| A | B |
|---|
| Inflammation of a vein | Thrombophlebitis |
| A clot in a vein | Deep vein thrombosis |
| The 3 main causative factors in the development of venous thrombosis | Venous stasis, endothelial damage, hypercoagulability of the blood (Virchow's triad) |
| Occurs when the valves are dysfunctional or the muscles of the extremities are inactive (age, CHF, obesity, surgery, immobility etc) | Venous stasis |
| May occur as a result of IV insertion; from IV administration of hypertonic substances; after pelvic or abdominal surgery; h/o DVT etc | Endothelial damage |
| May occur as a result of polycythemia, anemia, malignancies, hormone replacement therapy, oral contraceptive use, and smoking | Hypercoagulability |
| Symptoms may include unilateral leg edema, pain, warmth, and erythema | DVT |
| A life threatening complication of DVT | PE |
| Symptoms include a palpable, firm, subcutaneous cordlike vein; tenderness, redness and warmth | Thrombophlebitis |
| This complication of DVT results from valvular destruction, allowing retrograde flow of venous blood | Chronic venous insufficiency |
| The easiest and most cost effective way to decrease the risk of DVT in a patient at risk | Mobilization and ambulation |
| Collaborative treatment for thrombophlebitis | Elevate extremity, warm moist heat, ASA or aceetaminophen; (anticoagulation usually not needed) |
| Nonpharmacologic treatments for DVT | Bed rest; elevate extremity above the heart until thrombus is stable; warm compresses; TEDs when patient resumes excercise (X 3-6 months) |
| T or F. A goal of anticoagulant therapy in DVT is to dissolve the clot | False |
| How are clots disposed of in the body? | Lysis of the clot begins spontaneously through the body's intrinsic fibrinolytic system |
| What is the main advantage of Low molecular weight heparin (LMWH) over unfractionated heparin? | It does not require anticoagulant monitoring and dose adjustment |
| Drugs commonly used for DVT prophylaxis | LMWH and Warfarin |
| The drug of choice for very large DVTs | Heparin- IV bolus and drip for 5-7 days |
| This drug is used overlapping with IV heparin for treatment of DVT | Warfarin (coumadin) |
| Treatment used for patients with small, uncomplicated DVT | LMWH, with Warfarin concurrently |
| After a DVT, Warfarin is used for how long? | 3-6 months |
| What is a Greenfield filter? | A "sieve-type" device placed in the inferior vena cava that traps clots without interruption of blood flow |
| Incompetent valves of the deep veins increases hydrastatic pressure in the veins so serous fluid and RBCs leak out and cause edema | Chronic venous insufficiency |
| Why does brown discoloration in legs occur with chronic venous insufficiency? | Enzymes in the tissue break down RBCs, which release hemosiderin. Over time, the skin is replaced by fibrous tissue, resulting in thick, hardened, contracted skin |
| Symptoms include edema; large draining, painful ulcers; scaling and eczema, | Chronic venous insufficiency |
| Pulses present but hard to palpate due to edema; feet remain warm, nails not affected | Chronic venous insufficiency |
| Treatment includes compression, moist dressings, a high protein diet, and vitamins | Chronic venous insufficiency |
| Treatment may include antibiotics for cellulitis | Chronic venous insufficiency |
| Progressive narrowing of the arteries | Peripheral Arterial Disease (PAD) |
| The underlying cause of peripheral arterial disease | Atherosclerosis |
| Risk factors for peripheral arterial disease | Smoking, hyperlipidemia, HTN, DM, positive family history |
| The classic symptom of PAD | Intermittent claudication |
| Symptoms include decreased or absent pulses, ulcers or gangrene over bony prominences and pressure points on toes and feet | PAD |
| Skin becomes thin, shiny, and dry with hair loss and thick brittle nails | PAD |
| Feet may present with dependent rubor, pallor on elevation | PAD |
| Complications of PAD | Ischemic ulcers and gangrene |
| Three antiplatelet drugs used to treat PAD | Aspirin, Ticlid, and Plavix |
| The most common drug used to treat intermittent claudication | Trental |
| An inflammatory thrombotic disorder of the medium sized arteries, veins and nerves of the upper and lower extremities | Thromboangiitis obliterans (Buerger's disease) |
| The only patients that Buerger's Disease is found in | Smokers |
| Symptoms include intermittent claudication, rest pain, paresthesias, thrombophlebitis, gangrene | Buerger's disease |
| The only proven therapy for Buerger's disease | Smoking cessation |
| An episodic vasospastic disorder of the small cutaneous arteries of the fingers and toes | Raynaud's phenomenon |
| Characterized by color changes of the fingers, toes, ears and nose (white, blue and red) | Raynaud's phenomenon |
| Occurs primarily in young women; also seen with rheumatoid arthritis, SLE, scleroderma, typists and pianists | Raynaud's phenomenon |
| Treatment includes protecting from cold, avoidance of smoking, caffeine, and vasoconstrictors | Raynaud's phenomenon |
| Calcium channel blockers are the first line drug therapy for this disorder | Raynaud's phenomenon |
