Cardiac

• In atherosclerosis, what type of cells are injured in the initial stage?

  Endothelial cells
• What is the result of injured endothelial cells becoming inflamed in atherosclerosis?

  Influx of enzymes and toxic oxygen radicals
• What type of cells engulf LDL in the vessel intima, contributing to foam cell formation?

  Macrophages
• What is a foam cell?

  A lipid laden macrophage
• What is the role of foam cells in vessel damage?

  Produce more vessel damage
• What is a fatty streak composed of?

  Many foam cells
• What process occurs as smooth muscle cells proliferate in atherosclerosis?

  Collagen migrates over fatty streak
• What are the effects of collagen migration over a fatty streak?

  Further endothelial cell dysfunction and vessel narrowing
• What initiates the coagulation cascade in a complicated lesion?

  Platelet adhesion
• What is the consequence of fibrous plaque ulceration leading to coagulation?

  Total occlusion, ischemia, and infarct
• What is a thrombus?

  Stationary blood clot
• What does Virchow's triad describe?

  Predisposition to vascular thrombosis

  
• What are the three components of Virchow's triad?

  • Hypercoagulable state
  • Altered blood flow (stasis)
  • Endothelial/vessel wall injury

  
• How can oral contraceptives increase the risk of thrombosis?

  Estrogen increases clotting factors
• Which condition involving blood flow is a risk factor for thrombosis?

  Stasis

  
• What is a cause of altered blood flow that predisposes a person to develop vascular thrombosis?

  Pump failure
• What is a common cause of endothelial/vessel wall injury?

  Atherosclerosis
• What lifestyle choice increases the risk of endothelial/vessel wall injury?

  Tobacco
• What is the term for a sudden interruption of arterial flow to tissues or organs?

  Acute arterial occlusion
• What is the most common cause of acute arterial occlusion?

  Emboli or thrombus
• What can cause an arterial occlusion?

  Air, fat, blood clot, amniotic fluid
• How many "Ps" are associated with the presentation of acute arterial occlusion?

  Seven
• What are the seven "Ps" of acute arterial occlusion?

  • Pistol shot (acute onset)
  • Pallor
  • Poikilothermia/Polar (cold)
  • Pulselessness
  • Pain
  • Paresthesia
  • Paralysis (strength)
• What does poikilothermia/polar refer to in the context of acute arterial occlusion?

  Cold
• What condition is indicated by the seven "Ps" presentation?

  Compartment syndrome
• What is compartment syndrome related to?

  Poor/impaired tissue perfusion
• Which of the following is a manifestation of venous insufficiency?

  Edema
• What causes brown pigmentation of the skin in venous insufficiency?

  Hemosiderin deposits
• What is stasis dermatitis?

  Thin, shiny, strange looking skin
• Where are venous stasis ulcers most commonly located?

  Medial malleolus
• What are the key differences between Arterial Disease and Venous Insufficiency?

  Arterial Disease:

  • Pain, cool to touch, hairless
  • May get gangrene
  • Decreased or absent pulses
  • No edema
  • Ulcers more often on toes
  • Dusky rubor rather than pallor in dependent position, then turns pale when extremity goes up

  
  

  Venous Insufficiency:

  • Dull or no pain unless open sores, warm legs
  • No gangrene
  • Arterial pulses present
  • Edema present
  • Ulcers more often located medially on lower leg, ankles
  • Round, pigmented spots, skin thickening. Relief with LE elevation
• What kind of pain is associated with arterial disease?

  Pain
• What kind of pain is associated with venous insufficiency?

  Dull or no pain unless open sores
• What happens to extremity color in arterial disease when raised?

  Turns pale
• What provides relief in venous insufficiency?

  Leg elevation
• What does DVT stand for?

  Deep venous thrombosis
• What is deep venous thrombosis?

  A blood clot in the veins
• DVT is typically what?

  Unilateral
• What are the risk factors for DVT?

  • Immobility (stasis)
  • Hypercoagulability
  • Damaged vessel wall

  
• What is a major complication of DVT?

  Pulmonary embolism