Term
| What are risk factors for PAD? |
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Definition
Major: Smoking, HTN, lipids, DM2
Minor: CAD, age, homocysteine, GFR<60ml/min |
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Term
| What are the two most common signs of PAD? |
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Definition
- Intermittent Claudication - primary indicator. During exercise, resolves with rest.
- Pain at rest in lower extremities later in the disease due to ischemia. |
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Term
| What presents on a physical exam for PAD? |
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Definition
- Decreased lower pulse
- Cool, Shiny, hairless skin
- sores, ulcers, or thickened toenails |
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Term
| How is a PAD firmly diagnosed? |
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Definition
Ankle-brachial index
1 - 1.4 = normal
0.91 - 0.99 = borderlone
0.71 - 0.90 = mild
0.41 - 0.70 = moderate
0.00 - 0.40 = severe |
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Term
| Which patients may have non-compressible arteries? |
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Definition
| - Diabetic, elderly, and dialysis patients |
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Term
| What are the goals of treatment of PAD? |
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Definition
- increase maximum walking distance and duration of pain free walking
- improve quality of life
- control risk factors |
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Term
| What risk factor goals exist for PAD patients? |
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Definition
<140/90 BP
Lipids <100
A1C < 7%
Quit smoking |
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Term
| What is the first line of treatment for PAD? |
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Definition
Aspirin 81-325 mg po daily
Use Plavix in patients who cannot tolerate ASA |
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Term
| What other drug therapy options are there for PAD? |
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Definition
- Cilostazol 100 mg BID for nonsurgical patients who have failed lifestyle modifications. Avoid in CHF.
- Pentoxifylline 400 TID - last line |
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Term
| What kind of exercise program is recommended in PAD? |
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Definition
| Minimum of 30 minutes supervised training 3x/week x12 weeks to produce symptoms of IC within 5 minutes and then allow to resolve. |
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Term
| What is Raynaud's Phenomenon? |
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Definition
A vascular response to cold and stress, usually in women. Secondary is autoimmune.
Primary is in young women, no pain. |
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Term
Where does Raynaud's appear?
How is it treated? |
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Definition
in the hands. White --> Blue --> Red
Must have history for at least 2 years
Avoid cold temperatures and stress, stop smoking.
Tx with Nifedipine or Amlodipine, sometimes topical NTG |
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