Peripheral Vascular Diseases

Question 1

PVD vs. PAD

Answer 1

only called PAD when arteries are affected

Question 2

patho of PVD

Answer 2

–related to atherosclerosis processes in the extremities

Question 3

risk factors of PVD/PAD

Answer 3

–smoking**
–diabetes
–high cholesterol
–heart disease
–stroke
–increased age > 50

Question 4

etiology of PVD/PAD

Answer 4

–atherosclerosis (most common)
–thrombus
–inflammation (thromboangitis obliterans)
–vasospasm (Raynaud’s)

Question 5

thromboangitis obliterans

Answer 5

inflammatory condition of the arteries

Question 6

symptoms of PVD/PAD

Answer 6

–pain (calf, buttock pain)
–numbness/burning
–heaviness
–intermittent claudication
–wounds that don’t heal
–diminished sensation in extremities
–trophic skin changes

Question 7

trophic skin changes

Answer 7

–shiny, thick toenails
–loss of leg hair
–diminished pulses
–elevation pallor, cyanosis
–reactive hyperemia
–erectile dysfunction

Question 8

intermittent claudication

Answer 8

–consistent pain precipitated by consistent level of exercise
–ceases with rest
–caused by ischemic tissue

Question 9

what does pain depend on with intermittent claudication?

Answer 9

–site of plaque build up
–collateral circulation

Question 10

diagnosis of intermittent claudication

Answer 10

patient can usually describe walking a certain distance when pain starts

Question 11

common site for PAD

Answer 11

femoral artery

Question 12

symptoms of PAD in femoral artery

Answer 12

–pain
–decreased pulse
–coolness of leg
–pallor of leg
–loss of sensation in foot

Question 13

etiology of PAD in femoral artery

Answer 13

–ischemia of muscle in lower leg
–cellular hypoxia

Question 14

5 P’s of PVD/PAD

Answer 14

(1) pain
(2) pulselessness
(3) palpable coolness
(4) paresthesias
(5) paresis (weakness)

Question 15

ankle-brachial index

Answer 15

–comparison of the BP in the leg v. the arm
–normal: ankle pressure is greater than brachial pressure

Question 16

severe PAD ankle-brachial index

Answer 16

0.5

Question 17

symptoms of PVD (venous)

Answer 17

–dull, achy pain
–lower leg edema
–pulse present
–drainage
–sores with irregular borders
–yellow slough or ruddy skin

Question 18

location of sores in PVD (venous)

Answer 18

ankles

Question 19

location of sores in PAD

Answer 19

toes and feet

Question 20

symptoms of PAD

Answer 20

–intermittent claudication
–no edema
–no pulse or weak pulse
–no drainage
–round, smooth sores
–black eschar

Question 21

chronic venous insufficiency

Answer 21

a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively

Question 22

what does CVI cause?

Answer 22

causes blood to “pool” or collect in veins = venous stasis

Question 23

symptoms of venous insufficiency

Answer 23

–lower extremity edema
–achiness or tiredness in legs
–leathery looking skin
–stasis ulcers
–flaking or itching skin
–new varicose veins

Question 24

nonpharm treatment of PVD

Answer 24

Reduction of contribution factors
–smoking cessation
–increase physical activity
–weight reduction
–stress reduction
–diabetes management
–HTN control

Interventions aimed at the occlusion
–meds
–bypass operation
–intravascular balloon
–intravascular stent

Question 25

pharm treatment of PVD

Answer 25

–antiplatelet agents
–anticoagulants agents
–thrombolytics
–lipid lowering agents

Question 26

cilostazol (Pletal)

Answer 26

treatment for intermittent claudication

Question 27

MOA for cilostazol (Pletal)

Answer 27

–platelet inhibitor
–vasodilation

Question 28

adverse effects of cilostazol (Pletal)

Answer 28

–headache
–dizziness
–diarrhea
–abnormal stools
–palpitations
–peripheral edema

Question 29

drug interactions with cilostazol (Pletal)

Answer 29

metabolized by Cytochrome P450

Question 30

pentoxifylline (Trental) class

Answer 30

vasoactive agent

Question 31

indication for pentoxifylline

Answer 31

treatment of intermittent claudication caused by PVD

Question 32

MOA for pentoxifylline

Answer 32

–relieves leg pain by increasing blood flow and oxygen through the BV
–helps to increase walking distance and duration

Question 33

adverse reactions of pentoxifylline

Answer 33

–N/V
–dizziness

Question 34

route of pentoxifylline

Answer 34

PO TID