PAD highlights

Question 1

List 3 venous forms of peripheral vascular disease

Answer 1

Varicosities
Venous insufficiency
Venous thrombosis (DVT)

Question 2

What is the #1 risk factor for AAAs?

Answer 2

Cigarette smoking

Question 3

What is the pathogenesis of AAAs?

Answer 3

ASCVD, smoking, HTN, connective tissue d/o, trauma, syphilis

Question 4

List 3 risk factors for AAA

Answer 4

1) Male sex
2) Older age* > 65 y/o
3) Tobacco use*

Question 5

Who should be referred for elective repair of AAA?

Answer 5

AAA > 5.5 cm

Question 6

List 2 important aspects of the presentation of AAA

Answer 6

1) Severe “tearing” abdominal pain radiating to back/flank
2) Tender Pulsatile abdominal mass, or bruit

Question 7

If a pt has an AAA of 5-5.9cm, what is their risk of rupture at 1 year:?

Answer 7

1-11%

Question 8

When is it time for elective repair of AAA?

Answer 8

> 5.5cm or rapid expansion

Question 9

What has the best evidence to slow progression of AAAs?

Answer 9

Smoking cessation

Question 10

List 3 important aspects of AAA Tx

Answer 10

1) Optimize ASCVD risks
2) Smoking Cessation – best evidence to slow progression
3) Statins

Question 11

When should you do elective surgical repair for AAAs?

Answer 11

Elective repair @ 5.5 cm or with rapid expansion (> 0.5 cm in 6 months)

Question 12

List the risk factors for aortic dissection

Answer 12

Chronic HTN, age, pregnancy, cocaine use, connective tissue d/o, bicuspid aortic valve, trauma

Question 13

Differentiate type A and type B aortic dissections

Answer 13

Ascending thoracic aorta = Type A
Descending thoracic aorta = Type B

Question 14

Wide mediastinum on CXR is a finding in what?

Answer 14

Aortic dissection

Question 15

List 4 important Sx of PAD on physical exam

Answer 15

1) Weak/absent pulses
2) Thin/shinny skin
3) Hair loss
4) Lateral malleolar ulcers

Question 16

What is abnormal resting ABI?

Answer 16

</= 0.90

Question 17

Describe risk factor mgmt for claudication mgmt

Answer 17

Smoking cessation
HTN GDMT
DM GDMT
Lipids GDMT

Question 18

How do you Tx claudication?

Answer 18

1) Exercise
2) Antiplatelet therapy (not DAP)
Aspirin 81 mg
or
Clopidogrel 75 mg
3) Cilostazol (Pletal)
4) Statins

Question 19

List 2 diagnostics for acute arterial occlusion (type of PAD)

Answer 19

Arterial doppler exam
CT or catheter based Angiography

Question 20

What are 2 important elements of acute arterial occlusion Tx?

Answer 20

1) Anticoagulate
2) Emergent re-vascularization

Question 21

GCA: What is the general Tx?

Answer 21

High dose corticosteroids

Question 22

GCA:
1) How to Tx without visual loss?
2) What abt with threatened or established visual loss at presentation?

Answer 22

1) Prednisone
2) Methylprednisolone