Peripheral Arterial disease Flashcards
1
Q
What is peripheral arterial disease?
A
Atherosclerosis of arteries in the limbs
2
Q
How does atherosclerosis occur?
A
Accumulation of intracellular + extracellular lipid in the intima and media of arteries
Early changes
- proliferation of smooth muscle cells
- accumulation of foam cells
- extracellular lipid
Later changes
- fibrosis
- necrosis
- cholesterol clefts
- disruption of internal elastic lamina
- damage extends into media
3
Q
Risk factors of PAD
A
Modifiable
- hypertension
- diabetes
- obesity
- smoking
Non-modifiable
- male
- family history
4
Q
What is the Fontaine classification?
A
Clinical classification of presentation of PAD
I - asymptomatic IIa - mild claudication IIb - moderate-severe claudication III - ischaemic rest pain IV - ulceration or gangrene
5
Q
What is the Rutherford classification?
A
Clinical classification of presentation of PAD
0 - asymptomatic Ia - mild claudication Ib - moderate claudication Ic - severe claudication II - ischaemic rest pain III - minor tissue loss IV - ulceration or gangrene
6
Q
Investigations for suspected PAD
A
Bloods
- FBC
- LFT
- U&Es
- cholesterol
BM
ABPI
Duplex arterial ultrasound
7
Q
What is ABPI?
A
Ankle brachial pressure index
Method
- take lying brachial blood pressure
- using doppler take ankle blood pressure (dorsalis pedis and posterior tibial - use highest)
ankle pressure / brachial pressure
1-1.2 = normal <1 = arterial disease
