PVD & DVT

Question 1

Gold standard for DVT

Answer 1

Contrast venography

Question 2

Other tests for DVT

Answer 2

Duplex with doppler

Question 3

Prevention of DVT

Answer 3

Ambulation
Pressure stockings
Pneumatic compression
Heparin
Warfarin

Question 4

Tx of DVT

Answer 4

Heparin
Short term anticoag w/ hep
Long term w/ paraffin
IVC filters
Compression in surgical pt

Question 5

Virchow’s Triad

Answer 5

Venous stasis
Hypercoaguable
Endothelial damage

Question 6

What is a PE

Answer 6

embolization from venous system to lung through right ventricle

Question 7

Presentation of PE

Answer 7

Dyspnea
Pleuritic CP
Hemoptysis
Tachycardia & tachypnea
low o2

Question 8

Gold standard for PE

Answer 8

Pulmonary angiography

Question 9

Treatment of PE

Answer 9

• Anticoagulant with heparin then warfarin
• Thrombolytic in in unstable pt
• Surgery to remove thrombus

Question 10

What are 3 presentations of PE

Answer 10

Acute cor pulmonate
Pulmary infarction
Acute dyspnea

Question 11

Cor pulmonale

Answer 11

Massive pulmonary embolism
Acute hypotension/cardiac arrest
Dyspnea, tachycardia, tachypnea
Can resemble MI or septic

Question 12

Pulmonary infarction

Answer 12

Pleuritic CP
Rales or wheezes
Confused with pneumonia, pleuritic, or MI
XRAY: small effusion of infiltrates; elevated hemidiaphragm

Question 13

Acute unexplained dyspnea

Answer 13

Sub massive embolism without infarction

Lungs clear, ECG/CXR wnl

Question 14

Peripheral Arterial Occlusive Disease

Answer 14

Most important of PVD
Atherosclerosis of artier
Reduced perfusion of peripheral tissues

Question 15

Hallmark of peripheral arterial occlusive disease

Answer 15

Intermittent claudication relieved by legs in dependent position

Question 16

TX of PAOD

Answer 16

• Antiplatelets
• Exercise
• Reduce cardiovascular risk
• Surgery

Question 17

Differential Dx of PAOD

Answer 17

Spinal cord compression
Osteoarthrisits
Venous disease

Question 18

Arterial Thrombus

Answer 18

• Loss of distal circulation due to thrombosis or embolism

- Severe unrelenting pain

Question 19

5 (6) P’s of arterial thrombus

Answer 19

Pain, pallor, paresthesia, paralysis, pulselessness, ( poikilothermic)

Question 20

Raynaud’s

Answer 20

• Episodic, vasospastic ischemic attacks of digits

- Digital vessels overly reactive to cold

Question 21

Manifestation of Raynaud’s

Answer 21

White-Blue-Red

Question 22

Lived reticularis

Answer 22

• Reticular (fishnet) pattern of blanching and bluish skin

- Vasospams

Question 23

Varicose Veins

Answer 23

• Venous insufficiency

- Superficial veins become engorged and back flow occurs

Question 24

Tx of varicose veins

Answer 24

• Stripping/sclerosing

- Stockings

Question 25

Stasis Dermatitis

Answer 25

- Incompetent veins and leakage of blood into tissues - Swelling, pigmentation, ulcers - Pitting edema

Question 26

Lymphedema

Answer 26

- Limb enlargement due to decreased lymphatic drainage - Primary: lamp system - Secondary: breast cancer tx and filariasis

Question 27

Lymphangitis

Answer 27

- Bacterial/fungal info of lymphatics with cellulitis - Red streaking - Leukocytosis - Antibx and elevate limb