Peripheral Vascular Disease Flashcards Preview

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Flashcards in Peripheral Vascular Disease Deck (24):
1

What are the categories of risk factors for PAD. (2)

Modifiable.
Non-modifiable.

2

What is the chief complaint in PAD.

Intermittent claudication.

3

What is the prevalence of intermittent claudication.

10%.

4

What is PAD due to.

Due to atherosclerosis causing stenosis of arteries via a multifactorial process.

5

What percentage of patients with PAD have co-existing cerebral or coronary artery disease.

65%.

6

What are the symptoms of PAD. (6)

Cramping pain is felt in the calf, thigh, or buttock after walking for a given distance.
The pain is relieved by rest.
Ulceration.
Gangrene.
Foot pain at rest.
Impotence.

7

What are the critical signs of limb ischaemia. (3)

Gangrene.
Foot pain at rest.
Ulceration.

8

What are the features of Leriche's syndrome. (2)

Buttock claudication.
Impotence.

9

Who is at risk of developing Buerger's disease.

Young, heavy smokers.

10

What classification system is used in PAD.

Fontaine.

11

What are the classifications of the fontaine classification of PAD. (4)

Asymptomatic.
Intermittent claudication.
Ischaemic rest pain.
Ulceration/gangrene (critical ischaemia).

12

What are the physical signs of severe limb ischaemia. (7)

Absent femoral, popliteal or foot pulses.
Cold, white leg.
Atrophic skin.
Punched out ulcers (often painful).
Postural/dependent colour change.
A vascular angle of 15s.

13

What are the test that should be done in a patient presenting with PAD. (9)

Eclude DM, arteritis.
FBC 9anaemia, polycythaemia).
UandEs.
Lipids.
ECG.
Thrombophilia screen.
Serum homocysteine if

14

What imaging should be done in a patient with PAD. (2)

Colour duplex ultrasound is 1st line.
MR/CT angiography if intervention is being considered.

15

What is the treatment for PAD. (3)

Risk factor modification.
Management of claudication.
Amputation.

16

What are the aspects of treatment to manage the claudication. (5)

Supervised exercise programmes (improve symptoms by increasing collateral blood flow).
Vasoactive drugs (naftidrofuryl oxalate).
Percutaneous transluminal angioplasty (used for disease limited to single arterial segment).
Surgeical reconstruction (if atheromatous disease is extensive but distal run off is good).
Amputation (

17

What are the 6 Ps of acute limb ischaemia. (6)

Pale.
Pulseless.
Painful.
Paralysed.
Paraesthetic.
Perishingly cold.

18

What is acute limb ischaemia.

A surgical emergency.

19

What is the first step in acute limb ischaemia.

Revascularization is required within 4-6h to save the limb.

20

What is acute limb ischaemia due to. (4)

Thrombosis in situ (40%).
Emboli (38%).
Graft/angioplasty occlusion (15%).
Trauma.

21

What is the mortality rate in acute limb ischaemia.

22%.

22

What is the amputation rate in acute limb ischaemia.

16%.

23

How do you manage acute limb ischaemia. (2)

Surgical embolectomy or tissue plasminogen activator.
Anticoagulate with heparin after either procedure and look for the source of injury.

24

What are some potential complications after treatment of acute limb ischaemia. (2)

Reperfusion injury.
Compartment syndrome.