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Cardiology > 02.19 Diseases of the Aorta and its Branches > Flashcards

02.19 Diseases of the Aorta and its Branches Flashcards

1
Q

Abnormal weakening and dilatation of the artery

A

Aortic aneurysm

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2
Q

Aneurysm is most located in the ______

A

Abdominal aorta

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3
Q

RF of AA

A 
Older age
Male sex
Fam Hx
Smoking
HPN
Hypercholesterolemia
Connective tissue disorders
DM
Inflammation
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4
Q

Two most common complications of AAA

A

Rupture

Thromboembolism

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5
Q 
Frequently asymptomatic
Abdominal mass or fullness
Low back pain
Abdominal rigidity
Fainting or lightheadedness
Excessive thirst
Vomiting
A

AAA

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6
Q

PE of AAA

A

Pulsatile mass

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7
Q

Best screening tool for the definitive diagnosis of AAA in the ER setting

A

US

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8
Q

What are the information that you can gather through US

A

Absolute diameter
Relationship of aneurysm with the renal artery
Involvement of the iliac arteries
Detects presence of thrombus

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9
Q

Gives more accurate size of the aortic aneurysm
For the evaluation for endovascular repair
Most sensitive test for detecting a rupture

A

CT Scan

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10
Q

Signs of rupture in CT

A

Contrast extravasation
Stranding of blood in ventral peritoneum
Break in calcification ring

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11
Q

Do repair for AAA if

A

Symptomatic
Rapidly growing aneurysms (>0.5 cm in 6 months)
With RF (strong fam hx, irregular shape, uncontrolled HPN, COPD)

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12
Q

Threshold size of AAA for repair

A

5.5 cm

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13
Q

Treatment options for AAA

A

Open surgery
Endovascular repair
Grafts

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14
Q

Midline laparotomy
Retroperitoneal
Resect the aneurysm with restoration of distal flow

A

Open surgery

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15
Q

Extrude the aneurysmal sac from the aortic circulation
Uses fluoroscopic guidance
Proximal neck fixation to prevent migration
Adequate seal to ensure aneurysmal sac exclusion
Sac shrinkage

A

Endovascular repair

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16
Q

Endoleak related to graft device itself; endo leak that happens at the attachment site
Must be repaired

A

Type 1 endoleak type

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17
Q

Endoleak due to retrograde flow from collateral branches

Must only be observed

A

Type II

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18
Q

Endoleak due to fabric tears, graft disconnection, or disintegration
Must be repaired

A

Type III

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19
Q

Flow through the graft presumed to be associated with graft wall “porosity”

A

Type Iv

20
Q

Persistent or recurrent pressurization of the sac with no evidence or endoleak

A

Endotension

21
Q

Eligibility criteria for EVAR

A

Access
Iliac vessels
Aberrant Vessels
Neck

22
Q

Critical features that limit eligibility for EVAR

A

Alterations in neck composition (presence of thrombus, calcification)
Neck angulation
Undesirable neck length and diameter

23
Q

Neck: Angulation ___, Length at least _____, Diameter _____, Reversed ____ shape neck, no thrombus, atheroma, calcification

A

< 60 deg C
1.5 cm
< 32 mm
Cone

24
Q

Clinical syndromes of carotid artery disease

A 
Asymptomatic
Transient ischemic attacks
Reversible ischemic neurologic deficit
Crescendo TIAs
Amaerosis fugax
25
Q

A temporary loss of vision in one eye due to a lack of blood flow
Stroke

A

Amaeurosis fugax

26
Q

Mechanism of CAD that causes stroke

A

Embolization/thrombosis

Hypoperfusion

27
Q

Risk of stroke is related to:

A

Degree of stenosis
Symptom status
Plaque morphology

28
Q

Types of plaque

A

Calcified
Dense
Soft

29
Q

PE for CAD

A

Bruits
Absence of carotid pulse
Embolic material in retinal artery branches

30
Q

Embolic material in retinal artery branches

A

Hollenhorst plaque

31
Q

Diagnostic tools for CAD

A

Carotid duplex US
Magnetic resonance angiography
CT angiography
Contrast angiography

32
Q

Data obtained in CDUs

A

Degree of stenosis

Plaque morphology

33
Q

Less susceptible to overestimating carotid stenosis and provides good quality images that can be viewed in multiple planes
Limited use in patients with calcified vessels because of possible overestimation

A

CT angiography

34
Q

Gold standard

Anatomic measurement is done to measure the degree of stenosis

A

Contrast angiography

35
Q

Patient is under general anesthesia
The carotid vessels are exposed, do vascular control open up the vessel, take out the plaque and close it using a commercially available patch

A

Carotid endarterectomy

36
Q

Done in catheterization lab under laparoscopic guidance
The gold standard is that you have to have embolic protection device because if the plaque is soft, or ulcerated, any manipulation can cause the plaque to dislodge and travel to the brain and cause a stroke

A

Carotid artery stenting

37
Q

Complications of CAD

A

Stroke
Surgical
Endovascular

38
Q

Syndrome of elevated arterial blood pressure due to reduced kidney perfusion

A

Renovascular hypertension

39
Q

Most common form of surgically correctable hypertension

A

Renal artery occlusive disease

40
Q

Onset before age 30 without risk factors
Presence of abdominal bruit
Accelerated hypertension or resistant hypertension
Renal failure of uncertain etiology
Recurrent flash edema
Acute renal failure precipitated by ACE I or ARBs

A

Renal hyperternsion

41
Q

Anatomic studies for renal hypertension

A

Renal duplex ultrasonography
MRI/MRA
CT angiography
Contrast angiography

42
Q

Best screening method

A

Renal duplex ultrasonography

43
Q

Gold standard
Determines imporatnce of suggestive lesions
Concurrently perform endovascular therapy

A

Contrast angiography

44
Q

Functional studies

A

Captopril renography

Renal vein rein assay

45
Q

Goals of treatment for renal hypertension

A

Control hypertension

Preservation of renal function

46
Q

Treatment of renal hypertension

A

Medical
Percutaneous transluminal renal angioplasty with or without stenting
Bypass surgery

Cardiology (13 decks)

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