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Clin Med - Cardio Exam #2 > Peripheral Artery Disease > Flashcards

Flashcards in Peripheral Artery Disease Deck (103)
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1

Define Peripheral artery disease

A disorder where there is a stenosis or occlusion in the aorta or distal arteries of the limbs

2

What is the most common cause of peripheral artery disease?

Atherosclerosis

3

Other than atherosclerosis what are causes of peripheral artery disease?

Thrombosis
Embolism
Vasculitis
Fibromuscular dysplasia
Entratpment
trauma

4

The highest prevalence of atherosclerotic PAD occurs in the ______ decade of life?

6th/7th

5

What factors increase risk of atherosclerotic PAD

Cigarette smoker
DM
Hypercholesterolemia
HTN

6

What is the most modifiable of all the risk facotors of atherosclerotic PAD?

Cigarette smoking

7

What sized vessels is atherosclerotic PAD usually located in?

Large and medium sized-typically at branch sites

8

What are the 3 primary sites of involvement of atherosclerotic PAD?

Aortoiliac
Femoral/popliteal
Lower leg/foot (distal vessels)

9

Which of the 3 primary sites of involvement is most commonly effected by atherosclerotic PAD?

Femoral and popliteal

10

What percentage of Pt's with Atherosclerotic PAD are symptomatic?

50%

11

What is the most common symptom of atherosclerotic PAD

Claudication-pain, ache, cramp, numbness or sense of fatigue during exercise and relieved with rest (intermittent claudication)

12

The site of claudication is always __________ to the site of the lesion?

Distal

13

What are the general PE findings of a patient with atherosclerotic PAD?

Decreased/absent pulse distal to obstruction
Presence of bruit over narrowed artery
Muscle atrophy distal to lesion

14

What are the general PE findings of a patient with SEVER atherosclerotic PAD?

Hair loss
thickened nails
smooth shiny skin
reduced skin them
pallor to skin

15

If pt has aortoiliac dz what would you expect to see?
a. claudication in calves and feet only
b. strong femoral pulses
c. decrease ABI throughout entire leg with decreased waveforms

C-Decreased ABI throughout entire leg with decreased waveforms

16

Where does claudication occur in aortoiliac artery disease?

Calves, thighs, or buttocks

17

Other than claudication what other signs/symptoms may occur in a pt with aortoiliac artery disease?

ED
femoral pulse and distal pulse absent/weak
bruit over aorta, iliac or femoral artery (or all 3)
ABI decrease throughout entire LE

18

What artery is the MOST common to be occluded by atherosclerosis?

Superficial femoral artery

19

What signs and symptoms will be found on a patient with Femoral/popliteal artery disease?

symptoms confined to calf
atrophic changes in lower leg and foot
femoral pulse is normal, decreased pulses in pop and pedal pulses

20

What signs and symptoms are specific to pt's with lower leg/foot arterial disease?

rest pain confined to dorsum of foot and relived with dependency (hanging foot off side of bed)
pain is severe, burning and may awaken pt from sleep, skin is cool, atrophic and hairless
pedal pulses are absent

21

Which disease is a major risk factor for lower leg/foot arterial disease?

DM

22

What vessels are primarily involved in lower leg/foot arterial disease?

tibial vessels

23

What is a normal ABI?

greater than 1.0

24

In the presence of stenosis _____ in the legs is decreased

SBP

25

Patients with severe PAD have an ABI less than

0.5

26

What noninvasive testing can be done to determine extent of AsPAD?

Treadmill-assess claudication with exercise
Duplex Doppler US-useful in medium and superficial arteries
MRA, CTA prior to surgery

27

Management goals for ALL PAD?

Improve ability to walk/symptoms
Prevent progression

28

What can progression of PAD lead to?

limb ischemia and amputation

29

Conservative TX for ALL pt's with PAD?

Smoking cessation!!!
risk factor reduction
-control BP/HTN (ACE-I)
-Lower cholesterol w/ a statin (LDL goal less than 100)
-Weight loss
-tx DM aggressively
Consistent moderate exercise
foot care

30

T/f Patient with PAD should be prescribed compression stockings when their ABI goes below 0.5 (severe)

FALSE!!!! Never give a patient with PAD compression stockings!!!!! This reduces the blood flow to the skin.