Peripheral Vascular Disease Flashcards Preview

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Flashcards in Peripheral Vascular Disease Deck (32):
1

What are peripheral vascular diseases?

Atherosclerotic disease of non-cardiac,
arteries

2

What are peripheral vascular disease risk factors the same as?
Except for what? (2)

same as for CAD,

except that cigarette smoking
and diabetes mellitus appear to
increase the risk of PVD

3

Peripheral vascular disease can effect what locations? 4

GI tract, GU tract, brain,
extremities

4

What is pathogenesis in peripheral vascular disease?

vessel occlusion by atherosclerotic plaques
with "downstream" ischemia and
necrosis

5

GI involvement in peripheral vascular disease can occur with what? (2)

1. occlusive atherosclerosis of the celiac or mesenteric arteries
2. atherosclerotic emboli from the aorta (cholesterol emboli)

6

If you have occlusion in GI, where and what changes do you see?

ischemic changes and/or infarction
of the bowel "downstream" from the
occlusion

7

Ischemic changes in the colon can lead to what?

3 symptoms

ischemic colitis
1. atrophy of surface epithelium,
2. hyalinization/fibrosis of the lamina propria
3. diarrhea that can be bloody

8

What people should you look for PVD causing ischemic colitis?

Elderly with athersclerosis factors

9

Infarction of the bowel can cause what?

1. ileus
2. severe abdominal pain
3. bloody diarrhea

10

Can infarction of bowel by fatal?
Why?

Yes
Bacterial overgrowth

11

How do you recognize infarction of bowel? (3)

1. High level of suspicion
2. Abomdinal pain out of proportion to physical exam
3. Metabolic acidosis

12

What GU organs are involved in PVD?

1. kidneys
2. male erectile tissues

13

3 renal effects of PVD?

1. Occlusion of renal arteries --> Decreased perfusion --> Activate RAS
2. HTN injuries
3. Renal infarctions

14

Effect on male erectile tissue in PVD?

Male erectile dysfunction (impotence)

15

PVD of carotid arteries is a significant caues of what?

TIA's
Strokes (CNS infarcts)

16

Are TIA's and strokes associated with emboli or occlusion?

Emboli

17

Progressive occlusion can lead to what with carotid arteries?

Collateral formation

18

Can a complete occlusion of coronary artery have no effects?

yes due to circle of willis

19

Disease similar to coronary arteries in PVD can occur where?

Posterior portion of circle of willis via the basilar artery

20

Partial occlusion in carotid arteries have what effects though?

1. Hypotensive
2. Injure CNS in sensitive areas

21

What arteries are most affected by Partial occlusion of carotid arteries?

Middle cerebral arteries

22

Treatments of carotid artery PVD? 3

Treatment of atherosclerosis in general
Anti-platelet therapy (ASA)
Surgical intervention (carotid endarterectomy)

23

What chronic changes can be seen in PVD in extremities? 6

skin atrophy,
fatty replacement of muscle (muscle atrophy),
delayed wound healing,
claudication,
ulceration
eventual necrosis (dry gangrene) with secondary
infection (wet gangrene)

24

Acute occlusion of larger vessels causes what? 2

Acute necrosis
Gangrene

25

What is gangrene necrosis?

blood supply lost and tissue undergoes coagulative necrosis

26

What is wet gangrene?

Superimposed bacterial infection results in coagulative necrosis being altered by liquefactive action of bacteria and attracted leukocytes

27

In PVD, which is affected more, lower or upper extremities?

Lower

28

Why are lower extremities affected more?

Abdominal atherosclerotic emboli can
shower both lower extremities

29

What increases risk of lower extremity disease with PVD? (2)

Cigarette smoking and diabetes mellitus

30

Diagnosis of PVD? 6

1. Claudication
2. Atrophy of skin and muscles
3. Diminished pulses
4. Ulceration
5. Vascular flow studies
6. Radiographic studies

31

Treatment of PVD?

1. Treatment of general atherosclerosis
2. Anti-platelet therapies
3. Surgical and invasive radiology procedures

32

6 surgeries to repair PVD?

 Angioplasty +/- stents
 ABF bypass
 Fem-pop bypass
 Fem-fem bypass
 Axillary-fem bypass
 Fem-distal bypass