PAEA EOC & Summative Practice
aka Buerger's disease
what exactly causes the inflammatory thrombi affecting the medium and small vessels
occlusive vascular disease of (nonatherosclerosis)
thromboangiitis obliterans?
polymorphonuclear leukocytes, microabscesses, and
multinucleated giant cells may be presen
smoking cessation most important!
Treatment options for
thromboangiitis obliterans? cilostazol (PDE 3 inhibitor) has vasodilator properties
(alleviated symptoms) if raynauds also present, CCB
(nifedipine)
ACE inhibitors
what heart failure treatment
provides a benefit of beta blockers can also reduce M&M
reduction in morbidity and
mortality? diuretics have no reduction in mortality
how would you manage a benzodiazepin
patient with a MI in the e early no
setting of cocaine use? beta blockers
fibrolytic therapy
then do PCI & coronary angiography when
,If PCI cannot be done for a it can be done ideally PCI is done within
STEMI patient within 120 90 minutes
minutes, what should be done? fibrolytic therapy can be used up to 12 hours of symptoms
catheter-based arteriography (digital subtraction
If you suspect an acute limb
arteriography) provides the most useful information. can
ischemia due to arterial
also help with treatment
embolism, what imaging
should you get?
can help distinguish between thrombosis and embolus
, lower extremities more common than upper extremities
The common femoral, common iliac, and popliteal artery
bifurcations are frequent locations
where are arterial emboli often
majority originate in the heart
found?
fun fact: Compared with thromboemboli, atheroemboli are
less likely to produce symptoms of acute limb ischemia
24-hour ambulatory monitoring (to ensure
not white coat) medical hx (assess
adherence to meds, other meds)
how would you work up a
physical exam (look for abominal/renal
patient with treatment
bruits)
resistant hypertension that
labs (electrolytes, glucose, creatinine, UA)
you suspect a secondary
cause?
If pheo suspected: measure fractionated metanephrines and
catecholamines in a 24- hour urine collection
other than atherosclerosis fibromuscular dysplasia (usually in a young pt)
leading to renal artery stenosis
and secondary HTN, what is
another causes of a renal-
associated secondary HTN?
most important modifable risk smoking cessation!
factor for AAA?
when is it okay to do screening if AAA is <5.5 cm then annual screening with US is
survelliance for AAA rather recommended. may need every 6 months if rapidly
aka Buerger's disease
what exactly causes the inflammatory thrombi affecting the medium and small vessels
occlusive vascular disease of (nonatherosclerosis)
thromboangiitis obliterans?
polymorphonuclear leukocytes, microabscesses, and
multinucleated giant cells may be presen
smoking cessation most important!
Treatment options for
thromboangiitis obliterans? cilostazol (PDE 3 inhibitor) has vasodilator properties
(alleviated symptoms) if raynauds also present, CCB
(nifedipine)
ACE inhibitors
what heart failure treatment
provides a benefit of beta blockers can also reduce M&M
reduction in morbidity and
mortality? diuretics have no reduction in mortality
how would you manage a benzodiazepin
patient with a MI in the e early no
setting of cocaine use? beta blockers
fibrolytic therapy
then do PCI & coronary angiography when
,If PCI cannot be done for a it can be done ideally PCI is done within
STEMI patient within 120 90 minutes
minutes, what should be done? fibrolytic therapy can be used up to 12 hours of symptoms
catheter-based arteriography (digital subtraction
If you suspect an acute limb
arteriography) provides the most useful information. can
ischemia due to arterial
also help with treatment
embolism, what imaging
should you get?
can help distinguish between thrombosis and embolus
, lower extremities more common than upper extremities
The common femoral, common iliac, and popliteal artery
bifurcations are frequent locations
where are arterial emboli often
majority originate in the heart
found?
fun fact: Compared with thromboemboli, atheroemboli are
less likely to produce symptoms of acute limb ischemia
24-hour ambulatory monitoring (to ensure
not white coat) medical hx (assess
adherence to meds, other meds)
how would you work up a
physical exam (look for abominal/renal
patient with treatment
bruits)
resistant hypertension that
labs (electrolytes, glucose, creatinine, UA)
you suspect a secondary
cause?
If pheo suspected: measure fractionated metanephrines and
catecholamines in a 24- hour urine collection
other than atherosclerosis fibromuscular dysplasia (usually in a young pt)
leading to renal artery stenosis
and secondary HTN, what is
another causes of a renal-
associated secondary HTN?
most important modifable risk smoking cessation!
factor for AAA?
when is it okay to do screening if AAA is <5.5 cm then annual screening with US is
survelliance for AAA rather recommended. may need every 6 months if rapidly
