Vascular Disorders

Question 1

Risk Factors for all Vascular Disorders

Answer 1

older age
hypertension
high lipid and cholesterol diet
CAD
DM

Question 2

General TX for Vascular Disorders

Answer 2

reducing risk factors
dieting
exercise
antiplatelet
pentoxifyllines and other blood thinners
fish oil
gingko biloba

Question 3

Sacroidosis

Answer 3

chronic multisystem granulomatous disease of unknown cause that impacts the lungs primarily
can travel to lymph nodes, liver, kidneys, skin, eyes, and heart

Question 4

Pulmonary Edema

Answer 4

abnormal life threatening accumulation of fluid in the alveoli and interstitial spaces that can be caused by fluid, over hydration, hypoalbuminemia, altered cap permeability, hypoxia, near drowning, malignancies of lymph system and resp distress

Question 5

Pulmonary Embolisms (PE)

Answer 5

blockage of pulmonary arteries by a thrombus, fat, air, or tumor that can travel through the vessels and becomes lodged in the lungs

Question 6

CM of PE

Answer 6

typically only dyspena, chest pain and hemoptysis
mild to moderate hypoxia
low O2 sat
pallor
hypotension
ECG changes for tachy and R ventricle strain
productive cough with bloody sputum
crackles on auscultation of the chest
fever
accentuation of the pulmonic heart sounds
sudden changes in LOC

Question 7

Etiology of PE

Answer 7

DVT in legs
VTE
lethal are from femoral or iliac veins that traveled
fat or air emboli
bacterial vegetations
amniotic fluid
tumors

Question 8

Risk Factors for PEm

Answer 8

sedientary lifestyle
smoking
recent surgery
malignancy
obesity
oral contraceptives and hormone therapy
prolonged air travel
HF
pregnancy
clotting disorders

Question 9

Tx of PE

Answer 9

O2 and intubation
fibrinolytic agent
un-fractioned heparin IV
limited activity
monitoring aPTT and INR levels
opioids for pain
inferior vena cava filter
pulmonary embolectomy

Question 10

Complications of PE

Answer 10

pulmonary infarction
pulmonary hypertension
alveolar necrosis
hemorrhage

Question 11

Critical Limb Ischemia

Answer 11

a tx that is revascularization through surgery or endovascular procedure and conservation management

Question 12

Phlebitis

Answer 12

inflammation, redness, tenderness, warmth, and mild edema of a superficial vein

Question 13

Venous Thromboembolism

Answer 13

thrombus forms in association with inflammation of a vein, most common disorder of the veins that can be superficial or DVT

Question 14

VTE CM

Answer 14

lower extremity pain
edema
tenderness with palpitation
dilated superficial veins 
sense of fullness in the thigh or calf
paresthesia
warm skin
erythema
fever
\+ve Homan's sign

Question 15

Post-Thrombotic Syndrome PTS

Answer 15

occurs with 20-50% with VTE from chronic hypertension caused by valvular destruction, stiffness, and compliance of vein walls

Question 16

PTS CM

Answer 16

pain
aching
heaviness
swelling and tingling
eczema
pigmented skin
secondary varicosities
lipodermatolsclerosis

Question 17

DVT Deep Vein Thrombosis

Answer 17

thrombus in the deeper veins like iliac or femoral t

Question 18

Pathophys DVT

Answer 18

localized platelet aggregation of fibrin entrap EBC, WBC, and more blood forms it to be bigger
partial blockage causes endothelial cells cover the thrombus and stops thrombotic process
can detach and result in emboli that flows through the venous circulation to the heart and pulmonary vessels

Question 19

Etiology of DVT

Answer 19

Virchow’s Triad is venous stasis, damage to the endothelium and hypercoagulability of the blood

Question 20

CM of DVT

Answer 20

Palpable, firm, or subcutaneous cord like vein
tenderness
rubor
warmth
pain
inflammation and induration along the vein
edema
febrile
milk leukocytosis
infections related to IV

Question 21

Risk Factors of DVT

Answer 21

increased age
pregnancy
obesity
malignancy
thrombophilia
estrogen therapy
recent travel, and sclerotherapy
history of chronic venous inefficiency, STV, or VTE

Question 22

Diagnostics

Answer 22

US
ACT
aPTT
INR
Hbg
Hct
platelet count
venous ultrasonography
CTV
R venography contrast venography

Question 23

TX DVT

Answer 23

compression socks
promoting activity
antiplatelet therapy- vit K, warfarin and heparin
revascularization therapy
venous thrombectomy
vena cava interruption devices
catheter for clot
clot busters
skin care
monitoring bloodwork and for sites of bleeding
fall risk assessment and prevention
pressure to venipuncture sites

Question 24

Peripheral Artery Disease

Answer 24

Thickening of the artery walls is also progressive narrowing of arteries in the upper and lower extremities that can cause more complications
under recognized which can lead to limb loss

Question 25

Risk Factors for PAD

Answer 25

tobacco
DM
Hyperlipidemia
hypertriglyceridemia
elevated C reactive protein levels
uncontrolled hypertension
sedentary life
Hyperhomocysteinemia
hyperuricemia
obesity
family history
increasing age
stress
black or Hispanic
history of vascular disease, MI or stroke

Question 26

CM of PAD

Answer 26

leg pain
paresthesia
intermittent claudication
appearance of limb be funky
edema with pitting
pedal pulses diminished or gone
rest pain
ulceration
gangrene
necrotic tissues
cold skin
erectile dysfunction
dependent rubor
thin, shiny skin
muscle atrophy
no or delayed cap refil

Question 27

TX of PAD

Answer 27

proper screening and early detection is vital
proper nail and feet care
proper footwear
exercise
antiplatelet
statins for lipids
wound care and aseptic techniques
revascularization surgery or endovascular procedure for conservation management
protecting extremity from trauma
peripheral artery bypass graph
enterectomy
patch graph angioplasty
amputation