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Peripheral Vascular Problems

jennifer12345's version from 2018-09-25 14:21

Section 1

Question Answer
Risk factors for PADcigarette use, age, family history, DM, HTN, HL, CKD
Symptoms of PADintermittent claudication, pain relieved by rest
Advanced signs of PAD includeparesthesias and numbness, ulcerations and gangrene
Physical findings of PADdiminished pulses, dependent rubor, thickened toenails, LE hair loss, bruits, pallor with leg elevation
Differential diagnosis of PAD includenerve root compression, osteoarthritis, raynaud's disease, aneurysm, diabetic neuropathy
Signs of acute ischemia in PADpain, pallor, pulselessness, paresthesia, paralysis
DVT risk factorsadvanced age, malignancy, pregnancy, HF, thrombophilias, smoking, obesity
3 strong predictors of DVT (virchow's triad)venous stasis, vascular injury/abnormality of intimal layer, hypercoagulopathy
Disease states that increase warfarin effectsdiarrhea, fever, hypothyroidism, CHF, liver disease

Section 2

Question Answer
The primary cause of PAD is atherosclerosisTrue
Most common arteries affected in PAD aorta, iliofemoral, popliteal, posterial tibialTrue
Collateral vessels develop in acute occlusionsFalse
Location of pain with PAD can indicate location of the occlusionTrue
The ankle brachial index is not needed to establish a diagnosis of PADFalse
Testing for PAD includes lipids, CMP, doppler ultrasoundTrue
Gold standard for diagnosing varicose veins is duplex doppler ultrasoundTrue
Most PE's originate from below the kneeFalse
Calf DVT without PE risk prefer LMWH over UFHTrue
Heparin lyses clotsFalse
post-thrombotic syndrome is damage to veins usually within one year of DVTTrue
CXR and ABG may be normal in PETrue

Section 3

Question Answer
Symptoms with 70% stenosisexertional pain
Symptoms with 70-90% stenosisnocturnal pain
Symptoms with 90% stenosisischemic pain at rest and gangrene

Section 4

Question Answer
Location of pain in calf indicatesfemoral-popliteal region occlusion
Location of pain in hip, buttock, or thigh indicatesaortal-iliac region occlusion

Section 5

Question Answer
ankle brachial index of < 0.9 indicatesdiminished blood flow (PAD)
ankle brachial index of < 0.5 indicatesischemia, need for referral
ankle brachial index of > 1.4 indicatescalcification
ankle brachial index of 1.0-1.4 indicatesnormal

Section 6

Question Answer
PAD Stage 1asymptomatic
PAD Stage 2symptoms with walking, relieved with rest, intermittent claudication
PAD Stage 3symptoms with rest, rest ischemia
PAD Stage 4skin ulceration or gangrene

Section 7

Question Answer
Initial treatment for PADaspirin 75-325 mg daily
Second line therapy for PAD clopidogrel 75mg daily
Patient unresponsive to conservative therapycilostazol 100mg BID, vasodilator with antiplatelet effect, cannot use if pt with CHF

Section 8

Question Answer
Chronic venous insufficiencyDVT underlying etiology
Varicose vein pathophysiologyincompetent valves and decreased elasticity
post-thrombotic syndrome pathophysiologyambulatory venous HTN causes progressively dilated vein, ulcer formation above medial malleolous

Section 9

Question Answer
Thrombusclot that forms
Embolus clot that moves

Section 10

Question Answer
Rivaroxaban (Xarelto)direct factor Xa inhibitor, used after hip/knee replacement, PE treatment or stroke prevention
Dabigatran etexilate (Pradaxa)direct thrombin inhibitor, use in CVA, embolism
Apixaban (Eliquis)newest direct factor Xa inhibitor

Section 11