157 Questions
Which of the following is a characteristic of rest pain in peripheral arterial disease (PAD)?
It is worsened by limb elevation
What is critical limb ischemia (CLI)?
A condition characterized by chronic ischemic pain lasting more than 2 weeks
Why does rest pain occur more often at night in patients with PAD?
Cardiac output tends to drop during sleep
What do patients with PAD often do to achieve pain relief from rest pain?
Dangle their legs over the side of the bed
Which of the following is a risk factor for critical limb ischemia (CLI) in patients with PAD?
Diabetes
What is the main cause of rest pain in PAD?
Insufficient blood flow to the distal tissues
Which of the following statements about lower extremity PAD is most accurate?
Arterial ulcers in lower extremity PAD most commonly occur over bony prominences.
Which of the following can result from minor trauma to the feet in patients with lower extremity PAD?
Delayed healing, wound infection, and tissue necrosis
What is the most common location for arterial (ischemic) ulcers in lower extremity PAD?
Over bony prominences on the toes, feet, and lower legs
Which of the following is the most serious complication of peripheral arterial disease (PAD)?
Gangrene
What can prevent gangrene in patients with peripheral arterial disease (PAD) that develops over an extended period?
Collateral circulation
Which of the following is NOT a common complication of peripheral arterial disease (PAD)?
Varicose veins
Which age group is most likely to experience symptomatic peripheral artery disease (PAD)?
Middle-aged adults in their 40s and 50s
What is the estimated number of people in the United States over age 40 who have PAD?
8.5 million
Which racial/ethnic group has a higher prevalence of PAD in the United States?
Blacks
What is the relationship between peripheral artery disease (PAD) and other types of cardiovascular disease (CVD)?
PAD is a marker of advanced systemic atherosclerosis
What is the most significant risk factor for mortality in patients with peripheral artery disease (PAD)?
Smoking
Which of the following conditions are patients with PAD more likely to have?
Hypertension
Which of the following risk factors for PAD is considered the most important?
Tobacco use
What percentage of vessel blockage is typically associated with the onset of symptoms in PAD?
60% to 75%
Which racial group is particularly at higher risk for PAD when presenting with multiple risk factors?
Blacks
Which vessels are affected by peripheral artery disease (PAD) in the lower extremities?
Popliteal vessels
What happens to the tissues in the affected extremities in PAD?
They receive less oxygen and nutrients
What can cause reduced perfusion in PAD?
Presence of a large plaque within the vessel
What happens if there is less oxygen being delivered to the tissues in the affected area in PAD?
The tissues become more susceptible to infarction
What can happen if ischemia in PAD is not fixed and becomes severe?
Death of the tissue (infarction)
What can exacerbate ischemia in PAD?
Increased oxygen demand
What can cause reduced oxygen supply in PAD?
Thrombus or embolus
What is the consequence of reduced oxygen supply in PAD?
Decreased oxygen delivery to the tissues
What is the result of increased exertional activities in PAD?
Increased mismatch between oxygen supply and demand
What happens if ischemia in PAD is not fixed and becomes severe?
Death of the tissue (infarction)
Which type of peripheral artery disease (PAD) is characterized by a gradual and progressive thrombus formation?
Thrombosis
What is the main cause of thrombus formation in PAD?
Atherosclerosis
Which risk factor is NOT associated with thrombus formation in PAD?
High LDL or Low HDL
What can happen if a plaque within the vessel wall leads to a reduction in oxygen supply in PAD?
Ischemia
In PAD, what can cause a stent to become thrombosed?
Non-compliance with medications
Which medications are typically prescribed for patients with a stent in PAD?
Aspirin and Plavix (Clopidogrel)
Which type of PAD is characterized by an acute issue with sudden development of complications?
Embolic
In embolic PAD, where does the clot typically get stuck, causing severe ischemia?
Iliac area
What is the result of reduced perfusion in embolic PAD beyond the area where the clot is stuck?
Infarction
Which type of PAD is more chronic and characterized by gradual and progressive thrombus formation?
Thrombosis
Which condition can cause atrial fibrillation in the presence of a left ventricular thrombus in peripheral artery disease (PAD)?
Myocardial infarction
In PAD, what can cause a clot to form in the dilated area of an abdominal aortic aneurysm?
Stasis of blood flow
What happens if a piece of a clot breaks off from an abdominal aortic aneurysm and gets stuck in one of the actual vessels in PAD?
It occludes the vessel
Which condition can cause aneurysmal dilation and clot formation in the popliteal area in PAD?
Stasis of blood flow
In PAD, what can happen if there are plaques or clots within the vessels, leading to reduced blood flow to the tissues?
Muscle pain
Which classification of limb pains in PAD helps determine the severity and urgency of intervention?
Intermittent claudication
Which condition is NOT caused by an embolic problem in PAD?
Vasculitis
What can cause reduced perfusion in PAD due to embolic problems?
Stasis of blood flow
Which type of PAD is characterized by gradual and progressive thrombus formation?
Chronic PAD
What is the main cause of rest pain in PAD?
Reduced blood flow
Which artery is responsible for supplying blood to the hips and buttocks in patients with iliac artery pain in PAD?
Femoral artery
Which pulses will be diminished in patients with iliac artery pain in PAD?
Femoral, popliteal, and pedal pulses
Which artery is affected in patients with pain in the genital area in PAD?
Genital artery
What symptom may patients with pain in the genital area in PAD experience?
Erectile dysfunction
Where does the clot get stuck in patients with pain in the femoral and popliteal artery in PAD?
Thigh area
What symptom may patients with pain in the femoral and popliteal artery in PAD experience?
Calf pain
Which artery is affected in patients with pain in the tibiofibular artery in PAD?
Tibiofibular artery
What symptom may patients with pain in the tibiofibular artery in PAD experience?
Foot pain
What type of pain is associated with vascular issues in PAD?
Claudication pain
What happens to the pain in patients with intermittent claudication in PAD when they rest?
It improves
Which of the following is a characteristic of resting claudication in peripheral arterial disease (PAD)?
It improves when the legs are elevated
What is the primary cause of critical limb ischemia (CLI) in PAD?
Decreased blood supply to the limb
Which of the following is a sign of critical limb ischemia (CLI) in PAD?
Pain lasting for more than 2 weeks
What is the effect of plaque or embolus occluding blood flow in peripheral arterial disease (PAD)?
Reduced or absent pulse distal to occlusion
Which of the following is a characteristic of intermittent claudication in PAD?
It worsens with increased oxygen demand
What is the significance of Buerger's sign in resting claudication in PAD?
It causes a change in leg color in specific positions
Which of the following is a characteristic of critical limb ischemia (CLI) in PAD?
It is accompanied by gangrene and arterial ulcers
What is the effect of elevating the legs in resting claudication in PAD?
Change in leg color to pale
What is the effect of hanging the legs in resting claudication in PAD?
Improved blood flow with gravity
Which of the following is a characteristic of pulse bruits in peripheral arterial disease (PAD)?
It worsens with increased oxygen demand
Which is the most common cause of acute limb ischemia in peripheral arterial disease (PAD)?
Embolus
What is the consequence of acute occlusion of a blood vessel in acute limb ischemia in PAD?
Reduced blood flow
What can cause compression of blood vessels in acute limb ischemia in PAD?
Compartment syndrome
Which condition can result in acute limb ischemia in PAD due to trauma?
Fractured bone
What is the primary manifestation of acute limb ischemia in PAD?
Severe ischemia
What happens to the affected tissue in acute limb ischemia in PAD?
Infarction
Which type of blockage is most commonly associated with acute limb ischemia in PAD?
Complete blockage
What is the result of reduced blood flow in acute limb ischemia in PAD?
Severe ischemia
Which of the following is a skin manifestation of peripheral artery disease (PAD)?
Thickened brittle nails
Which of the following is a characteristic of arterial ulcers in PAD?
Punched out and dry
What is the potential consequence of decreased oxygen and nutrient supply in PAD?
Muscle atrophy
Which of the following is a characteristic of dry gangrene in PAD?
Black discoloration and lack of erythema
What is the potential consequence of arterial ulcers progressing to wet gangrene in PAD?
Sepsis
Which of the following is a potential cause of pale cold extremities in PAD?
Insufficient oxygen supply to the skin
What can potentially cause hair loss in PAD?
Decreased oxygen and nutrient supply
What is the potential consequence of decreased blood flow in PAD?
Colder skin and decreased color
Which of the following is NOT one of the clinical features of acute limb ischemia in PAD?
Paralysis
What is the significance of positive Doppler pulses in PAD?
The limb is viable and can be revascularized
What are the clinical features of a non-viable limb in PAD?
Weakness and paralysis, no pain, loss of sensations
What is the main cause of absent pulses in Doppler pulse in PAD?
Thrombus formation
What happens to the skin temperature in acute limb ischemia in PAD?
It cannot be regulated and becomes poikilothermal
What is the significance of weakness in PAD?
It indicates a non-viable limb
What is the significance of sensory loss in PAD?
It indicates a non-viable limb
What is the main cause of pain in PAD?
Infarction of muscle tissue
What is the main cause of paresthesia in PAD?
Nerve destruction
What is the main cause of pallor in PAD?
Reduced blood flow
Which of the following is the first-line diagnostic test for peripheral arterial disease (PAD)?
Ankle-Brachial Index
What is the diagnostic range for the Ankle-Brachial Index in PAD?
<0.9
Which of the following conditions is NOT an indication for revascularization in PAD?
Medial calcific sclerosis
What is the characteristic of critical limb ischemia (CLI) in PAD?
All of the above
Which of the following risk factors increases the risk for critical limb ischemia (CLI) in patients with PAD?
All of the above
What can result from prolonged ischemia in lower extremity PAD?
Atrophy of the skin and underlying muscles
Which of the following diagnostic tests can assess PAD and determine if the patient is a good candidate for revascularization?
Computed Tomography Angiography
What is the main cause of delayed healing, wound infection, and tissue necrosis in PAD?
All of the above
Which of the following is a characteristic of intermittent claudication in PAD?
Pain with walking that resolves with rest
What is the primary cause of critical limb ischemia (CLI) in PAD?
Severe obstruction of the arteries
Which of the following is the first treatment goal for patients with PAD?
Reducing CVD risk factors
What is a well-known risk factor for PAD progression?
Hypertension
What is essential to reduce the risk for CVD events, PAD progression, and death in PAD patients?
Comprehensive tobacco cessation strategies
What is the normal range for Ankle-Brachial Index (ABI)?
1.00–1.30
What is the range for Ankle-Brachial Index (ABI) that indicates Borderline ABI?
0.91–0.99
What is the range for Ankle-Brachial Index (ABI) that indicates Mild PAD?
0.70–0.41
What is the range for Ankle-Brachial Index (ABI) that indicates Severe PAD?
≤0.40
Which medication is NOT recommended for preventing cardiovascular disease (CVD) events in patients with peripheral arterial disease (PAD)?
Warfarin
What is the target glycosylated hemoglobin (A1C) level for patients with diabetes and PAD?
Below 7.0%
Which medication can reduce symptoms of peripheral arterial disease (PAD)?
Cilostazol
Which medication is commonly used for antiplatelet therapy in patients with PAD?
Aspirin
Which medication is NOT recommended for reducing the risk of cardiovascular disease (CVD) events in patients with PAD?
Gemfibrozil
Which medication can improve the flexibility of red blood cells (RBCs) and white blood cells (WBCs) in patients with PAD?
Pentoxifylline
Which medication can inhibit platelet aggregation and increase vasodilation in patients with PAD?
Cilostazol
Which medication can be used by aspirin-intolerant patients for antiplatelet therapy in PAD?
Clopidogrel
Which medication can reduce the risk for myocardial infarction (MI) and stroke in patients with PAD?
Omeprazole
Which medication is usually stopped within 3 months due to side effects in patients with PAD?
Cilostazol
Which of the following statements about exercise therapy for PAD is most accurate?
Women with PAD have slower functional decline and greater mobility loss compared to men.
Which of the following is the recommended waist circumference for women with PAD?
Less than 35 inches
What is the recommended body mass index (BMI) for patients with PAD?
Less than 25 kg/m2
What is the effect of sustained weight loss in patients with PAD?
Reduction in triglycerides, glucose, A1C, and the risk of developing type 2 diabetes
What type of diet is recommended for obese or overweight persons with PAD?
Low-calorie and low-salt diet
Which of the following medications should patients with critical limb ischemia (CLI) continue to take to reduce the risk for a cardiovascular disease (CVD) event?
ACE inhibitors
Which of the following is the optimal therapy for a patient with critical limb ischemia (CLI) in peripheral artery disease (PAD)?
Bypass surgery
Which of the following actions should be taken to prevent skin cracking and infection in patients with peripheral artery disease (PAD)?
Keeping the affected foot clean and dry
What is the recommended footwear for patients with peripheral artery disease (PAD)?
Soft and roomy footwear
Which of the following is a potential risk of taking dietary or herbal supplements for patients with peripheral artery disease (PAD)?
Potential interactions
Which of the following is a part of conservative management for patients with peripheral artery disease (PAD)?
Preventing and controlling infection
What is the recommended position for the bed in patients with peripheral artery disease (PAD) to control pain and increase perfusion to the lower extremities?
Reverse Trendelenburg position
What is the main goal of revascularization in the treatment of critical limb ischemia (CLI) in peripheral artery disease (PAD)?
To improve perfusion to the affected limb
What should be done to protect the heels of patients with peripheral artery disease (PAD)?
Use a commercially available heel protection device
What is the recommended treatment for deep ulcers in patients with peripheral artery disease (PAD)?
Using wound care products
Which procedure for peripheral arterial disease (PAD) involves the insertion of a specialized catheter into the femoral artery and the use of a balloon at the tip to compress the atherosclerotic intimal lining?
Angioplasty
What is the purpose of placing expandable metallic devices, such as stents, within the artery after balloon angioplasty in PAD?
To limit the growth of new tissue
Which procedure for PAD involves the removal of the obstructing plaque using a high-speed cutting disk or ultraviolet energy?
Atherectomy
What is the main purpose of cryoplasty in PAD?
To combine PTA and cold therapy
Which alternative to open surgery is commonly used for the treatment of lower extremity PAD in interventional radiology?
Stent placement
What are some promising strategies to stimulate blood vessel growth (angiogenesis) in patients with critical limb ischemia (CLI) in PAD?
Growth factors and gene therapy
What is the prognosis for patients with critical limb ischemia (CLI) in PAD?
Almost half will die within 5 years
Where do catheter-based procedures for PAD take place?
Catheterization laboratory
What is the purpose of coating angioplasty balloons and peripheral stents with a drug in PAD?
To limit the growth of new tissue
Which procedure for PAD involves the insertion of a catheter with a diamond-coated tip that rotates at a high speed?
Atherectomy
Which surgical approach is typically used when a person's own vein is not available for peripheral artery bypass surgery in PAD?
Composite sequential bypass graft
What surgical procedure involves opening the artery, removing the obstructing plaque, and sewing a patch to widen the lumen in PAD?
Endarterectomy
In PAD, when is amputation typically needed?
All major arteries in the limb are blocked
What is the in-hospital mortality like for women undergoing revascularization in PAD compared to men?
Higher in women
Which surgical option involves opening the artery and removing the obstructing plaque in PAD?
Endarterectomy
What is the main goal of peripheral artery bypass surgery in PAD?
To improve blood flow beyond a blocked artery
What is the recommended approach for surgical treatment of long routes in PAD?
Axillary-femoral bypass
What is the purpose of PTA with stenting in combination with bypass surgery in PAD?
To improve blood flow beyond a blocked artery
Test your knowledge of rest pain in peripheral arterial disease (PAD) with this quiz. Learn about the causes, symptoms, and management of rest pain in the foot or toes, including its relationship to limb elevation and cardiac output during sleep.
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