Vascular Disorders Flashcards
Peripheral artery disease
What it is
Narrowed vessels from atherosclerosis
PAD RF
Smoking
DM
HTN
High cholesterol
age >60
PAD clinical manifestations
Hallmark: intermittent claudication
*pain in leg
Rest pain occurs
Keep legs lowered
COLD SKIN
Unhealthy skin
Hair loss
Decreased/absent pedal/popliteal/femoral pulses
Elevated pallor when foot is elevated
PAD complications
Atrophy of skin/muscle
Nonhealing wounds (gangrene)
PAD diagnostic studies
Arterial doppler: ultrasound
ABI (ankle brachial index)
*ankleSBP/brachial SBP
Angiography:
*inject dye see if there is a block (like a cardiac cath)
Management of PAD
First line is to reduce CVD risks: smoking cessation
Exercise
Diet: high protein (HH)
Control BP/DM/hyperlipidemia
Protect limbs
Foot care
Meds for PAD
ASA and maybe add clopidogrel if high risk
Intermittent claudication:
Cilostazol
Pentoxifyline
PAD surgical management
Stent placement
Amputation if too bad
Postop management
Perfusion assesments
Ambulation
Chronic venous insufficiency
Clinical manifestations
Leathery skin
Color change
Edema
Pruritus
Venous ulcers
Management of chronic venous insufficiency
Compression (check perfusion first)
Elevate legs
Daily walking
Diet: high in protein
Skin care
Thromboanginitis obliterans (Buergers disease)
Nonatherosclerotic inflammatory disorder of vessels in fingers and toes
Associated with long h/o: tabacco and marijuana
smoking cessation-no nicotine replacement
Raynauds phenomenon
What it is
Who is common
Triggers
Vasospasms in fingers and toes
Common women 15-40
Triggers:
Cold
Stress
Tabacco
Caffeine
Raynauds pt education
Prevent triggers
Warm water
Vasodilators:
Ca channel blockers
Topical nitroglycerin
VENOUS THROMBOSIS
Blood clot and vein inflammation
Superficial vs deep
Venous thromboembolism
Virchows triad
Venous stasis
Endothelial damage
Hypercoagulability (preg)
Venous thromboembolism
S/s
Diagnosis
Unilateral edema
Pain
Warmth
Fever
Diagnosis: venous ultrasound
VTE management
Prevention
Asses for what
Limit what
Do not do what
Prevention: scd, ambulation, hydrate
Tx: anticoagulants
Assess: PE
Limit activity
Do not massage calf
Superficial vein thrombosis
Palpable cordlike vein
Edema
Itchy,red,warm
Mild fever
Superficial vein thrombosis
Diagnosis
Tx: mild vs severe
Ultra sound to diagnose
Mild tx: NSAIDS
Severe: anticoagulants
