Peripheral Vascular Disease

Question 1

def

Answer 1

slow progressive circulation disorder caused by narrowing, blockage, or spasms in a blood vessel
involves any vessels outside the heart (arteries, veins, lymphatic vessels)

Question 2

what is the difference in claudication between venous and arterial peripheral disease

Answer 2

venous - claudication constant

arterial - claudication intermittant, pain comes on exertion, relieved by rest

Question 3

epi

Answer 3

common in elderly

males>females

Question 4

what is common with PVD

Answer 4

CAD

Question 5

what is the chief feature of PVD

Answer 5

intermittent claudication

Question 6

history

Answer 6

1 claudication (cramping in calf/thigh/buttock)
2 ulceration/gangrene
3 foot pain at rest (relieved by hanging leg over side of bed)

Question 7

what does calf claudication suggest

Answer 7

femoral disease

Question 8

what does buttock claudication suggest

Answer 8

iliac disease

Question 9

what does buttock claudication _ impotence suggest

Answer 9

Leriche’s syndrome

Question 10

what is the Fontaine classification of PVD

Answer 10

1 asymptomatic
2 intermittant claudication
3 ischaemic rest pain
4 ulceration/gangrene (critical ischaemia)

Question 11

signs

Answer 11

1 absent pulses
2 cold, white leg(s)
3 capillary refill time >15s in severe ischaemia

Question 12

examination

Answer 12

1 absent pulses
2 cold, white leg(s)
3 capillary refill time >15s in severe ischaemia

Question 13

investigations

Answer 13

1 bloods (for exclusion)
-blood glucose (DM)
-lipids (hyperlipidaemia)
-FBC (anaemia, polycythaemia)
2 ECG for cardiac ischaemia
3 ankle-brachial pressure index
4 Colour Duplex USS is 1st line imaging

Question 14

what is the normal result from an ankle-brachial pressure index

Answer 14

1-1.2

Question 15

what score would indicate PVD from an ankle-brachial pressure index

Answer 15

0.5-0.9

Question 16

what score would indicate critical limb ischaemia from an ankle-brachial pressure index

Answer 16

<0.5 or ankle systolic BP <50mmHg

Question 17

what could produce falsely high results from an ankle-brachial pressure index

Answer 17

calcified vessels in severe atherosclerosis