Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology > 02.20 Peripheral Arterial Occlusive Disease > Flashcards

02.20 Peripheral Arterial Occlusive Disease Flashcards

1
Q

Atherosclerotic occlusive disease of the arterial system distal to the aortic bifurcation

A

PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Atherosclerosis commonly occurs in:

A

Aortic cusps
Branches of the aorta (subclavian and carotid)
Bifurcations (aorta to iliac artery, iliac artery to the superficial and deep femoral, anterior tibial to peroneal and posterior tibial artery, lumbar and iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Progression of atherosclerosis

A 
Initial lesion
Fatty streak
Intermediate lesion forms
Atheroma develops
Fibroatheroma
Complicated lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Histologically normal
Macrophage infiltration in sites of inflammation
Isolated foam cells

A

Inital lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Intima of the vessel becomes thickened because of intracellular lipid accumulation

A

Fatty streak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Due to intracellular lipid accumulation and small extracellular lipid pools

A

Intermediate lesion forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mixture of lipid intracellular accumulations core of extracellular lipid
Stage where disease may already become overt, presenting with clinical symptoms

A

Atheroma develops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fibrotic or calcific layers

A

Fibroatheroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Because the intima is no longer smooth, there are hematoma-hemorrhages and some degree of thrombosis

A

Complicated lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How lesions cause symptom

A

Stenosis/occlusion

Embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Symptoms appear if _____

A

Collateral circulation is poor

Artery occludes acutely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Leg attack

pain is felt in large muscle groups distal to an arterial lesion after exercise

A

Intermittent claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Severe compromise of arterial flow
Failure of compensatory mechanisms
Exacerbated by elevation
Limb threatening

A

Ischemic rest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tissue necrosis occurs when blood flow is inadequate to maintain tissue viability even at rest

A

Gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

RF for atherosclerosis

A 
Tobacco use
Diet
DM
Hyperlipidemia
HPN
Fam Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Important things to elicit in Hx

A

Cardiopulmonary assessment
Neurological assessment
Renal assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Specific vascular evaluation

A 
Inspection of skin changes
Capillary refill
Auscultate for bruits in central vessels
Pulse examination
Pulse grading
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Absence of pulse

A

0/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Weak (may suggest impairment)

Effort must be made to search for the pulse

A

1/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Normal

A

2/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Full

A

3/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bounding (may suggest aneurysm or calcification)

A

4/4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classification of PAD based on the Fontaine

A 
I - asymptomatic
IIa - mild claudication
IIb - moderate to severe claudication
III - ischemic rest pain
IV - ulceration or gangrene
24
Q

Classification of PAD based on Rutherford

A 
00 - asymptomatic
I1 - mild claudication
I2 - moderate claudication
I3 - severe claudication
II4 - ischemic rest pain
III5 - minor tissue loss
III6 - major tissue loss
25
Q

To confirm diagnosis
To establish patient baselines
Assess RF of the patient

A

Non-invasive vascular testing

26
Q

Non-invasive vascular testing

A

ABI
Doppler/Duplex waveform analysis
Segmented pressure and waveform studies

27
Q

Normal ABI value

A

1 to a little over 1

28
Q

Reflect the degree stenosis

A

Waveforms

29
Q

Sources of error in noninvasive vascular testing

A

Wrong cuff width
Incompressible arteries
Operator/technician factors

30
Q

Not used solely fro diagnosis, but is generally reserved for treatment planning

A

Invasive complex imaging

31
Q

General complications of invasive complex imaging

A 
Contrast reactions
Arterial complciations
Thrombosis
Atheroembolism
Puncture site complications
32
Q

Reserved for cases when there’s a plan for intervention since it’s already an invasive procedure

A

Conventional angiography

33
Q

Complications of conventional angiography

A

Hemorrhages or pseudo-aneursym formation at site of needle insertion
Too invasive

34
Q

Still need IV needle and contrast

Can produce a 2D or #d picture

A

CT angiography

35
Q

Risks/complications of CT angiographyh

A 
Dye-induced nephrotoxicity
Dye allergy
Thrombosis
Atheroembolism
Puncture-site
36
Q

Risk of MR angiography

A

Presence of any metallic objects in the body is CI

37
Q

Invasive complex imaging

A

Convetional arteriography
CT angiography
MR angiography

38
Q

Most important risk factor modification

A

Cessation of tobacco use

39
Q

Overall strategy in treatment of critical limb ischemia

A

Relieve ischemic pain
Heal ischemic ulcers
Improve patient functionality and quality of life
Prolong survival

40
Q

Primary outcome of treating CLI

A

Amputation-free survival

41
Q

Common profile of CLI patients you will encounter

A

Elderly
Multiple co-morbidities
Non-ambulant/non-functional leg

42
Q

Medical treatment

A

Cilostazol

Pentoxphylline

43
Q

In patients with limb threat

A

Revascularization

44
Q

Revascularization procedure

A

Percutaneous endovascular intervention
Surgical revascularization
Medical vascularization

45
Q

Percutaneous endovascular intervention

A

Angioplasty
Atherectomy
Stenting

46
Q

Surgical revascularization

A

Enderarterectomy

Bypass surgery

47
Q

Indications for surgical management

A

Gangrene
Pain at rest
Non-healing arterial ulcer
Disabling claudication

48
Q

Gold standard

Established long-term patencies, lim salvage and mortality outcomes

A

Operative bypass

Open surgical revascularization

49
Q

First line teratment

Minimally invasive, more tolerated by sick patients

A

Angioplasty

Stenting

50
Q

Minimally invasive endovascular techqnies for infra-inguinal disease

A 
Percutaneous angioplasty
PTA with stenting
Atherectomy
Subintimal angioplasty
Percutaneous endografting
51
Q

Intermediate-term outcome of angioplasty, when used preferentially for critical ischemia in anatomically suitable patients, provides very acceptable limb salvage and survival despite a relatively high stenosis rate

A

Primary angioplasty for critical limb ischemia

52
Q

Use of VEGF and basic FGF to promote collaterall circulation growth

A

Medical revascularization

53
Q

Single stenosis < 1 cm in length
Endovascular treatment
Endovascular

A

TASC-A

54
Q

Multiple stenosis focal, each < 1 cm in length
Endovascular therapy is the preferred treatment even in long lesions or tandem lesions
Endovascular therapy is preferred treatment

A

TASC-B

55
Q

Stenoses 1-4 cm in length
Short occlusions < 2cm in length
Surgery

A

TASC-C

56
Q

Diffuse long stenosis < 4 cm in length
Occlusions > 2cm in length
Surgery

A

TASC-D

Cardiology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions