Cs2 - Vascular Diseases

Front 1

Most common etiology for peripheral vascular disease?

Back 1

atherosclerosis (plaque buildup within the vessel walls)

Front 2

PVD mostly affects the _

Back 2

lower extremities

Front 3

What is the biggest and most important symtpoms of PVD? What makes it better?

Back 3

Claudication
Aching, cramping, fatigue, weakness in the calves, thighs or buttocks brought on by walking and completely relieved after a few minutes of REST *

Front 4

On P/E what would you expect to find in a pt with PAD

Back 4

Smooth, shiny, hairless skin (lower extremities)*

Diminished or delayed distal pulses*

Severe ischemia causes pallor, cyanosis, decreased skin temperature, ulceration and may cause gangrene*

Front 5

How can you make the diagnosis of PAD?

Back 5

Signs and symptoms
Ultrasound
ANKLE BRACHIAL INDEX (<.9)

Front 6

In PAD, the ABI will get (larger/smaller) with exercise

Back 6

smaller

this is diagnostic, you measure the ABI at rest, and measure again after exercise. The amount it decreases is indicative of the severity of the dz

Front 7

What are the three phases of treatment for PAD?

Back 7

1. conservative (walking,smoking cessation)
2. Medical
3. Surgical

Front 8

What drugs are used to treat PAD?

Back 8

Cilostazol*


also pentoxifylline, aspirin, statins, aspirin, clopidogrel

Front 9

Acute limb ischemia is a vascular _. it is the _

Back 9

Vascular emergency!

sudden occlusion of a peripheral artery

Front 10

The big symptom of arterial embolism is _.

Back 10

Pain

Front 11

An aneurysm is when the abdominal aorta is greater than _ cm.

> _ cm is worrisome and requires surgical intervention

Back 11

3 cm

>5 cm (concern of rupture)

Front 12

_ and _ should prompt consideration of an aneurysm rupture **

Back 12

Hypotension and acute abdominal/back pain

Front 13

Aortic dissection typically occurs in the _

Back 13

thorax

Front 14

Hypertension, cocaine use, trauma, herediary connective tissue disease are all risk factors for what vascular dz?

Back 14

aortic dissection

Front 15

Type A Stanford dissection involves the _

Type B involves the _

Back 15

ascending aorta,

distal aorta

Front 16

What are symptoms of a type A Standford aortic dissection?

Back 16

acute onset of severe chest pain or back pain **

syncope, abdominal pain

Front 17

Acute onset of chest pain or back pain, syncope, and possibly abdominal pain are symptoms of _

Back 17

type A stanford aortic dissection

Front 18

What are symptoms of a type B stanford aortic dissection?

Back 18

acute onset chest or back pain **

lower extremity ischemia and ischemic neuropathy, pulse deficits, neurologic defitics

Front 19

What should you use to diagnose an aortic dissection?

Back 19

TEE - transesophageal echocardiography

CT angiography

Front 20

How do you treat a type A aortic dissection?

Type B?

Back 20

Emergent Repair (fatal)

Medical therapy, or surgery if blood flow to legs is compromised

Front 21

Raynaud's phenomenon is typically relieved by _

Back 21

warmth

Front 22

How do you treat raynaud's phenomenon?

Back 22

avoid cold temperatures *

calcium channel blockers reduce frequency of vasospasms

Front 23

Buerger's disease is a _ process, and is a/w with a history of _

What are the symptoms?

Back 23

inflammatory, tobacco use

claudication of the feet, legs, hands or arms **
Skin changes (in extremities)

Front 24

How do you treat Buerger's disease?

Back 24

Complete tobacco abstinance (even patches)

Surgical amputation is required in >40% of pts who don't stop smoking.

Front 25

How do you treat giant-cell arteritis?

Back 25

high dose corticosteroids,

start treatment when highly suspicious even before biopsy results

Front 26

What is the most common sign of takayasu's?

How do you treat this?

Back 26

hypertension**

Corticosteroids are first line*

Front 27

What are symptoms of arteriovenous fistulas?

Back 27

pulsatile mass, bleeding from spontaneous rupture, neurologic deficits or seizures

Front 28

_ is the presence of coagulated blood, or thrombus in a vein, it encompasses both DVT and PE

Back 28

Venous Thromboembolic Disease

Front 29

What are the predisposing factors for Venous thromboembolic disease?

Back 29

("Virchow's triad"

Endothelial damage,
Venous stasis
Hypercoagulation

Front 30

What is Virchow's triad and what is if for?

Back 30

Endothelial damage, venous stasis, hypercoagulation

It is the predisposing factors for venous thromboembolic disease

Front 31

Hypercoaguable states include _

Back 31

hereditary diseases such as deficiencies in antithrombin III, protein C, or protein S.*

Front 32

What is the big symptom for a DVT?

Back 32

Pain And Swelling **
(PE reveals tenderness, eythema, WARMTH, and swelling below the thrombus)*

(also superior vena cava syndrome or thoracic outlet obstruction)

Front 33

Pain with dorsiflexion of the foot is aka

Back 33

Homan's sign

This is a sign that helps in the dx of dvts

Front 34

What's the best diagnostic test for dvts?

How do you treat?

Back 34

duplex ultrasound


Heparin (1st) and then Warfarin (long term)

Front 35

Sudden onset of dyspnea and pleuritic chest pain are symptoms of _

Back 35

Pulmonary Embolism

Front 36

What are symptoms and Physical findings of pulmonary embolism?

Back 36

Sudden onset of dyspnea, pleuritic chest pain


tachypnea, tachycardia**

Front 37

What diagnostic tests are used for pulmonary embolism?


How is it treated?

Back 37

Spiral CT of chest**, D dimer, Arterial blood gas

Immediate angticoagulation with unfractionated Heparin! Warfarin should be started after
Thrombolytics are reserved in pts with hypotension or severe hypoxemia

Front 38

How would you treat a pulmonary embolism in a pt who is severely hypoxemic or hypotensive?

Back 38

Thrombolytics

(the normal tx is IV heparin)