PAD Flashcards
1
Q
describe atherosclerosis risk factors
A
- diabetes
- HTN
- Tobacco exposure
- obesity
- hyperlipidemia
- Chronic kidney disease
2
Q
Non-invasive testing
A
- H&P are sufficient to establish diagnosis
- Segmental pressure measurement = SBP at different upper and lower extremities segments
- Ankle-brachial index
- treadmill exercise protocols
3
Q
describe Ankle-Brachial index
A
- Ankle systolic blood pressure/Brachial SBP
- Above = 1.4 = calcified, non-compressible vasculature
- Normal + 1-1.4
- Abnormal = less than .9
- Lower the ABI, the less distance and lower speed in walking
- Ankle SBP < 55mmHg: poor healing
4
Q
risk factor modification
A
- QUIT SMOKING
- Weight loss
- HTN –> ACEi or beta-blockers
- Hyperlipidemia
- Rehabiliation (supervised exercise training (SAME OR BETTER THAN PHARMACOLOGY))
5
Q
Points of emphasis
A
- atherosclerosis is a SYSTEMIC disease with REGIONAL preference
- Peripheral arterial disease presents in a variety of ways from asymptomatic to acute life threatening events
- treatmet of PAD involves lifestyle changes, medical therapy, and surgical intervention
6
Q
diagnosis of PAD
A
7
Q
describe antiplatelet medications
A
- ASA, clopidogrel
- all patietns with symptomatic PAD, intermittent claudication + risk factors, all patients with previous revascularization
8
Q
anti-claudication meds
A
- Cilostazol
- phosphodiesterase inhibitor –> vasodilator
- reversibly inhibits platelet aggregation
- improves symptoms and walking distance
9
Q
surgical intervention
A
- endovascular
- open bypass
- amputation
10
Q
Acute limb ischemia
A
- Sudden decrease in limb perfusion that causes a potential threat to limb viability
- Six Ps
–> paresthesia, pain, pallor, pulselssness, poikilothermia, paralysis
- management = intervention via cathetor directed thrombolysis, endovascular and/or open leg bypass
- AMPUTATION MAY BE NEEDED
