CV

Question 0

What are the signs/symptoms of PAD?

Answer 0

• pain with walking, stops at rest — intermittent claudication (pain and cramping in legs)
• pain with increased speed, workload, incline
• diminished pulses, cool limb, pallor

Question 1

What is peripheral artery disease (PAD)?

Answer 1

• same as CAD, just blocking blood flow in periphery

- atherosclerosis - plaque builds up in peripheral arteries and occludes blood flow

Question 2

When severe, what is PAD considered?

Answer 2

An occlusive disease

Question 3

What are chronic changes in occlusive diseases? (Due to decreased blood flow)

Answer 3

• thick nail beds, dry skin, muscle atrophy, decreased sensation, and decreased strength

Question 4

What is one type of severe occlusive disease?

Answer 4

Critical limb ischemia

Question 5

Characteristics of critical limb ischemia?

Answer 5

• more likely to have this if have diabetes

- ulcerations, gangrene, pain, decreased functional capacity

Question 6

What is commonly used to diagnose PAD?

Answer 6

Ankle brachial index (ABI)

Question 7

How is ABI found?

Answer 7

Systolic pressure in ankle pulse divided by systolic pressure in arm

Question 8

What are the categories for ABI?

Answer 8

1-1.29 --- Normal
0.91-0.99 --- borderline
0.41-0.9 --- mild/mod PAD
0-0.4 --- severe PAD
*anything below 0.91 have some arterial occlusion

Question 9

PAD treatment

Answer 9

• risk factor modification
• decrease CV risk
• PROGRESSIVE EXERCISE
• foot care — any small would could cause problems due to not being able to heal bc of lack of blood flow
• angioplasty, bypass surgery, amputation

Question 10

What is an aneurysm?

Answer 10

• cardiac condition where vessel wall is weakened
• localized dilation or out pocketing of arterial wall
• as out pocketing increases, get increased wall tension and thrombi

Question 11

True vs false aneurysm

Answer 11

True – deterioration of media

False – blood accumulates, disrupts vessel layers

Question 12

What is a possible issue for aneurysm?

Answer 12

Longstanding HTN

Question 13

Aneurysm characteristics

Answer 13

• asymptomatic - first sign usually death or unrelenting pain in back in thoracic spine and in brain
• palpable out pocketing in LE
• severe abdominal back pain
• rupture – poor prognosis

Question 14

Treatments for aneurysm

Answer 14

• monitor size and location

- grafting – resect aneurysm, graft

Question 15

DVT

Answer 15

• blood clot in venous system

Question 16

What are the parts of the Virchow Triad?

Answer 16

1. Stasis of blood flow - limits muscular pump, immobility
2. Endothelial injury - trauma
3. Hypercoagulability of blood - oncologic disease

Question 17

DVT characteristics

Answer 17

• can be asymptomatic
• unilateral swelling distal to occlusion
• pain and warmth from blood stuck in extremity
• erythema
• if bilateral may be systemic issue

Question 18

Thromboembolic disease risks

Answer 18

• dehydration
• malignancy
• surgery/trauma
• pregnancy
• obesity
• transatlantic flight

Question 19

What are treatments for DVT?

Answer 19

• anticoagulation - blood thinners
• filters - IVC filter prevents clot from moving
• prevention – mobility, compression stockings (help prevent DVT post surgery and decrease pain)

Question 20

Pulmonary Vasculature disorders examples

Answer 20

• PE – blood clot in pulmonary artery blocks blood supply

- DVT - blood clot in venous system - cause embolism from air, tumor, bone marrow

Question 21

Risks of pulmonary Vasculature disorders

Answer 21

• virchows triad
• > 60 yrs old
• cigarettes
• obesity

Question 22

Pulmonary Vasculature disorders prognosis

Answer 22

• 10% die within one hour

- favorable for survivors

Question 23

Thrombus

Answer 23

• travels and becomes an embolus - if embolus is large, can cause death

Question 24

Pulmonary embolism - where do they come from?

Answer 24

- almost always come from DVTs | - clot broke off and traveled up to the heart to pulmonary artery and clogged

Question 25

What are symptoms of PE?

Answer 25

- chest wall tight - shoulder pain - hemoptysis (throw up blood) - dyspnea * occur in 20% of pop

Question 26

PE tests

Answer 26

- search for clot - Doppler - V/Q scan - chest CT

Question 27

PE Treatment

Answer 27

- anticoagulation, fibrinolytics, compression garments, oxygen, mobility

Question 28

What is congenital heart disease?

Answer 28

- heart defect in-utero - usually occurs in 1st trimester - not common in children (8/1000)

Question 29

Congenital heart disease etiology

Answer 29

- 10% have genetic defect | - other causes - alcohol, diabetes, viruses, hypoxemia, premature

Question 30

What are the two main types of congenital defects?

Answer 30

- cyanotic and acyanotic

Question 31

Cyanotic congenital heart disease

Answer 31

- affects oxygen levels | - impaired blood flow to lungs, mix of oxygenated and deoxygenated blood

Question 32

Acyanotic defects

Answer 32

- no oxygen problems | - shunt blood from left side of heart to right side

Question 33

Cyanotic defects

Answer 33

- transposition of great vessels - tetralogy of fallot - tricuspid atresia

Question 34

Acyanotic defects

Answer 34

- ventricular septal defect (VSD) - atrial septal defect (ASD) - coarctation of aorta - PATENT DUCTUS ARTERIOSIS (PDA)

Question 35

Patent ductus arteriosis

Answer 35

- acyanotic - in fetus, ductus arteries is connects pulmonary a. to aorta - blood bypass lungs - goes from high (aorta) to low (pulmonary a.) pressure - oxygenated blood - right to left shunt

Question 36

What are signs and symptoms of congenital heart disease?

Answer 36

- respiratory distress - cyanosis - grunting/wheezing - failure to thrive - signs of HF - SOB

Question 37

What are the diagnosis options for congenital heart disease?

Answer 37

- prenatal scree - genetic disorders - ultrasound - echocardiogram * often occurs with other NM, MS, or organ issues

Question 38

PT Implications for congenital heart disease

Answer 38

- assess activity tolerance - breathing patterns - HR response - posture - developmental milestones