Exam 2: Wk 1: PAD & Interventions

Question 1

PAD

Answer 1

• leg pain with activity
• increases w/ age, diabetes, AA
• lower in Asian and Hispanic

Question 2

ABI Results

Answer 2

ABI > 1.3 likely PAD
ABI .9-1.29 normal
ABI <= .9 without symptoms (asymptomatic)
ABI <.9-.6 pain with activities - NOT reproducible in terms of pace, time, or rest
ABI < .9 - .6 pain with activities - reproducible in terms of pace, time, and rest
ABI <.3-.6 pain at rest; critical limb ischemia

Question 3

Critical limb ischemia

Answer 3

• Presence of ischemic pain at rest
• ABI <.3-.4
• non healing wounds and gangrene

Question 4

Neurogenic CLAUDICATION

Answer 4

Look for spinal stenosis, peripheral neruopathy, peripheral nerve pain, sciatica, restless leg pain, bakers cyst, muscle cramps, hip or knee OA

Question 5

5 Ps of PVD

Answer 5

Pain
Pulselessnessness
Pallor
Paresthesia
Paralysis

Question 6

When to do a TBI Toe Brachial (Index)

Answer 6

When Abi is not possible due to noncompressible pedal pulses

• divide toe pressure by higher of the two brachial

Results: <= .7 diagnostic for LE PAD

Question 7

Segmental Pressures

Answer 7

BP measured along the LE to localize an area of decline in systolic pressure

Question 8

Pulse Volume Recordings

Answer 8

Measures ratio of volume changes during systole and diastole

• relative lack of blood flow during diastole is indicative of arterial disease

Question 9

Exercise ABI testing

Answer 9

Confirms PAD

• assesses the functional severity of CLAUDICATION

Question 10

Plantar flexion exercise ABI

Answer 10

Used if Abi is impractical
- inexpensive
- does not measure functional capacity
- may be able to reporduce a treadmill derived fall in Abi then measure the pressure differences

Question 11

Main risk factors with PAD

Answer 11

Smoking
High Cholesterol
Diabetes
High bp

Question 12

Plavix vs Asprin risk reduction

Answer 12

Plavix > asprin
- Plavix better prevents CVA, PAD

Asprin > Plavix
- better at preventing MI

Question 13

Plavix vs Pletal

Answer 13

Plavix - favored for improving ISCHEMIA

Pletal - favored for improving CLAUDICATION

Question 14

Exercise Protocol for PAD

Answer 14

5-10 min warm up and cool down
Treadmill / track walking
Resistance exercise supplementary

Intensity: cause CLAUDICATION within 3-5 min
Time: until moderately severe CLAUDICATION is reached
Rest: until CLAUDICATION resolves in sitting or standing

Question 15

FITT

Answer 15

Freq: 3-5 sessions/wk
Intensity: CLAUDICATION within 3-5 min
Time: 50 min of walking for up to 6 months