Statin
What is cilostazole (Pletal) used for?
improve walking distance during exercise
What are the 4 indications for surgical intervention for PAD?
- disabling claudication
- ischemic rest pain
- ulcerations
- gangrene