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27 Cards in this Set
- Front
- Back
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Obstruction:
...% cross sectional area or ...% reduction in diameter |
75%
50% |
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Poiseuille’s Law:
Energy losses related to the ... of blood Defines ... energy losses |
viscosity
minimal |
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Entrance and Exit:
Doubling the length of a lesion ... affect energy loss significantly. Two separate lesions of equal length and diameter will ... resistance Entrance and exit effects Two stenoses of unequal diameter in series, ... of the two has greatest effect on resistance |
does not
double tighter |
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...:
Random velocity vectors Occur at branch points and after areas of narrowing. Short-lived Energy losses not accounted for by Poiseuille’s law. |
Turbulence
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Ischemia --> claudication --> ... --> ulceration/tissue loss/gangrene
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rest pain
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define claudication (4 things)
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1) reproducible
2) pain with 3) exercise, 4) relieved by cessation |
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pain reproduced almost exactly the same time and place under the same conditions – think ...
variable pain - ... constant pain - ... |
claudication
orthopedic neurologic |
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claudication pain is usually in a ... distribution
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muscular
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Patients with ... disease often have to lie down and put their leg up to stop the pain, unlike claudication.
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venous
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Claudication often foreshadows a more ... disease
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severe systemic
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the ABI (ankle/brachial index) can be measured in office by doppler and the normal values are ...-...
it is used to ... suspected disease |
1.0-1.2
confirm |
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What are the 4 standard levels where PAD can occur?
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aorto-iliac
fem-pop tib-peroneal pedal |
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History – area:
Hip, thigh, buttock - ... calf - ... or ... foot – pathogneumonic for ... |
aortoiliac
aortoiliac or fem-pop buerger’s disease |
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A patient with > two block calf claudication who has a femoral pulse has ...
and if he has a bruit in hunter’s canal, he has ... or if he has an absent or diminished femoral pulse, he has ... if he has an iliac or femoral bruit, think ... |
fem-pop disease
fem-pop stenosis aortoiliac disease aortoiliac stenosis (not occlusion) |
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Segmental pressures:
a difference of greater than ... mm between segments is significant |
20
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What is the most important thing as far as treatment for someone with claudication?
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reduce their risk factors
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control risk factors:
Lipids -LDL CHOL < ... mg/dl, better < 70 mg/dl for high risk PAD pts -... for low HDL and high TG -statins (simvastatin) – check liver enzymes, rhabdomyolysis HTN - controlled below 140/90 (although 120/80 is ideal) -beta blocker (atenolol) and ACE inhibitor Homosysteinemina -for level > 5mmole/L, folic acid, B12, B6 |
100
Fibrates |
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control risk factors:
diabetes -FBS range ...-... mg/dl -postprandial (following a meal) < ... mg/dl -Hemoglobin A1C < ...% -foot care (orthotics, inspection) |
80-120
180 7 |
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Antiplatelet therapy:
... – reduces cardiac and vascular death, nonfatal MI and peripheral artery surgery ... – reduces stroke, MI or vascular death |
ASA (baby aspirin)
Clopidogrel |
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Would you give a vasodilator to a person with ischemia? why?
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no, because when you have ischemia, your body already tries to maximally vasodilate. Giving a vasodilator would be pointless since you can’t really vasodilate any more.
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pharmacotherapy:
... (mainstay) -Antiplatelet activity (mainly) -phsophodiesterase III inhibitor -vasodilator (minor) -improvement/side effects |
Cilostazol
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... reduction reduces risks of death and other cardiovascular complications
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risk factor
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What diagnostic test is the gold standard if we’re going to invasively intervene?
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contrast angiography
(CT angiography is good too) |
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Primary stent patency:
Hormone replacement therapy users have ... instances of stenosis when compared to non-HRT users |
increased
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Primary stent patency:
Which artery has increased instances of stenosis? Common iliac artery External iliac artery |
external iliac artery
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Hormone replacement therapy:
MAY AFFECT CARDIAC RISK IN PATIENTS WITH PREEXISTING DISEASE AFFECTS ... OF VASCULAR INTERVENTIONS MAY BE RESULT OF INDUCED ... STATE OR INTIMAL ... |
PATENCY
HYPERCOACUABLE HYPERPLASIA |
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Claudication review:
-DIAGNOSIS BY ... -CONFIRM BY ... -TREAT ... -MEDICAL THERAPY -REFER FOR INVASIVE INTERVENTION -LONG TERM ... |
HISTORY AND PHYSICAL
ANKLE/BRACHIAL INDEX RISK FACTORS FOLLOW UP |
