Arterial Disease of the Limbs Flashcards Preview

R-Cradio-illness > Arterial Disease of the Limbs > Flashcards

Flashcards in Arterial Disease of the Limbs Deck (57)
Loading flashcards...
1

What is intermittent claudication?

Cramp like pain in the muscles of the buttock, thigh and calf which occurs on exercise and is relieved by rest

2

What is critical limb ischaemia?

A more severe disease than intermittent claudication
Rest pain, ulceration and gangrene which starts peripherally and moves centrally

3

What are the potential causes of peripheral arterial disease?

Atherosclerosis
Diabetes mellitus
Less common vasculitis e.g. Beurger's disease, hyperhomocysteinaemia, thromboangiitis obliterans

4

How is peripheral arterial disease diagnosed?

History
Examination
Ankle brachial pressure index (ABPI)

5

What investigations are needed if surgery or angioplasty is planned to treat peripheral arterial disease?

Duplex scan
MRA
Angiography

6

What is the prevalence of intermittent claudication in patients > 55 years?

4-7?

7

What percentage of people with intermittent claudication require intervention to prevent limb loss?

10%

8

What percentage of people with intermittent claudication require amputation?

1% per year

9

What are the important aspects to consider in amputation/treatment of perisperhal vascular disease?

Quality of life
Survival

10

What is the reduction in functional capacity in people with intermittent claudication compared to a healthy population?

50% reduced functional capacity

11

What are the risk factors of peripheral arterial disease?

Smoking
Lack of exercise
Diabetes
Hypertension
Hyperlipidaemia

12

What drugs can be prescribed for peripheral arterial disease prevention/secondary prevention?

Aspirin
Statins
ACEIs

13

What is the single most powerful risk factor associated with the aetiology and clinical progression of peripheral arterial disease?

Smoking

14

Within how long does the excess risk of cardiovascular disease diminish following smoking cessation?

4-6 years

15

What should be screened for in peripheral arterial disease? Why?

Diabetes
10% of those attending clinic will have undiagnosed diabetes

16

What effect does diabetes have on peripheral arterial disease?

Associated with more severe peripheral arterial disease

17

What will tight glycaemic control help the prevention of in peripheral arterial disease?

Microangiopathy

18

What will tight blood pressure control lead to in peripheral arterial disease?

Reduction in macrovascular complications and mortality rates

19

When is lipid lowering therapy with a statin recommended (according to SIGN)?

For patients with peripheral arterial disease and total cholesterol > 3.5 mmol/l

20

What do statins decrease the 5 year incidence of?

Major coronary events, coronary revascularisation and stroke by 1/5th per mmol/l reduction in LDL cholesterol

21

What are the kinds of statins?

Cholesterol lowering
Pleiotrophic

22

How do statins work?

Inhibit platelet activation, thrombosis, plaque rupture, inflammatory activation and endothelial activation

23

According to SIGN, what is the current BP target for hypertensive patients with peripheral arterial disease?

< 140/85mmHg

24

According to SIGN/TASC II, what patients with peripheral arterial disease should be prescribed anti-platelet therapy?

All patients

25

What measures can be taken in the secondary prevention of peripheral arterial disease?

Anti-platelet therapy with aspirin (or clopidogrel 2nd line)
Statins
Screen for diabetes
Diabetics achieve HbA1C < 7% and reassess at 3-6 months for exercise and PTA
Smoking cessation
BP control, to < 140/85 mmHg

26

What can be done for the symptom improvement of peripheral arterial disease?

Pharmacotherapy
Exercise therapy
Angioplasty
Surgery

27

After an acute MI, what is the reduction in mortality caused by cardiovascular rehabilitation?

25% reduction

28

What does exercise in peripheral arterial disease improve?

BP
Dyslipidaemia
Endothelial function

29

What is severe limb ischaemia?

Rest pain in more than 2 weeks per year
Tissue loss
ABPI < 0.5

30

What is critical limb ischaemia?

Absolute ankle pressure < 50mmHg