108. Vascular Surgery questions Flashcards
1
Q
- Which layer of an artery must be carefully handled during vascular surgery to prevent thrombus formation? A) Tunica externa B) Tunica media C) Tunica intima D) Tunica adventitia
A
C) Tunica intima
2
Q
- What is the main function of the valves found in veins? A) Prevent backflow and pooling of blood B) Increase arterial pressure C) Control smooth muscle contraction D) Regulate blood flow to organs
A
A) Prevent backflow and pooling of blood
3
Q
- Which surgical instrument is ideal for fine vascular anastomosis? A) Potts scissors B) Castroviejo needle holder C) Kelly forceps D) Metzenbaum scissors
A
B) Castroviejo needle holder
4
Q
- What type of suture material is generally preferred for vascular surgeries to reduce tissue reactivity? A) Silk B) Polypropylene C) Nylon D) Vicryl
A
B) Polypropylene
5
Q
- The ‘white line’ during vascular dissection indicates: A) Location of an arterial pulse B) Plane of dissection between adventitia and surrounding tissues C) Damage to the tunica intima D) Thrombosis within the vessel
A
B) Plane of dissection between adventitia and surrounding tissues
6
Q
- In vascular surgery, which type of clamp is commonly used to occlude larger vessels atraumatically? A) Satinsky clamp B) Bulldog clamp C) Kelly forceps D) Allis tissue forceps
A
A) Satinsky clamp
7
Q
- What is the recommended suture size for vessels with a diameter of less than 2 mm? A) 3-0 B) 4-0 C) 6-0 D) 8-0
A
D) 8-0
8
Q
- Which technique is used to prevent air emboli and thrombi from being trapped during vascular anastomosis? A) Continuous suturing B) Transfixation ligature C) Temporary release of occlusive clamps D) Use of hemostatic sponges
A
C) Temporary release of occlusive clamps
9
Q
- The most significant risk of handling the tunica intima improperly during surgery is: A) Infection B) Vasospasm C) Activation of the clotting cascade D) Vascular dilation
A
C) Activation of the clotting cascade
10
Q
- The Kaswan and Martin technique is commonly used for: A) Repairing vascular aneurysms B) Prolapse of the nictitating membrane C) End-to-side vascular anastomosis D) Microvascular reconstruction
A
B) Prolapse of the nictitating membrane
11
Q
- Which material is most commonly used for prosthetic vascular grafts in small animals? A) Dacron B) PTFE (Polytetrafluoroethylene) C) Stainless steel D) Silicon rubber
A
B) PTFE (Polytetrafluoroethylene)
12
Q
- What is the primary indication for using an end-to-end anastomosis technique? A) Connecting vessels with significant luminal disparity B) Creating a vascular shunt C) Reconstructing severed vessels with similar diameters D) Preventing thrombosis in large arteries
A
C) Reconstructing severed vessels with similar diameters
13
Q
- Which of the following is a common anticoagulant used intraoperatively in small animals? A) Aspirin B) Heparin C) Warfarin D) Clopidogrel
A
B) Heparin
14
Q
- What is the primary benefit of using magnification (loupes or microscopes) in microvascular surgery? A) Reduces bleeding B) Increases visualization accuracy C) Increases surgery speed D) Lowers infection rates
A
B) Increases visualization accuracy
15
Q
- The technique developed by Dr. Alexis Carrel for vascular anastomosis involves: A) End-to-end anastomosis using a triangulation technique B) Creation of vascular grafts C) Use of silk sutures for arterial repair D) Double ligature technique for vein closure
A
A) End-to-end anastomosis using a triangulation technique
16
Q
- Which technique is commonly used to create a vascular shunt in dogs? A) End-to-end anastomosis B) End-to-side anastomosis C) Side-to-side anastomosis D) Continuous suture technique
A
B) End-to-side anastomosis
17
Q
- The use of vascular grafts is most commonly indicated for: A) Repairing large vessel aneurysms B) Treating superficial skin wounds C) Ligating small veins D) Closing abdominal incisions
A
A) Repairing large vessel aneurysms
18
Q
- Which artery is most commonly used for catheterization in small animals? A) Femoral artery B) Carotid artery C) Brachial artery D) Radial artery
A
A) Femoral artery
19
Q
- During vascular surgery, what is the primary purpose of using a Rumel tourniquet? A) To control bleeding B) To dissect tissues C) To dilate blood vessels D) To stabilize bone fractures
A
A) To control bleeding
20
Q
- What is the primary complication of using synthetic grafts in small animal patients? A) Thrombosis and infection B) Excessive bleeding C) Vessel rupture D) Tissue necrosis
A
A) Thrombosis and infection
21
Q
- Which suture technique helps prevent narrowing of the vessel lumen during vascular anastomosis? A) Simple interrupted B) Horizontal mattress C) Continuous locking D) Simple continuous
A
B) Horizontal mattress
22
Q
- The optimal angle for end-to-side anastomosis to reduce turbulence is: A) 90 degrees B) 60 degrees C) Less than 45 degrees D) 75 degrees
A
C) Less than 45 degrees
23
Q
- What is the primary advantage of using self-expanding stents? A) Increased flexibility and adaptability B) Higher radial strength C) Lower thrombogenicity D) Reduced need for anesthesia
A
A) Increased flexibility and adaptability
24
Q
- Which imaging technique is considered the gold standard for vascular diagnostics? A) Ultrasound B) MRI C) Angiography D) CT scan
A
C) Angiography
25
Q
- In the Seldinger technique, what is the initial step? A) Inserting a guide wire B) Puncturing the vessel with a needle C) Using a balloon catheter D) Placing a stent
A
B) Puncturing the vessel with a needle
26
Q
- The use of low-molecular-weight heparin is beneficial because it: A) Requires less frequent dosing B) Has a higher risk of bleeding C) Is less effective than unfractionated heparin D) Requires intravenous administration
A
A) Requires less frequent dosing
27
Q
- Which condition may require surgical creation of an arteriovenous fistula in dogs? A) Hemangiosarcoma B) Renal failure requiring dialysis C) Inflammatory bowel disease D) Osteosarcoma
A
B) Renal failure requiring dialysis
28
Q
- A longitudinal vessel incision is preferred over a transverse incision because: A) It allows better extension and retraction B) It heals faster C) It reduces the risk of infection D) It causes less bleeding
A
A) It allows better extension and retraction
29
Q
- Which anticoagulant solution is commonly used intraoperatively to flush vessels? A) Heparinized saline with lidocaine B) Normal saline C) Ringer’s lactate D) Dextrose solution
A
A) Heparinized saline with lidocaine
30
Q
- The Satinsky clamp is ideal for which type of vascular procedure? A) Partial occlusion of large vessels B) Full occlusion of small veins C) Dissecting soft tissue D) Stabilizing bone fractures
A
A) Partial occlusion of large vessels
31
Q
- Which factor increases the risk of thrombus formation during vascular surgery? A) Using monofilament sutures B) Improper handling of the tunica intima C) Gentle tissue handling D) Application of heparin
A
B) Improper handling of the tunica intima
32
Q
- The Castroviejo needle holder is primarily used in: A) Orthopedic surgery B) Microvascular surgery C) Gastrointestinal surgery D) Neurologic surgery
A
B) Microvascular surgery
33
Q
- Which surgical technique involves joining the donor artery to the recipient vein? A) End-to-side anastomosis B) Side-to-side anastomosis C) End-to-end anastomosis D) Arteriovenous fistula creation
A
D) Arteriovenous fistula creation
34
Q
- What is the main advantage of using PTFE grafts? A) High resistance to infection B) Biologic compatibility C) Low cost D) Increased thrombogenicity
A
B) Biologic compatibility
35
Q
- The ‘heel’ of the anastomosis refers to: A) The proximal end of the vessel B) The area with the least visualization C) The distal end of the vessel D) The midpoint of the suture line
A
B) The area with the least visualization
36
Q
- Which type of incision is recommended for small vessels (less than 4 mm) to reduce the risk of luminal narrowing? A) Longitudinal incision B) Circular incision C) Diagonal incision D) Transverse incision
A
D) Transverse incision
37
Q
- In microvascular surgery, which imaging tool is mandatory for delicate procedures? A) C-arm fluoroscopy B) Ultrasonography C) Operating microscope D) Endoscope
A
C) Operating microscope
38
Q
- What is the primary risk associated with placing synthetic vascular grafts in infected fields? A) Graft infection and failure B) Excessive bleeding C) Vascular dilation D) Reduced blood flow
A
A) Graft infection and failure
39
Q
- What type of stent is preferred for areas with significant vessel motion? A) Self-expanding stents B) Balloon-expandable stents C) Stainless steel stents D) Braided stents
A
A) Self-expanding stents
40
Q
- Which technique involves occluding a vessel using a Silastic loop? A) Potts loop B) Rumel tourniquet technique C) Satinsky clamp method D) Bulldog clamp technique
A
B) Rumel tourniquet technique
41
Q
- The first reported use of microvascular surgery involved: A) Skin grafting B) Cardiac valve replacement C) Replantation of severed appendages D) Tumor removal
A
C) Replantation of severed appendages
42
Q
- The presence of collateral circulation is essential in vascular surgery because it: A) Reduces blood pressure B) Increases risk of thrombosis C) Allows sacrifice of some vessels without compromising perfusion D) Prevents infection
A
C) Allows sacrifice of some vessels without compromising perfusion
43
Q
- An aortic stent-graft is most commonly used to treat: A) Peripheral artery disease B) Carotid artery stenosis C) Femoral artery blockage D) Aortic aneurysms
A
D) Aortic aneurysms
44
Q
- The best approach to control hemorrhage from a vessel trauma in a surgical field is: A) Use of hemostatic sponges B) Direct pressure and vessel ligation C) Continuous suture technique D) Use of vascular clamps only
A
B) Direct pressure and vessel ligation
45
Q
- The Kaswan and Martin technique is used to treat which condition? A) Corneal ulceration B) Lens luxation C) Nictitating membrane gland prolapse D) Retinal detachment
A
C) Nictitating membrane gland prolapse
46
Q
- During vascular anastomosis, the best suture pattern to minimize leakage is: A) Interrupted sutures B) Horizontal mattress pattern C) Simple interrupted D) Continuous suture pattern
A
D) Continuous suture pattern
47
Q
- The recommended suture for feline renal transplantation vessels is: A) 3-0 suture B) 5-0 suture C) 7-0 to 10-0 suture D) 2-0 suture
A
C) 7-0 to 10-0 suture
48
Q
- A side-to-side vascular anastomosis is typically used for: A) Preventing aneurysm formation B) Creating a communication between adjacent vessels C) Repairing damaged veins D) Increasing blood pressure
A
B) Creating a communication between adjacent vessels
49
Q
- Which method is used to flush thrombi from a vessel before final suturing? A) Ice-cold heparinized saline solution B) Warm saline flush C) Ringer’s lactate infusion D) Blood transfusion
A
A) Ice-cold heparinized saline solution
50
Q
- What complication can occur if the adventitia is included in a vascular anastomosis? A) Vessel dilation B) Increased blood flow C) Vascular rupture D) Thrombosis due to luminal compromise
A
D) Thrombosis due to luminal compromise
51
Q
- True/False: In small animal surgery, the use of self-expanding stents is preferred in areas with significant vessel movement.
A
True
52
Q
- True/False: PTFE grafts are preferred over autologous vein grafts due to their superior biocompatibility and lower thrombosis rates.
A
False
53
Q
- True/False: The tunica intima of a vessel is more resilient to damage during dissection compared to the tunica media.
A
False
54
Q
- True/False: Surgical loupes providing 2.5x to 4.5x magnification are commonly used for general vascular surgeries.
A
True
55
Q
- True/False: Endovascular stents can be retracted and repositioned after partial deployment.
A
True
56
Q
- Fill in the blank: The preferred suture size for vascular anastomosis in feline renal transplantation is typically between … ______ and …______.
A
7-0 and 10-0
57
Q
- Fill in the blank: The ______ technique is used to temporarily occlude blood flow using a loop of Silastic.
A
Rumel tourniquet
58
Q
- Fill in the blank: The ______ artery is most commonly used for percutaneous catheterization in dogs.
A
Femoral
59
Q
- Fill in the blank: The introduction of ______ techniques has greatly expanded the ability to treat vascular conditions that were previously considered inoperable.
A
Endovascular
60
Q
- Fill in the blank: The ______ needle holder is ideal for microvascular surgery due to its fine control and delicate grip.
A
Castroviejo
61
Q
- Short Answer: What are two primary benefits of using an operating microscope in microvascular surgery?
A
Increased visualization accuracy and reduced tissue damage
62
Q
- Short Answer: What is the main complication associated with improperly handling the tunica intima during vascular surgery?
A
Activation of the clotting cascade leading to thrombosis
63
Q
- Short Answer: Why is it important to excise the adventitia from the ends of vessels during anastomosis?
A
To prevent inadvertent inclusion in the suture line, which could narrow the lumen and lead to thrombosis
64
Q
- Short Answer: What is the function of vascular clamps during arterial dissection?
A
To occlude blood flow temporarily and prevent hemorrhage
65
Q
- Short Answer: In which situations would you choose to use a side-to-side anastomosis technique?
A
For creating a communication between adjacent vessels or in bypass grafts to preserve blood flow
66
Q
- Case Scenario: A 6-year-old Labrador Retriever presents with severe limb ischemia following an accidental laceration to the femoral artery. Which surgical technique would be most appropriate to restore blood flow?
A
End-to-end anastomosis after controlling hemorrhage and assessing the vessel ends
67
Q
- Case Scenario: During surgery, you notice that a previously placed vascular graft has developed signs of infection. What would be your next step in management?
A
Remove the infected graft if possible, replace with an autologous vein graft, and administer systemic antibiotics
68
Q
- Case Scenario: A cat presents with acute hindlimb paralysis and a cold limb. Doppler ultrasound confirms an aortic thromboembolism. What immediate treatment options would you consider?
A
Administer anticoagulants (e.g., heparin), consider thrombolytic therapy, and monitor for reperfusion injury
69
Q
- Case Scenario: A small breed dog is undergoing surgery for renal transplantation. During vascular anastomosis, you notice minor bleeding along the suture line. What should you do?
A
Apply gentle pressure to control bleeding, and if necessary, place additional fine sutures
70
Q
- Case Scenario: You are performing an endovascular procedure to treat a patent ductus arteriosus in a young dog. During the procedure, the fluoroscopy shows migration of the occlusion device. What should you do?
A
Retrieve the device using a snare catheter if accessible, or perform surgical intervention if necessary
