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cardiovascular system > Arterial disease of the limbs- presentation, investigation and therapy > Flashcards

Arterial disease of the limbs- presentation, investigation and therapy Flashcards

1
Q

what are the symptoms of chronic limb ischaemia

A

intermittent claudication

cramp like pain in muscles that occurs on exercising

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2
Q

what are the symptoms of chronic limb ischaemia

A

intermittent claudication

cramp like pain in muscles that occurs on exercising

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3
Q

what are the symptoms of critical limb ischaemia

A

rest pain

ulceration and gangrene

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4
Q

what is the pathogenesis of PAD

A

atherosclerosis

diabetes mellitus

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5
Q

what are rare causes of PAD

A

beurgers disease

hyperhomocysteinaemia

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6
Q

patients with PVD (PAD) should be managed in the same way as those with what condition

A

Chronic heart disease

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7
Q

what are some of the risk factors of developing PAD/PVD

A 
smoking
not enough exercise 
diabetes
hypertension 
excessive lipids in the blood
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8
Q

what would you prescribe to manage risk factors to a patient already diagnosed with PAD

A

aspirin
statin
ACE inhibitor

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9
Q

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

A

smoking

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10
Q

if a patient stopped smoking how long would it take for their excess risk of cardiovascular disease to disappear

A

4-6 years

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11
Q

how does diabetes influence PAD

A

makes it more severe

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12
Q

why is it important to screen for diabetes in patients with PAD

A

as up to 10% attending the clinic are undiagnosed diabetics

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13
Q

what do statins inhibit

A

plaque rupture
platelet activation & thrombosis
endothelial activation

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14
Q

what is the blood pressure target for patients with hypertension

A
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15
Q

what is the modern secondary prevention management of peripheral arterial disease (5 things)

A 
Anti-platelet therapy- clopidogrel 2nd line
Statin- for all
Screen for diabetes
Smoking cessation
BP control: BP
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16
Q

what can help improve symptoms in those with PAD

A

medicine
exercise therapy
angioplasty
surgery

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17
Q

what effects does doing exercise have on patients with PAD

A

improves BP
improves dyslipidaemia
improves endothelial function

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18
Q

what can surgery do in those with PAD to manage symptoms

A

very little as extensive disease is not suitable for percutaneous transluminal coronary angioplasty

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19
Q

in patients with PAD who is suitable for surgery

A

those who currently have a poor QOL
have acceptable co-mobidity
clear understanding of the risks of surgery

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20
Q

what is the modern management for critical limb ischaemia

A

first line secondary prevention and surgery,angioplasty, amputation

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21
Q

in critical limb ischaemia what signs show the limb is at risk

A

presence of rest pain

ulcers gangrene

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22
Q

in patients with critical limb ischaemia what is the 5 year survival rate

A

50% still alive at 5 years

23
Q

how do you tell if acute limb ischaemia is due to an emblous

A

if all pulses are present in contralateral limb and there is atrial fibrillation, suggests embolus

24
Q

how do you tell if ischaemia is due to in situ thrombosis

A

presence of intermittent claudication suggests in situ thrombosis

25
Q

what investigations could be done for acute limb ischaemia

A

ECG
CXR
routine bloods
Angiography for suspected in-situ thrombosis

26
Q

if a patient has acute limb ischaemia due to an embolus what is the treatment

A

straight to theatre

27
Q

in acute limb patients present with all the Ps, list these

A 
pain 
pulseless
papathesia
pallor
paralysis
perishing cold
28
Q

if a patient has acute limb ischaemia due to an embolus when is surgery required in order to save the limb

A

6-8 hours

29
Q

what are the symptoms of critical limb ischaemia

A

rest pain

ulceration and gangrene

30
Q

what is the pathogenesis of PAD

A

atherosclerosis

diabetes mellitus

31
Q

what are rare causes of PAD

A

beurgers disease

hyperhomocysteinaemia

32
Q

patients with PVD (PAD) should be managed in the same way as those with what condition

A

Chronic heart disease

33
Q

what are some of the risk factors of developing PAD/PVD

A 
smoking
not enough exercise 
diabetes
hypertension 
excessive lipids in the blood
34
Q

what would you prescribe to manage risk factors to a patient already diagnosed with PAD

A

aspirin
statin
ACE inhibitor

35
Q

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

A

smoking

36
Q

if a patient stopped smoking how long would it take for their excess risk of cardiovascular disease to disappear

A

4-6 years

37
Q

how does diabetes influence PAD

A

makes it more severe

38
Q

why is it important to screen for diabetes in patients with PAD

A

as up to 10% attending the clinic are undiagnosed diabetics

39
Q

what do statins inhibit

A

plaque rupture
platelet activation & thrombosis
endothelial activation

40
Q

what is the blood pressure target for patients with hypertension

A
41
Q

what is the modern secondary prevention management of peripheral arterial disease (5 things)

A 
Anti-platelet therapy- clopidogrel 2nd line
Statin- for all
Screen for diabetes
Smoking cessation
BP control: BP
42
Q

what can help improve symptoms in those with PAD

A

medicine
exercise therapy
angioplasty
surgery

43
Q

what effects does doing exercise have on patients with PAD

A

improves BP
improves dyslipidaemia
improves endothelial function

44
Q

what can surgery do in those with PAD to manage symptoms

A

very little as extensive disease is not suitable for percutaneous transluminal coronary angioplasty

45
Q

in patients with PAD who is suitable for surgery

A

those who currently have a poor QOL
have acceptable co-mobidity
clear understanding of the risks of surgery

46
Q

what is the modern management for critical limb ischaemia

A

first line secondary prevention and surgery,angioplasty, amputation

47
Q

in critical limb ischaemia what signs show the limb is at risk

A

presence of rest pain

ulcers gangrene

48
Q

in patients with critical limb ischaemia what is the 5 year survival rate

A

50% still alive at 5 years

49
Q

how do you tell if acute limb ischaemia is due to an emblous

A

if all pulses are present in contralateral limb and there is atrial fibrillation, suggests embolus

50
Q

how do you tell if ischaemia is due to in situ thrombosis

A

presence of intermittent claudication suggests in situ thrombosis

51
Q

what investigations could be done for acute limb ischaemia

A

ECG
CXR
routine bloods
Angiography for suspected in-situ thrombosis

52
Q

if a patient has acute limb ischaemia due to an embolus what is the treatment

A

straight to theatre

53
Q

in acute limb patients present with all the Ps, list these

A 
pain 
pulseless
papathesia
pallor
paralysis
perishing cold
54
Q

if a patient has acute limb ischaemia due to an embolus when is surgery required in order to save the limb

A

6-8 hours

cardiovascular system (34 decks)

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