Peripheral vascular exam - arterial

Question 1

Why might someone have vascular disease?

Answer 1

Vascular - systemic sclerosis, connective tissue disorder, arterisclerosis and atherosclerosis

Infection - endocarditis

Trauma

Autoimmune - SLE, vasculitis

Metabolic - hyperlipidemia, Diabetes

Iatrogenic - OCP

Neoplasm

Congenital

Degenerative - aging and stiffening

Question 2

What are the two types of Raynaud’s disease?

Answer 2

Primary: idiopathic

Secondary: SLE, RA, systemic sclerosis

Question 3

What are the signs of peripheral arterial disease?

Answer 3

Cool feet/ toes (Raynauds)

Ulceration

Toenail dystrophy

Shiny/ hairless skin

Gangrene (check in between toes)

Question 4

What are the symptoms of peripheral arterial disease?

Answer 4

Pain upon walking

Question 5

What is the structure of the vascular exam for arteries?

Answer 5

WIPE

G - general inspection - cool feet/ hands (Raynauds), ulcers, shiny/hairless skin/ toe nail changes
A - arms and hands - tar stains
P - pulses
C -carotids
A - abdomen and renal bruits
L - legs
Special tests like Buergers test - will go blue when up then red quickly if diseased

Further investigations - ABPI (<0.9 indicates disease), nerve exams, FBC, metanephrines, doppler, CT, angiography

Question 6

What is ABPI?

Question 7

What are the features of arterial disease?

Answer 7

Painful

Perishingly cold

Pulseless

Pale

Paralysed

Parastesia

Question 8

What other symptoms are associated?

Answer 8