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Cardiology > Peripheral Vascular Disease > Flashcards

Peripheral Vascular Disease Flashcards

1
Q

full-thickness dilation of the abdominal aortic artery to 1.5 times the diameter measured at the level of the renal arteries

A

abdominal aortic aneurysm (AAA)

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2
Q

what diameter of the abdominal aorta considered aneurysmal?

A

3cm or more

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3
Q

what population is affected by AAA? (2)

A

men
smokers
caucasians

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4
Q

mortality from AAA rupture is ____ to ____%

A

70-95%

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5
Q

what is the most commonly used predictor for AAA rupture?

A

maximum diameter of AAA

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6
Q

where do AAA tend to develop?

A

infrarenal aorta

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7
Q

5-yr rupture rate of asymptomatic AAA is ___ to ___% for aneurysms over 5cm in diameter

A

25-40%

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8
Q

5-yr rupture rate of asymptomatic AAA is ___ to ___ for AAA 4-5cm

A

1-7%

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9
Q

screening for AAA via ultrasound is recommended for who? (2)

A

men 65-75 yrs + smoking hx

over 60 yrs + fam hx of AAA

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10
Q

what is the monitoring rule for a patient with a AAA measuring 4-5.4 cm?

A

ultrasound or CT every 6-12 months

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11
Q

what is the monitoring rule for a patient with a AAA that is less than 4cm?

A

ultrasound every 2 years

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12
Q

a patient presents with abdominal, back, flank/groin pain + early satiety, nausea, and vomiting with compression of bowel. what are they likely experiencing?

A

AAA

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13
Q

what are 3 diagnostics that can be used for a AAA?

A

abdominal ultrasound
CT scan
MRA

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14
Q

what may indicate a thrombus within the anuerysm?

A

elevated D-dimer

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15
Q

what is the main medical treatment for AAA?

A

antibiotics (doxy + roxithromycin)

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16
Q

when can a beta blocker be used to treat AAA?

A

AAA + marfan’s syndrome

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17
Q

what are 2 surgical treatments for AAA?

A

endovascular aneurysm repair
open repair

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18
Q

blood passing through an intimal tear, separating the intima from the medial layers and creating a false lumen; intramural hematoma leads to this…

A

aortic dissection

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19
Q

what are 3 risk factors for aortic dissection?

A

hypertension
atherosclerosis
age

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20
Q

a patient presents with sudden onset of severe sharp/tearing/ripping chest pain and syncope. what are they likely experiencing?

A

aortic dissection

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21
Q

anterior chest pain is indicative of what kind of aortic dissection?

A

ascending dissection

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22
Q

back and abdominal pain is indicative of what kind of aortic dissection?

A

descending dissection

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23
Q

what are 4 diagnostics that can be used for an aortic dissection?

A

transesophageal echo
CTA
MRI
multidetector CT

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24
Q

what is the acute general treatment for an aortic dissection?

A

pain control
lower BP with IV beta blockers (CCB if BB contraindicated)

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25
Q

inhibition of blood flow to the lower extremities

A

peripheral artery disease

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26
Q

what are the 2 main causes of PAD?

A

atherosclerotic disease
plaque formation

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27
Q

what are 4 risk factors of PAD?

A

smoking
diabetes
hypertension
hypercholesterolemia

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28
Q

a patient presents with claudication of the calf/thigh/buttock, bruits, changes in skin color, and prolonged capillary refill. what are they likely experiencing?

A

PAD

29
Q

what is a sign of a more serious case of PAD?

A

aching/burning of toes and feet

30
Q

what are the essential parts of a physical for a patient with suspected PAD? (4)

A

BP in both arms - note symmetry

palpate pulses

bruits

inspect extremities

31
Q

the highest resting systolic BP at the ankle is compared with the highest systolic brachial pressure, and the ratio of the two pressures give us this number

A

ankle-brachial index (ABI)

32
Q

what should be performed to establish diagnosis of lower extremity PAD in patients

A

ankle-branchial index

33
Q

what are 3 diagnostics used for PAD?

A

CTA
MRA
Ultrasound

34
Q

what diagnostic is used for patients with PAD who are being considered for revascularization?

A

contrast angio

35
Q

what are 2 therapies indicated to treat PAD?

A

antiplatelet therapy (ASA or clopidogrel)
ramipril (for HTN)

36
Q

what medication can be used for PAD to increase pain-free walking and ABI?

A

pletal (cilostazol)

37
Q

inflammation of medium and large arteries on the side of the head

A

giant cell arteritis

38
Q

a patient presents with scalp tenderness, fever, weight loss, stiff trunk, visual loss, and claudication of the jaw and tongue on mastication. what are they likely experiencing?

A

giant cell arteritis

39
Q

what diagnostic is used for giant cell arteritis?

A

temporal artery biopsy

40
Q

what is the treatment for giant cell arteritis? (2)

A

IV methylprednisolone
oral prednisone

41
Q

what are 3 main causes of a DVT?

A

prolonged immobilization (>3 days)

postoperative state

trauma to LE/pelvis

42
Q

what are 3 differentials of a DVT?

A

cellulitis
lymphangitis
achilles tendinitis

43
Q

what is the presentation of a patient with a DVT?

A

pain/swelling of extremity
leg pain on dorsiflexion of the foot (homan sign)

44
Q

what is the diagnostic test of choice for a DVT?

A

compression ultrasound with doppler

45
Q

what lab can be useful to check for a DVT?

A

d-dimer (sensitive - SNOUT)

46
Q

what medications can be used to treat a DTV? (4)

A

heparin
enoxaparin
fondaparinux
warfarin

47
Q

what can reduce the incidence of post-thrombotic syndrome in a DVT?

A

compression stockings

48
Q

what treatment can be used for a DVT if a patient cannot have anticoagulants?

A

IVC filter

49
Q

what should be considered in all patients with unprovoked and frequent venous thromboembolisms?

A

cancer

50
Q

a patient presents with varicose eczema, hyperpigmentation, atrophie blanche, and lipodermatosclerosis. what are they likely experiencing?

A

chronic venous insufficiency (CVI)

51
Q

the most common and earliest sign of CVI that consists of pruritic, red, and scaly patches above the medial ankle

A

varicose eczema

52
Q

a sign of CVI caused by the breakdown of RBCs and leads to hemosiderin deposition

A

hyperpigmentation

53
Q

sign of CVI that are hypopigmented white patches with focal red punctate dots or telangiectasia surrounded by hyperpigmentation

A

atrophie blanche

54
Q

sign of CVI that is chronic, brawny induration of the skin, leading to inverted champagne bottle appearance of the leg; susceptible to ulcers

A

lipodermatosclerosis

55
Q

what diagnostic is used for CVI to identify reflux in the superficial, deep, and perforating veins + obstruction of the deep veins

A

duplex ultrasound

56
Q

what are some nonpharmacological treatments for CVI? (2)

A

leg elevation for 30mins 3-4x/day

compression stockings

57
Q

what is the medical treatment for CVI?

A

topical corticosteroids for inflammation + itching

58
Q

superficial venous insufficiency when venous return is impaired by valvular incompetence, obstruction, or calf muscle pump failure

A

varicose veins

59
Q

a patient presents with aching, heaviness, swelling, cramps, itchiness, tingling and pain of the lower extremities. what could they be experiencing?

A

varicose veins

60
Q

what are 2 complications of varicose veins?

A

SVT
bleeding

61
Q

what diagnostic can be used for varicose veins if a patient wants more than conservative therapy?

A

duplex ultrasound

62
Q

what is the treatment for varicose veins? (3)

A

aerobic exercise 30min/day
elevate legs
flex ankles

63
Q

inflammation of a superficial vein

A

SVT

64
Q

which vein is most commonly involved in SVT?

A

great saphenous vein

65
Q

what is the most common cause of upper extremity SVT?

A

IV catheters and IV drugs

66
Q

a patient has a tender cord or wormlike mass on their leg with increased warmth and erythema. what could it be?

A

SVT

67
Q

what diagnostic can confirm an SVT?

A

duplex ultrasound

68
Q

what is the treatment for an SVT? (2)

A

warm, moist compress
mobilization/exercise

69
Q

what medication can be used for a LE SVT within 1cm of the saphenofemoral or saphenopopliteal junction?

A

fondaparinux

Cardiology (19 decks)

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