Leg Pain, Chest Pain, Back Pain I Flashcards Preview

CV II Exam 3 > Leg Pain, Chest Pain, Back Pain I > Flashcards

Flashcards in Leg Pain, Chest Pain, Back Pain I Deck (49):
1

impotence, calf, thigh, buttock claudication, femorals not palpable

aorto-iliac occlusion

2

Tx of aorto-iliac occlusion

stop smoking
BP control
ASA and clopidogrel
cilostazol
pentoxifylline
ramipril
statin
stent
bypass
calf compression

3

phosphodiesterase inhibitors

cilostazol
pentoxifylline

4

cilostazol

PDE3 inhibitor

anti-platelet

5

pentoxifylline

PDE3 inhibitor

anti-platelet

6

dependent rubor

leg turn red with no circulation

7

pseudohypertension

oslers sign
-bc of calcified vessels

8

oslers sign

pseudo HTN bc of calcified vessels

9

wave form analysis

if calcified vessels

10

Tx of superficial and common femoral and popliteal stenosis

fem-pop bypass

11

worse pain when extend back and improvement when bending forward

spinal stenosis

can look like PVD

12

S4

atrial contraction to noncompliant ventricle

13

burning dorsal foot pain

tibial and pedal artery occlusion

gets better when get up and dangle foot

Tx - vein bypass

14

diabetic neurpoathy

no relief with standing

15

MRA

magnetic resonance angiography
-for Dx of arterial occlusion

16

pedal pulses not palpable

arterial occlusion

17

loss of light touch

do surgery

18

50% of cardiac emboli

to legs

19

before revascularization

bicarb administration

20

6 Ps of acute arterial occlusion**

pain
pallor
paralysis
paresthesia
pulselessness
poikilothermia

21

blood supply to brain

two sources
carotid
vertebral basilar

22

TIA

10 minutes to an hour

23

dizziness, diplopia, dysphagia, dysarthria, dysmetria

D's of vertebral basilar TIAs

24

lateral medullary syndrome

occlusion of vertebral or PICA

Ds + numbness in contralateral arm or leg and ipsilateral face

horners syndrome

25

ringing ear, dizziness, facial pain, nystagmus, perceptive deafness, intention tremor, positive romberg, loss of pain and temp over face and opposite trunk, ptosis of eye, constriction of pupil

lateral medullary syndrome
-occlusion of vertebral a or PICA

26

aphasia, unilateral weakness/numbness, amaurosis fugax

carotid territory TIA

can't understand what you are saying or speaking

amaurosis fugax - loss of vision in one eye

27

cramps after eating

abdominal angina

mesenteric occlusion

28

severe abdominal pain with no physical exam findings

watch out for abdominal angina
-vessel occlusion > infarction - BAD

29

thrombophilic factors

factor V
G20210A
ACLA

red clots

30

hypofibrinolytic factors

4G.5G polymorphism of plasminogen activator inhibitor-1 gene (PAI-1)

red clots

31

basis of white clot

smoking
HTN
hyperlipidemia
DM
cholesterol emboli

**platelet aggregation

32

myeloproliferative disease

JAK2

cause of arterial/venous clotting

33

causes of arterial and venous clotting

HIT
PNH - paroxysmal nocturnal hemoglobinuria
MPD
APLAS - anti phospholipid
ACLA - anti cardiolipin

34

thromboangiitis obliterans

buergers disease

vasculitis of arteries and veins

in cigarette smokers

35

significant aortic aneurysm

5-6cm

do coronary surgery prior to aneurysm repair**

36

before fixing aortic aneurysm

fix coronary arteries

37

aortic aneurysm Tx

labetolol
esmolol
nitroprusside
surgical repair - endovascular graft

38

3/6 diastolic decrescendo murmur at base and 2/6 systolic murmur at apex that lengthens with standing and shortens with handgrip

mitral valve prolapse

marfan syndrome

39

mitral regurg

should get louder with hand grip (increased afterload)

should get softer with standing (less filling)

40

hand grip

same as squatting

increase afterload

41

squat to stand

same as valsalva

decreased preload

42

aortic aneurysm dissection

into media

with sharp chest pain

43

associated with dissecting aortic aneurysm -

diastolic murmur - aortic regurg

as well as HTN and paraplegia**

44

paraplegia

with dissecting aortic aneurysm

45

causes of mediastinal widening

artifact - rotated patient
mass - T and B cell lymphoma, teratoma, thyroid, thymus (4 T's)

vessels - aortic aneurysm

anthrax

46

anthrax

results in mediastinal widening***

47

easily palpable popliteal pulse

aneurysm
-loss of distal pulse with acute leg or foot pain


conservative if light pulse intact
-otherwise - surgery

48

predisposition for trombophlebitis

trauma

49

virchows triad

hypercoagulability
stasis
trauma

for thrombosis