Peripheral vascular disease: Clinical (To be retired)
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Peripheral vascular disease: Clinical (To be retired)
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
Assessments
Peripheral vascular disease: Clinical (To be retired)
USMLE® Step 2 questions
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Questions
USMLE® Step 2 style questions USMLE
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Transcript
Content Reviewers
Rishi Desai, MD, MPHPeripheral vascular disease is an abnormal narrowing of arteries other than the ones that supply the heart or brain, and it most often affects the ones in the legs.
Risk factors include being older than 60 years, smoking, hypertension, hyperlipidemia, diabetes, and metabolic syndrome.
The most common underlying mechanism of peripheral artery disease is atherosclerosis, which results in the accumulation of lipid and fibrous material between the layers of the arterial wall.
Eventually, the affected artery becomes progressively narrower, and this may lead to pain, ulceration, and even gangrene.
Now, most people with peripheral vascular disease actually don’t have symptoms until occlusion becomes significant, which is when 70% of the vessel lumen is obstructed.
Symptoms include intermittent claudication, which includes pain, numbness, or tiredness in the legs during walking or standing, and is relieved by rest.
This is because the blood supply may be enough to meet the muscle needs at rest, but not the increased needs during activity, leading to ischemia – so basically, occurs when oxygen demand is greater than oxygen supply.
The perceived level of symptoms from intermittent claudication can be mild to extremely severe depending on the degree of blood supply.
Intermittent claudication can present unilaterally or bilaterally, as buttock and hip, thigh, calf, or foot pain, singly or in combination.
In addition, pulses in one or both groins are diminished, and bilateral aortoiliac disease that is severe enough almost always causes erectile dysfunction.
The triad of intermittent claudication, absent or diminished femoral pulses, and erectile dysfunction is known as Leriche syndrome.
Location of pain depends upon the artery involved. Lower aorta or iliac artery involvement causes pain in the hips and buttocks.
Iliac or common femoral artery involvement causes pain in the thigh.
Summary
Peripheral vascular disease (PVD) is a group of diseases that affect the circulation in the blood vessels outside of the heart and brain. PVD can cause the blood vessels to get narrowed or blocked, leading to poor circulation and possible ischemia of the affected body parts. Symptoms depend on the affected organ and may include leg pain, cramping, and fatigue. It is commonly associated with smoking, high blood pressure, diabetes, and high cholesterol. Treatment options for PVD include lifestyle changes, medications, and surgery.
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