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Vascular disorders

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Question
Answer
Atherosclerosis   A build up of fatty deposits (plaque) within blood vessels. Atherosclerosis leads to Arterioscleroisis and Ateriostenosis.  
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Infarct   dead tissue  
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Infarction   the process of tissue dying  
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Risk factors for Atherosclerosis   Smoking, Obesity, Hyperlipidemia, Alcohol, Diabetes, Stress, Hypertention, Inactivity, Sex (gender), and Genetic.  
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Stage 1 for atherosclerosis   Plaque is present and growing but not causing ischemia.  
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What is Plaque?   mostly cholesterol, Lipid deposite, Calcified Cholesterol  
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S/S in stage 1 of atherosclerosis   Asympotmatic  
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Stage 2 for atherosclerosis   Platelets start to stick to plaque forming a clot. Walls of artery become inflammed. Plaque + Clot + Inflammed wall  
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S/S of stage 2 Atherosclerosis   Ischemia causing angina or mini strokes or numbness and tingling.  
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Stage 3 for Atherosclerosis   Necrosis due to severe ischemia - Infarction  
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S/S for stage 3 Atherosclerosis   -Myocardial infarction -peripheral infarction -cerebral infarction  
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Coronary Artery Disease (CAD)   Atherosclerosis of the coronary arteries. Build up of plaque, clot, and inflamation in the arteries going to the myocardium.  
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Etiology of CAD   Idiopathic  
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Risk factors for CAD   Smoking, Obesity, Hyperlipidemia, Alcohol, Diabetes, Stress, Hypertention, Inactivity, Sex (gender), and Genetic.  
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Stage 1 for CAD   Can be detected in Stress Test and confirmed with angiogram. Best stage to catch disease.  
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Goal for stage 1 for CAD   Not to reach Stage 2.  
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Treatment for stage 1 for CAD   Look at risk factors and address them with lifestyle changes. Medication to manage risk factors. Take an Aspirin a day.  
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Stage 2 for CAD   Stable Angina = Occational chest pain durring times of activity (elevated heart rate) then goes away at rest. Unstable Angina = chest pain not associated with activity.  
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Goal for stage 2 for CAD   Get them back to stage 1  
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Treatment for stage 2 for CAD   -Stent implant: done through cath -bypass surgery: done when they can't get stent in. CABG = coronary artery bypass graft  
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Stage 3 for CAD   Myocardial Infarction - Heart attack  
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Goal for stage 3 for CAD   survive  
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Treatment for stage 3 for CAD   - call 911 and take an aspirin - Give oxygen, Nitroglycerin, and hook up IV -TIME IS CRITICAL - confirm MI with EKG. Take drug called TPA to dissolve a clot. -Angiogram done in cath lab and placement of a stent -CABG or Bypass done in surgery  
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Cerebrovascular Disease (CVD)   Atherosclerosis of the carotid arteries and other arteries to or in the brain. Happens gradually.  
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Etiology of CVD   Idiopathic  
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Risk factors for CVD   Smoking, Obesity, Hyperlipidemia, Alcohol, Diabetes, Stress, Hypertention, Inactivty, Sex (gender) and Genetic.  
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S/S for stage 1 for CVD   Asymptomatic. Can be diagnosed in stage one with a carotid arteries ultrasound (doppler).  
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Goal in stage 1 for CVD   Not to get to stage 2  
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Treatment for stage 1 for CVD   - Analyse risk factors and address them with lifestyle changes. - Medications such as Zocor and Blood pressure Meds - Take an aspirin a day  
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Stage 2 for CVD   Patient starts to develope signs and symptoms.  
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S/S for stage 2 for CVD   -occational, temperary weakness in part of the body -Temporary changes in vision -Confusion or affect memory -Mini stroke (TIA) minutes to hours only -Tingling or numbness  
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Goal for stage 2 for CVD   Get them back to stage 1. Determine how severe and if it is CVD.  
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Treatment for stage 2 for CVD   -Angiogram to confirm and to determine the severity -Stent -Bypass  
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Stage 3 for CVD   Stroke, Cerebral Infarction, Cerebral Vascular Accident (CVA)  
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Goal for stage 3 for CVD   Survive  
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Treatment for stage 3 for CVD   -Call 911 and take an aspirin -Get to ER ASAP to confirm what type of stroke with and angiogram, Occlusive Stroke or Hemorrhagic Stroke.  
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Treatment for Occlusive Stroke   - Clot buster - TPA drug to dissolve clot - Stent -Bypass  
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Treatment for Hemorrhagic Stroke   (ruptured Aneurysm) - Surgical repair ONLY -No TPA  
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Peripheral Artery Disease (PAD) Peripheral Vascular Disease (PVD)   Artherosclerosis of arteries outside the heart or brain. Found in Brachial and Femorial arteries most often.  
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Eitology of PVD   Idiopathic  
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Risk factors for PVD   Smoking, Obesity, Hyperlipidemia, Alcohol, Diabetes, Stress, Hypertension, Inactivity, Sex (gender), and Genetics  
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Stage 1 for PVD   Screen with a doppler ultrasound to look at brachial and femorial arteries.  
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Goal for stage 1 for PVD   To keep it from getting worse  
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Treatments for stage 1 for PVD   - Address lifestyle changes form risk factors - Medications from risk factors - Take an Aspirin a day  
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Stage 2 for PVD   Patient starts to experience numbness and tingling, or feels like it is falling asleep.  
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Goal for stage 2 for PVD   Get back to stage 1  
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Treatment for stage 2 for PVD   Angiogram to decide whether to put in stent or do a bypass.  
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Stage 3 for PVD   Infarction Stage  
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Treatment for stage 3 for PVD   - Removal of Infarction, removal of tissue - Amputation  
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What two factors increase the chances of success and affect the size of the infarction.   - Time - Which artery is blocked  
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Systolic pressure for normal blood pressure   less than 120  
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Diastolic pressure for normal blood pressure   less than 80  
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Systolic pressure for prehypertension   120 - 139  
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Diastolic pressure for prehypertension   80 - 89  
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Systolic pressure for hypertension   140 +  
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Diastolic pressure for hypertension   90 +  
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Secondary Hypertension   chronic high blood pressure due to a complication of another condition. Can be cured with the cure of the other disease. EX= Hyperthyroidism and Kidney disease  
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Primary (Essential) Hypertension   Chronic high blood pressure of unknown origin Can be managed but not cured.  
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S/S of Hypertension   - Systolic greater than 140 - Diastolic greater than 90 - Has 1 sign but no symptoms  
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Complications of Hypertension   Atherosclerosis, CAD, CVD, PVD, Heart attack, Stroke, Amputation, LCHF, Kidney damage or failure, Retina damage, Aneurysm  
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Treatment for Hypertension   - Lifestyle changes (loose weight, Exercise, decrease salt intake) - Blood pressure medications (Vasodilaters to lower TPR, ARB are most common: Diuretics to lower blood volume)-cardiac glycosides to decrease cardiac output  
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What is the biggest challenge with Hypertensive patients?   Convincing patient to follow treatment. Educating the patient. Because of no symptoms.  
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Aneurysm   Localized dilation of an artery or chamber in the heart as a result of a weakness in the wall of the artery or heart. Good chance it will be fatal.  
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Varicose Veins   An enlarged dilated superficial vein. Most common in lower expremities and esophagus. Can happen anywhere on the body.  
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Most common cause of varicose veins   Pregnancy  
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Hemorrhoids   Varicose veins on the surface of the rectum  
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Varicose veins on the surface of the esophagus   - Caused by Cirrhosis of the Liver - Can be fatal  
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