322 Mesenteric Vascular Insufficiency

Question 1

Part of the colon where collateral vessels meet at the splenic flexure (H20 C322 P2292)

Answer 1

Griffith’s point

Question 2

Part of the colon where collateral vessels meet at the descending/sigmoid colon (H20 C322 P2292)

Answer 2

Sudeck’s point

Question 3

The splanchnic circulation can receive up to how much of the cardiac output (H20 C322 P2292)

Answer 3

30%

Question 4

Most significant indicator of survival in intestinal ischemia (H20 C322 P2292)

Answer 4

Timeliness of diagnosis and treatment

Question 5

Early feature of intestinal ischemia on abdominal radiograph (H20 C322 P2292)

Answer 5

Bowel wall edema a.k.a. “thumbprinting”

Question 6

Mesenteric duplex scan finding that is associated with an ~80% positive predictive value for mesenteric ischemia (H20 C322 P2292)

Answer 6

High peak velocity in the SMA

Question 7

Gold standard for diagnosis of acute arterial occlusive mesenteric ischemia (H20 C322 P2293)

Answer 7

Angiography

Question 8

Usual location of embolus in SMA occlusion (H20 C322 P2293)

Answer 8

Just proximal to the origin of the middle colic artery

Question 9

Surgical management of acute mesenteric ischemia of the small bowel (H20 C322 P2293)

Answer 9

Embolectomy via arteriotomy

Question 10

Intervention of choice to maintain hemodynamics in nonocclusive mesenteric ischemia (H20 C322 P2293)

Answer 10

Fluid resuscitation

Question 11

Colonoscopy finding that is associated with 100% reversibility if ischemic colitis (H20 C322 P2293)

Answer 11

Mild erythema

Question 12

Disease with the best prognosis among the acute intestinal ischemias (H20 C322 P2294)

Answer 12

Mesenteric venous insufficiency

Question 13

Clinical finding that rules out chronic intestinal ischemia (H20 C322 P2294)

Answer 13

Abdominal pain without weight loss

Question 14

Screening test for chronic intestinal ischemia (H20 C322 P2294)

Answer 14

Duplex scan

Question 15

Gold standard for confirmation of chronic mesenteric arterial occlusion (H20 C322 P2294)

Answer 15

Mesenteric angiography

Question 16

Alternative diagnostic for chronic intestinal ischemia if contrast dye is contraindicated (H20 C322 P2294)

Answer 16

Magnetic resonance angiography

Question 17

Treatment of choice of chronic mesenteric ischemia (H20 C322 P2294)

Answer 17

Angioplasty with endovascular stenting

Question 18

An area of nonfluoresence exceeding this size suggests nonviability of howel after Wood’s lamp illumination after fluorescein administration (H20 C322 P2294)

Answer 18

> 5 mm in diameter