Vascular Assessment

Question 1

Proper patient protocol for taking blood pressure

Answer 1

avoid caffeine, tobacco, and alcohol 30 min prior, rest quietly 5 min, feet flat, back supported, no talking or moving, few deep breaths, arm at level of heart

Question 2

Obtain orthostatic vital signs when concerned about…

Answer 2

dehydration, blood loss, syncope

Question 3

Obtaining orthostatic vitals

Answer 3

lay pt down 5 minutes, obtain pulse and bp, assist to seated position, check bp and pulse after 1-2 min

Question 4

Positive orthostatics

Answer 4

pulse increase 10bpm or greater, b/p decrease 20mmHg or greater

Question 5

0/4 pulse

Answer 5

absent, not palpable

Question 6

1/4 pulse

Answer 6

diminished, difficult to palpate

Question 7

2/4 pulse

Answer 7

normal, easy to palpate

Question 8

3/4 pulse

Answer 8

full, increased

Question 9

4/4 pulse

Answer 9

bounding, strong

Question 10

Prevalence of AAAs increases with what two factors

Answer 10

smoking and age

Question 11

Grade 1+ pitting edema

Answer 11

2mm

Question 12

Grade 2+ pitting edema

Answer 12

4mm

Question 13

Grade 3+ pitting edema

Answer 13

6mm

Question 14

Grade 4+ pitting edema

Answer 14

8mm

Question 15

6 P’s of acute limb ischemia

Answer 15

paraesthesia, perishing cold, pulselessness, pain, paralysis, pallor

Question 16

ABI equation

Answer 16

highest pressure in foot/highest pressure in arm

Question 17

ABI suggesting PAD

Answer 17

<0.9

Question 18

varicosities

Answer 18

small irregular dark blue lines that indicate venous congestion

Question 19

Stasis dermatitis

Answer 19

reddish/purplish discoloration that develops due to hemosiderin deposits staining the skin

Question 20

Cellulitis signs

Answer 20

marked erythema, increased warmth and swelling

Question 21

lymphedema

Answer 21

impaired fluid return due to hereditary or secondary causes including crush injuries and tropical infections

Question 22

1 infectious cause of lymphedema

Answer 22

filarial infection

Question 23

Clubbing of digits is associated with

Answer 23

lung disease

Question 24

Sxs emphysema

Answer 24

dyspnea, minimal cough, pink skin, tachypnea, cachexia, decreased sounds

Question 25

Sxs chronic bronchitis

Answer 25

chronic, productive cough, hemoptysis, mild dyspnea initially, cyanosis, obese, prolonged expiration

Question 26

Primary modifiable risk factors for CVD

Answer 26

smoking, obesity, diet, physical inactivity, dyslipidemia, hypertension, diabetes

Question 27

Modifiable risk factors for stroke

Answer 27

hypertension, DM, smoking, dyslipidemia, physical inactivity

Question 28

Non-modifiable risk factors for stroke

Answer 28

older age, race and ethnicity, sex, family history

Question 29

Goals in initial phase of stroke exam

Answer 29

ensure medical stability (ABC), reverse contributing factors, determine if patient is a candidate for IV thrombolytic therapy or endovascular thrombectomy

Question 30

PE for stroke patients

Answer 30

evaluate neck, palpate pulses, asses heart and lungs, assess skin, fundoscopic exam, head trauma

Question 31

Three most predictive exam findings for diagnosis of acute stroke

Answer 31

facial paresis, arm drift/weakness, abnormal speech

Question 32

Screening patients for carotid artery stenosis

Answer 32

not suggested to screen asymptomatic individuals

Question 33

Vascular testing may be indicated for pts based on…

Answer 33

symptoms. PE findings or pts with high risk factors for atherosclerosis or other arterial pathology

Question 34

Virchow’s triad

Answer 34

alterations in blood flow, vascular endothelial injury, alterations in constituents of blood

Question 35

Genetic risk factors for DVT

Answer 35

factor V Leiden mutation, Protein S or C mutation, antithrombin deficiency

Question 36

PE for DVT… look for…

Answer 36

dilated superficial veins, unilateral edema or swelling, unilateral warmth, pain and tenderness, local or general signs of malignancy

Question 37

Most common presentation of peripheral venous insufficiency

Answer 37

limb discomfort, pain, limb swelling

Question 38

Pain pattern of peripheral venous insufficiency

Answer 38

pain does not radiate as with radiculopathies and is not exacerbated by joint movement, relieved with leg elevation and walking

Question 39

Pain pattern PAD

Answer 39

pain with walking or when elevated