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Flashcards in Peripheral Vascular Dz Deck (25)
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0
Q

Most important risk factors for peripheral artery disease? Other risk factors?

A

Cigarette smoking and diabetes mellitus

Hypertension, dyslipidemia, elevated homocysteine

1
Q

Ankle brachial index? Determined by?

A

Ratio of ankle brachial systolic blood-pressure. determined using Doppler ultrasound

2
Q

Peripheral artery disease confers the same risk of cardiovascular death as?

A

Prior myocardial infarction or stroke

3
Q

Patient with aortoiliac disease may complain of exertional pain where?

A

Thighs or butt

4
Q

Rest pain in peripheral arterial disease indicates?

A

Severe occlusion

5
Q

Bruits on physical exam indicate?

A

Accelerated blood flow velocity and turbulence at the sites of stenosis

6
Q

In a patient with a peripheral artery disease, elevation of the feet will induce? If feet are then placed in dependent position?

A

Pallor in the soles. Redness as a result of reactive hyperemia

7
Q

Chronic arterial insufficiency may cause what findings? In severe cases?

A

Hair loss on legs and feet, thickened toenails, atrophic shiny skin

Ulcers or gangrene

8
Q

Normal ankle brachial index? In patients with claudication? In patients with critical leg ischemia?

A

1+

.41 - .90

Less than .40

9
Q

Mortality rate in patients with symptomatic peripheral artery disease

A

50% in 10 years

10
Q

Intervention that reduces the risk of fatal or nonfatal MIs by as much as 50%?

A

Smoking cessation

11
Q

Drug approved for the treatment of claudication? Mechanism of action?

A

Cilostazol. Phosphodiesterase inhibitor with vasodilatory and antiplatelet properties

12
Q

Treatment of PAD includes?

A
  1. Treat cardiovascular risk factors (smoking cessation, hyperlipidemia, hypertension, aspirin, ACE inhibitor)
  2. Assess severity of claudication with treadmill test or maximal walking distance
  3. Angioplasty or bypass grafting
13
Q

Who should be evaluated for revascularization?

A

patients with ankle brachial index less than .4, severe claudication, rest pain, or nonhealing ulcers should be evaluated for?

14
Q

An ideal candidate for revascularization?

A

Ideal candidates have discrete stenosis of large vessels (Diffuse or small-vessel disease patients respond poorly)

15
Q

Buerger’s disease: Size of vessels? Typical patient?

A

Inflammatory condition of small and medium-sized arteries found exclusively in smokers, especially males younger than 40

16
Q

Fibromuscular dysplasia? Size of vessels? Sex? Arteries generally affected?

A

Hyperplastic disorder affecting medium and small arteries and usually occurs in women. Generally affects renal and carotid arteries

17
Q

Takayasu arteritis: Typical patient? Vessels affected? Presentation?

A

Young women. Affects branches of the aorta, most commonly subclavian. Causes arm claudication, Raynaud’s phenomenon, fever, weight loss

18
Q

Patients with chronic peripheral artery insufficiency who present with sudden unremitting pain may have?

A

Acute arterial occlusion, most commonly from embolism or in situ thrombosis

19
Q

In acute arterial occlusion, most common source of emboli?

A

The heart

20
Q

Heart conditions that may cause cardiogenic emboli?

A

Atrial fibrillation, dilated cardiomyopathy, endocarditis

21
Q

Patients with acute arterial occlusion present with what signs?

A

6 p’s

Pain, pallor, pulselessness paresthesias, paralysis, poikilothermia (coolness)

22
Q

Management of patients with acute arterial occlusion?

A
  1. Anticoagulation with heparin
  2. Keep limb below horizontal plane without any pressure
  3. Surgical removal or balloon catheter
23
Q

31-year-old male smoker with resting pain in his legs and a nonhealing foot ulcer. Diagnosis?

A

Buerger disease

24
Q

62-year-old male with livedo reticulatus and three toes, including one with gangrene following cardiac catheterization. Dx?

A

Cholesterol embolus

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