10. MTB Step 3 - Peripheral Arterial Disease (PAD)

Question 1

PRESENTATION

What are (3) Common Presenting Signs/Symptoms of Peripheral Arterial Disease (PAD)?

Answer 1

1. Claudication (pain in calves on exertion)
2. Smooth, Shiny Skin with Loss of Hair and Sweat Glands
3. Loss of Pulses in the Feet

Arterial Occlusion = Pain + Pallor + Pulselessness

Question 2

DIAGNOSIS

1. What is the Best INITIAL Test for PAD?
2. What is the Most ACCURATE Test for PAD?

Answer 2

1. Ankle-Brachial Index (ABI)
   
   • Normal > 0.9
   • Obstuction > 10% difference between Legs and Arms
2. Angiography

Question 3

TREATMENT

What are the (5) Therapies that make up the Best INITIAL Therapy for PAD?

Answer 3

1. Aspirin
2. ACEIs
3. Exercise (as tolerated)
4. Cilostazol
5. Statin (Target = LDL < 100)

Question 4

ACUTE ARTERIAL EMBOLUS

What are (3) Common Presenting Signs/Symptoms of Acute Arterial Embolus?

Answer 4

1. Sudden Onset of Pain
2. Loss of Pulse
3. Cold Extremity