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47 Cards in this Set
- Front
- Back
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what is the most prominent symptom of peripheral vascular disease?
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claudication
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what can peripheral vascualr disease look like?
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smooth, shiny, hairless skin
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what is a good test for peripheral vascular disease?
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ankle-brachial index
normally, lowe extrmity should be greater, so if ratio goes below 0.9, it indicated PVD recheck with excercise and its even lower |
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what is phase I treatment of peripheral vascular disease?
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lifestyle changes
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what is phase II treatment of peripheral vascular disease?
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medical
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what are 5 drugs used for peripheral vascular disease?
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pentoxiffyline
cilostazol hypertensive agents statins aspirin |
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what is phase III treatment of peripheral vascualr disease
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surgical
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what can acute limb ischemia be due to? (2)
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arterial embolism or thrombosis in situ
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where does acute limb ischemia usually originate?
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left atrium
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how will symptoms differ in acute limb ischemia if pain is due to aterial embolism or thrombisis in situ?
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AE will be sudden without history
TIS will have a history or worsening claudication |
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what 2 things can help dx acute limb ischemia?
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hand-held dopler
TEE |
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3 ways to treat acute limb ischemia
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anticoagulation with IV heparin
embolectomy catheter directed infusion of plasminogen activator |
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what is the major concern with abdominal aortic aneyrusm?
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rupture
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who is AAA more common in?
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older adult smokers with hypertension and a family history
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what 2 genetic diseases can predispose to AAA?
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marfans
ehlers-danlos |
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when will you see symptoms of AAA?
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5cm
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what 3 things should prompt consideration of aneurysm rupture?
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hypotension
acute abdominal pain acute back pain |
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what are 4 risk factors associated with aortic dissection?
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hypertension
cocaine trauma hereditary CT disease |
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what type of dissection is worst?
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type A
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what are 4 symptoms of type A dissection?
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acute onset
abd pain syncope stroke |
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how can you distinguish type A chest pain from MI?
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"tearing" or "ripping" descriptions
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what are 3 symptoms of type B dissection?
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acute chest pain
lower extremity ischemia or neuropathy neuro deficitis |
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what is a non-atherosclerotic disease of the small to medium sized arteries, veins, and nerves?
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buergers disease
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who does buergers disease most affect?
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usually men before 45
nicotine is a huge factor |
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what are 2 main symptoms of buergers disease?
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claudication
skin changes (ischemia, ulceration) in extremities |
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what is the most important in treatment of buergers disease?
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nicotine abstiencne
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what drug can you give for buergers disease?
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iloprost to vasodilate
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what disease is an inflammatory disease of medium-large arteries seen mostly in the elderly?
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giant cell arteritis
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what are 3 symptoms of giant cell arteritis?
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jaw claudication
visual loss due to ophthalmic artery disease headache from temporal arteries |
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how do you treat giant cell arteritis?
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high dose cotricosteorids
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when should you treat giant cell arteritis?
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when highly suspicious, before biopsy results
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what is an inflammatory granulomatous in the aorta, its main branches, and the pulmonary artery?
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takayasu's arteritis
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what are 3 findings on physical exam of takayasus?
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bruits over subclavian and aorta
diminished brachial pulses low brachial BP |
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what is the most common sign of takayasus?
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hypertension
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what is the first line treatment in takaysus?
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corticosteroids
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what presents as a pulsatile mass with good bruits, bleeding from spontaneous rupture, or neurologic deficits?
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arteriovenous fistulas
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what is virchow's triad?
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endothelial damage (recent surgery or trauma)
venous stasis (long plane rides) hypercoagulation (cancer) |
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what is trousseaus syndrome?
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migratory thrombophlebitis with noninfectious vegetations on the heart valves typically in the setting of mucin-secreting adenocarcinoma
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what are 2 main findings of DVT on physical exam?
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warm tender mass
pain with dorsiflexion (homan's sign) |
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what can yeild a lot of false positives for DVT?
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D-dimers
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in what patients will you consider surgical removal of an upper extremity DVT?
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young patients
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what is the pro and con of inferior vena cava filter?
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pro - reduce the indicdence of PE
con - increases the risk of recurrent DVT |
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suddent onset of dyspnea, pleuritic chest pain, syncope, and hemoptysis indicate
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PE
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what is the most helpful dx in PE?
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spiral CT with angiography
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when is d-dimer helpful for dx?
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to rule out DVT or PE
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who are thrombolytics reserved for in PE?
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patients with hypotension or severe hypoxemia
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what patients continue on anticoagulants indefinitely for DVT?
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those with DVT due to cancer or idiopathic
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