PVD & VD <3 - patho E3

Question 1

risk factors for PVD

Answer 1

smoking
diabetes
high chol
heart disase
stroke
increase age >50

Question 2

etiology of PVD

Answer 2

-atherosclerosis
-a thrombus
-inflammation (thromboangitis obliterans)
-vasospasm (raynauds)

Question 3

clinical manifestations of PVD

Answer 3

-pain (calf & buttock)
-numb, burning, intermittent claudication
-wounds that do not heal
-diminished sensation in the extremities
-trophic skin changes (shiny, thick toenails, loss of leg hair, diminished pulses, pallor/cyanosis, red legs when they hang, erectile dysfunction)

Question 4

intermittant claudication

Answer 4

consistent pain precipitated by consistent level of exercise
always when walking & stops w/ rest

Question 5

5 P’s of PAD

Answer 5

-pain
-pulselessness
-palpable coolness
-paresthesias
-paresis

Question 6

how to dx PVD

Answer 6

ankle - brachial index: BP in leg vs arm, normal is >1

Question 7

PAD S/s

Answer 7

-intermittent claudication pain
-no edema
-no pulse
-no drainage
-round, smooth sores on toes & feet
-black eschar

Question 8

PVD S/s

Answer 8

-dull, achy pain
-lower leg edema
-pulse present
-drainage
-sores w/ irregular borders on ankles
-yellow slough or ruddy skin

Question 9

CVI causes & treatment

Answer 9

blood to pool or collect in veins -> venous stasis
treat w/ anti platelets & coags, thrombolytics & lipid lowering agents

Question 10

CVI s/s

Answer 10

lower extremity edema
achiness or tiredness in legs
leathery looking skin
stasis ulcer on ankles
flaking or itching skin
new varicose veins

Question 11

pharm treatment of PVD/PAD

Answer 11

-anti platelet (aspirin)
-anti coag (warfarin)
-antiilipemics
-antihtn

Question 12

the AV valves are

Answer 12

tricuspid & mitral
open during systole & close w/ diastole

Question 13

the ventricular valve are

Answer 13

pulmonic & aortic

Question 14

valve abnormalities: pannus

Answer 14

failure to for the valve leaflets to close all the way

Question 15

endocarditis usually leads to what

Answer 15

a valve replacement

Question 16

what valve is most commonly effected by stenosis

Answer 16

aortic

Question 17

what valve is most commonly effected by regurgitation

Answer 17

mitral valve -> causes blood flow to go backwards instead of forward into the body

Question 18

aortic stenosis

Answer 18

blood is unable to flow freely from the left ventricle to the aorta during aortic stenosis

Question 19

what are the most common symptoms of aortic stenosis

Answer 19

syncope
light headedness
chest pain
+ pulm edema -> will hear rhonchi & crackles, cough and pulm congestion

Question 20

mitral regurgitation symptoms

Answer 20

fatigue bc not getting the amount of blood they body needs
SOB

Question 21

treatment for mitral regurgitation

Answer 21

most likely a valve replacement

Question 22

infective endocarditis

Answer 22

vegetations on the heart valves
infected mass which impede the opening and closing of valves
the vegetations can break off and spread through the body or lungs

Question 23

what valve does infective endocarditis most often affect

Answer 23

the tricuspid valve

Question 24

risk factors for infective endocarditis

Answer 24

1) prosthetic valve
2) pacemaker
3) IV drug abuse

Question 25

if you have a prosthetic valve, what should you do before going to dentist

Answer 25

take prophylactic antibiotic

Question 26

infective endocarditis symptoms

Answer 26

**very sick** fever, chills, anorexia, weight loss, myalgias, arthralgias, heart murmur

Question 27

what do people with infective endocarditis usually present to the hospital with

Answer 27

sign of ischemia or infarction of the extremities, spleen, kidney, bowel or brain (stroke)

Question 28

cerebral emboli caused by infective endocarditis

Answer 28

septic emboli that lodged in a cerebral artery or arteriole and cause an ischemic stroke -> pt may present w/ meningitis, seizures, encephalopathy or abscesses of the brain

Question 29

patho of septic emboli

Answer 29

microorganisms travel into the heart, adhere to damaged endothelial tissue & attract WBCs and platelets that release cytokines & coagulation factors -> coagulation cascade results in fibrin disposition & development of vegetation

Question 30

clinical manifestations of a septic emboli

Answer 30

petechiae splinter hemorrhages janeway lesions osler's nodes roth spots (spots in eyes)