Chapter 12 - PVD

Question 1

MC cause of peripheral arterial occlusive disease:

Answer 1

Atherosclerosis affecting medium-large sized vessels of the extremities

Question 2

AAA usually occurs below ____

Answer 2

Renal arteries

Question 3

AAA are MC in which population?

Answer 3

White males

Question 4

Rule of 15 in diabetic patients =

Answer 4

15% of diabetics will develop a foot ulcer
15% of those ulcers will lead to osteomyelitis
15% of ulcers lead to amputation

Question 5

Rule of 50 in diabetic patients =

Answer 5

50% of amputations are transfemoral/transtibial level
50% of pts have a 2nd amputation in 5 yrs or less
50% of pts die in 5 years or less

Question 6

What is the principle symptom of atherosclerosis?

Answer 6

Pain

Question 7

Define intermittent claudication

Answer 7

Pain in the lower extremity during exercise (relieved by rest)

Question 8

Where is the site of pain in occlusive atherosclerosis?

Answer 8

Distal to the occlusion

Question 9

Define venous claudication

Answer 9

Pain that occurs with DVT

Question 10

What is the unique feature of venous claudication?

Answer 10

Motionless standing is often more difficult than walking

Question 11

Define neurogenic claudication

Answer 11

• Common symptom of lumbar spinal stenosis
• Inflammation of the nerves
• Pain is often related to posture

Question 12

Leriche’s syndrome and what does the patient present with?

Answer 12

• Chronic aortoiliac obstruction

- Intermittent claudication and ED

Question 13

Define pseudoclaudication

Answer 13

• Bilat leg pain or numbness that occurs walking or at rest

- A/w musculoskeletal disease in lumbar area

Question 14

How is skin affected in arterial insufficiency vs. venous insufficiency?

Answer 14

• Arterial = cool and pale extremity

- Venous = red and warm extremity

Question 15

How do ulcers occur in arterial vs. venous disease?

Answer 15

• Arterial = d/t trauma to toes/heel, painful, “punched out”

- Venous = stasis ulceration = painless in the ankle/medial malleolus areas, “cobblestone”