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ICM Cardio > Aortic and Peripheral Vascular Disease > Flashcards

Aortic and Peripheral Vascular Disease Flashcards

1
Q

Which is more common aortic dissection or AAA?

A

Aortic dissection

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2
Q

Under which conditions does Aortic dissection become more likely?

A 
Marfan's
Ehler's Danlos
Congenital Heart 
Turner's syndrome
Trauma
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3
Q

Biggest risk factor for aortic dissection?

A

Hypertension

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4
Q

What part of the aorta degenerates in aortic dissection?

A

Medial, loss of smooth muscle and elastic fibers

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5
Q

Type 1 aortic dissection

A

Ascending and descending aorta involved

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6
Q

Type 2 aortic dissection?

A

Ascending only

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7
Q

Type 3a dissection?

A

Descending aorta but above diaphragm

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8
Q

Type 3b dissection?

A

Descending aorta below diaphragm

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9
Q

How does aortic dissection present?

A

“Tearing, ripping, knife like pain” that migrates
Vasovagal symptoms
Syncope

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10
Q

What will you see during an aortic dissection physical exam?

A

Cool clammy skin
BP difference between central and peripheral
Murmur
Tamponade

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11
Q

How do you treat Type A Ascending Dissections?

A

Surgical repair to resect original teat and graft blood to true lumen

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12
Q

How do you treat type B dissections?

A

Medical management involving BP control

Surgical management if increasing pain

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13
Q

How does one get a false aneurysm?

A

Trauma to the outer part of the blood vessel causes it to ballon out and not all three layers

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14
Q

When do most abdominal aortic aneurysms rupture?

A

When they are greater than 5 cm

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15
Q

Where will the pain be for AAA?

A

Abdominal pain, back, or flank pain with a gradual onset and vague dull colicky pain

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16
Q

Hallmark of AAA on physical exam?

A

Pulsatile expansile abdominal mass

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17
Q

Early findings of thromboembolic events suggest what?

A

Proximal source

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18
Q

Are pulses well maintained in AAA?

A

Yes

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19
Q

Management of asymptomatic AAA?

A

Serial DUS until greater than 4 cm

Patient education

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20
Q

Management of symptomatic AAA?

A

Surgical repair

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21
Q

Atherosclerosis affects which arteries?

A

Large/Medium sized arteries

22
Q

Atherosclerotic lesions are found where on the blood vessel?

A

Intima

23
Q

How do plaques progress?

A

They increase in size and thickness until they compromise arterial flow

24
Q

Atherosclerosis risk factors?

A

Cigarette smoking
Diabetes
Hypercholesterolemia
HTN

25
Q

How does Peripheral arterial disease present?

A

Thromboembolic

Symptoms of claudication

26
Q

Difference between arterial and venous insufficiency concerning movement?

A

Arterial: Moving makes symptoms worse
Venous: Moving makes it better

27
Q

Elevation difference between arterial and venous insufficiency?

A

Arterial: Elevation worsens
Venous: Elevation helps

28
Q

Pulses difference between arterial and venous insufficiency

A

Arterial: weak pulses
Venous: Normal pulses

29
Q

Ankle Brachial Index less than 0.7 indicates what?

A

Significant disease

30
Q

What is the 3rd most common cause of death among hospitalized patients?

A

Pulmonary Embolism

31
Q

How does venous flow work during muscle relaxation?

A

Blood is drawn inward through perforating veins

32
Q

What acts as the the collecting system for venous blood flow?

A

Superficial vein acts as collecting system

33
Q

When does hyper pigmentation occur?

A

Sustained venous pressure when homeless RBCs leave an iron deposit between the vessel wall and surface of the skin known as hemosiderin

34
Q

What is Eczematous Dermatitis?

A

Inflammation typically adjacent to a bulbous tributary

35
Q

What is Atrophie Blanche?

A

Inflammation and scarring lead to plaques of skin without pigment

36
Q

What is a corona phlebectatica a pre-cursor of?

A

Stasis ulceration

37
Q

Stasis dermatitis is what?

A

Heavy inflammatory changes in the gaiter area in a patient with bilateral saphenous vein reflux

38
Q

Stasis dermatitis is pre what?

A

Pre-ulcerus

39
Q

What is lipodermatosclerosis?

A

Painful inflammatory lesions that are firm and contracted

Pre-ulcerous

40
Q

What is superficial thrombophlebitis?

A

Firm palpable cords over superficial varicies
Overlying inflammation
Seasonal patterns are common

41
Q

What is stasis ulceration?

A

End stage venous disease representing true urgency for control of venous condition

42
Q

How likely is recurrent stasis ulcer if underlying condition left untreated?

A

30% per year

43
Q

What are the primary causes of varicose veins?

A

Heredity, hormonal, and pregnancy, and gravity

44
Q

Secondary causes of Varicose veins?

A

Obesity, Trauma, Gravity, Occupations requiring prolonged sitting/standing

45
Q

Main symptoms of varicose veins?

A

Pain
Heaviness
Intensification
Cramping

46
Q

What is superficial phlebitis associated with?

A

DVT

47
Q

How is complete whole leg duplex mapping best done?

A

Get an ultrasound

48
Q

Venous surgery minimizes what in stasis ulcers?

A

Recurrence rate

49
Q

What is Thrombophilia?

A

Imbalance between clot formation and dissolution

50
Q

What is Virchow’s triad?

A

Injury
Stasis
Inherited/Acquired changes

ICM Cardio (5 decks)

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