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VASCULAR SYSTEM > ARTERIAL DISORDERS > Flashcards

ARTERIAL DISORDERS Flashcards

1
Q

⚡⚡ MOST COMMON type of ANEURYSM (morphology)

A

Fusiform ANEURYSM

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2
Q

🌸 TYPES of ANEURYSM

🧠⚡MAD SCAB ⚡

A
  1. Mycotic
  2. Atherosclerotic
  3. Dissecting
  4. Syphilictic
  5. Capillary Micro-aneurysm
  6. AV-Fistula
  7. Berry ANEURYSM
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3
Q

Shapes of ANEURYSM

A
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4
Q

⚡⚡ MOST COMMON VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON EXTRA-CRANIAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON PERIPHERAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON VISCERAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON VESSEL INVOLVED IN MYCOTIC ANEURYSM

A

⚡⚡ MOST COMMON VESSEL INVOLVED IN ANEURYSM
🎯 CIRCLE OF WILLIS

⚡⚡ MOST COMMON EXTRA-CRANIAL VESSEL INVOLVED IN ANEURYSM
🎯 INFRA-RENAL ABDOMINAL AORTA

⚡⚡ MOST COMMON PERIPHERAL VESSEL INVOLVED IN ANEURYSM
🎯 POPLITEAL ARTERY

⚡⚡ MOST COMMON VISCERAL VESSEL INVOLVED IN ANEURYSM
🎯 SPLENIC ARTERY

⚡⚡ MOST COMMON VESSEL INVOLVED IN MYCOTIC ANEURYSM
🎯 AORTA

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5
Q

⚡⚡ MOST COMMON CAUSE OF MYCOTIC ANEURYSM

A

Staphylococcus aureus

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6
Q

⚡⚡ MOST COMMON SITE OF PSEUDO-ANEURYSM

⭐ CAUSE

A

Femoral ARTERY

⭐ CAUSE: Cannulation (OR) Trauma

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7
Q

⚡⚡ MOST IMPORTANT RISK FACTOR for ANEURYSM FORMATION

A

ATHEROSCLEROSIS

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8
Q

Screening of ABDOMINAL AORTA is done in ______ after age _____

A

UK
> 65 years

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9
Q

Why screening of ABDOMINAL AORTIC ANEURYSM is done?

A

⭐ Common above age > 65yrs
⭐ whether Critical diameter is reached or not

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10
Q

Critical diameters of ANEURYSMS:

⭐ Critical diameter of POPLITEAL ARTERY ANEURYSM

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♀️

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♂️

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM

⭐ Critical diameter of DESCENDING THORACIC AORTIC ANEURYSM

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM in MARFAN’S SYNDROME & BICUSPID AORTIC VALVE

A

⭐ Critical diameter of POPLITEAL ARTERY ANEURYSM
🎯 2-3cm

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♀️
🎯 5cm

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♂️
🎯 5.5cm

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM
🎯 5.5cm ➕ Rate of increase in size > 0.5 cm/yr

⭐ Critical diameter of DESCENDING THORACIC AORTIC ANEURYSM
🎯 6 cm ➕ Rate of increase in size > 1 cm/yr

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM in MARFAN’S SYNDROME & BICUSPID AORTIC VALVE
🎯 4.5-5cm

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11
Q

CLINICAL features of ABDOMINAL AORTIC ANEURYSM

A
  1. ASYMPTOMATIC
  2. ABDOMINAL Pain
  3. PULSATILE Mass
  4. EMBOLUS Formation ➡️ Blue toe SYNDROME
  5. Rupture ➡️ High Mortality
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12
Q

Blue Toe Syndrome

A

Showeringbof Embolus From ABDOMINAL AORTIC ANEURYSM to Foot
⬇️
Gangrene in toes

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13
Q

🩺 IOC of AAA

🩺 SCREENING IOC of AAA

A

🩺 IOC of AAA
🎯 CT ANGIOGRAPHY

🩺 SCREENING IOC of AAA
🎯 USG

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14
Q

INDICATIONS for SURGICAL INTERVENTION IN AAA

A

⭐ SYMPTOMATIC
⭐ Asymptomatic ➕ Size > 5.5 cm

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15
Q

SURGICAL INTERVENTION IN AAA

A
  1. EVAR (EndoVascular Aneurysmal Repair)
  2. OPEN SURGERY
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16
Q

🚫 CONTRAINDICATION of EVAR

A
  1. Difficult ILIAC AXIS
  2. ⬆️ ANGULATION
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17
Q

Identify

A

EVAR Stent

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18
Q

Why Lifelong monitoring after EVAR is needed?

A

Chances of ENDOLEAK
(Leak from EVAR)

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19
Q

Identify

A

EVAR in place

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20
Q

Types of ENDO-LEAKS

A
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21
Q

⭐ Type 1 ENDOLEAK MOST COMMONLY SEEN IN

⭐ Type 2 ENDOLEAK MOST COMMONLY SEEN IN

A

⭐ Type 1 ENDOLEAK MOST COMMONLY SEEN IN
🎯 THROCIC AORTIC ANEURYSM

⭐ Type 2 ENDOLEAK MOST COMMONLY SEEN IN
🎯 ABDOMINAL AORTIC ANEURYSM

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22
Q

Which GRAFT is used in OPEN SURGERY for AAA?

A

Dacron Graft

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23
Q

MATTOX PROCEDURE
🧠⚡LLRM ⚡

A

LEFT MEDIAL VISCERAL ROTATION

Left Descending Colon is ROTATED Medially
⬇️
Expose AORTA

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24
Q

CATTLE-BRASCH MANEUVER
🧠⚡CRRI ⚡

A

RIGHT ASCENDING COLON is ROTATED INTERNALLY (MEDIALLY)
⬇️
EXPOSES THE IVC

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25
KOCHERIZATION
Mobilization of DUODENUM
26
⚡⚡ MOST COMMON CAUSE of DEATH AFTER ABDOMINAL AORTIC ANEURYSM SURGERY
Cardiovascular causes
27
COMPLICATIONS of AAA SURGERY
1. Renal failure 2. Aorto-Duodenal Fistula: Upper GI hemorrhage & Melena 3. Colonic Ischemia: Lt side of colon IMA is involved. 4. PARAPARESIS
28
Cause of PARAPARESIS after AAA Surgery
Involvement of ARTERY OF ADAMKIEWICZ ⬇️ Supplies Anterior Spinal Artery
29
Upper GI HEMORRHAGE: Hemetemesis (OR) Melena ➕ H/O AAA Surgery
Aorto-Duodenal Fistula
30
🧑🏻‍⚕️ Clinical Features of RUPTURED AORTIC ANEURYSM
1. Shock 2. Pulsatile swelling 3. Flank Pain
31
⚡⚡ MOST COMMON site of BLEEDING accumulation in ruptured AAS
Left Retroperitoneum
32
🩺 IOC for RUPTURED AAA
CT ANGIOGRAPHY
33
💊💉 MANAGEMENT of RUPTURED AAA
Dacron Graft Repair
34
RUPTURED AAA
35
CRAWFORD Classification is used for
THORACO-ABDOMINAL AORTIC ANEURYSM
36
⚡⚡ MOST EXTENSIVE TYPE OF THORACO-ABDOMINAL AORTIC ANEURYSM
Type 2 (From Left SUBCLAVIAN ➡️ Aortic Bifercation (iliac artery)
37
Causes of THORACIC AORTIC ANEURYSM
1. 2deg to ATHEROSCLEROSIS 2. MARFAN Syndrome 3. Ehler Danlos Syndrome
38
🧑🏻‍⚕️ Clinical Features of THORACIC AORTIC ANEURYSM
1. ASYMPTOMATIC 2. HOARSENESS ➡️ ORTNER'S Syndrome 3. DYSPHAGIA 4. DYSPNEA 5. RUPTURE
39
Cause of HOARSENESS IN THORACIC AORTIC ANEURYSM
Pressure of DESCENDING THORACIC ANEURYSM on LEFT RECURRENT LARYNGEAL NERVE ⬇️ ORTNER SYNDROME
40
🧑🏻‍⚕️ Clinical Features of RUPTURED THORACIC AORTIC ANEURYSM
1. DYSPNEA 2. LEFT SIDED PLEURAL EFFUSION
41
💊💉 MANAGEMENT of THORACIC AORTIC ANEURYSM
1. Symptomatic 2. ASYMPTOMATIC patients with ✨ ASCENDING diameter: 5.5cm ✨ DESCENDING diameter: 6cm ✨ MARFAN SYNDROME: 4.5-5cm ⬇️ 1. EVAR 2. OPEN GRAFT REPAIR
42
⚡⚡ MOST COMMON RISK FACTOR FOR AORTIC DISSECTION
Hypertension
43
⚡⚡ MOST COMMON SITE FOR AORTIC DISSECTION
Lateral wall of ASCENDING THORACIC AORTA
44
🧑🏻‍⚕️ Clinical Features of AORTIC DISSECTION 🧠⚡ 5th DECADE MALE⚡
1. Chest Pain RADIATING to BACK in INTERSCAPULAR Region 2. Aortic & Coronary Insufficiency
45
Chest Pain of AORTIC DISSECTION
⭐ Chest Pain ⭐ RADIATING to BACK in INTERSCAPULAR Region
46
🩺 IOC for AORTIC DISSECTION ⭐ IN STABLE PATIENT ⭐ IN UNSTABLE PATIENT
⭐ IN STABLE PATIENT 🎯 CT ANGIOGRAPHY ⭐ IN UNSTABLE PATIENT 🎯 TRANS-ESOPHAGEAL ECHO
47
Identify 🧠⚡ identify line in the aorta⚡
CT ANGIOGRAPHY of AORTIC DISSECTION
48
Chest X-RAY of AORTIC ANEURYSM
1. Widening of CHEST 2. Left sided PLEURAL EFFUSION
49
Widening of MEDIASTINUM
1. THORACIC ANEURYSM 2. ABDOMINAL ANEURYSM 3. AORTIC DISSECTION
50
DeBakey classification used for
Aortic DISSECTION
51
Stanford Classification used for
Aortic Aneurysm
52
💊💉 MANAGEMENT of AORTIC DISSECTION
1. Permissive Hypotension: ESMOLOL 2. Grade 1 & 2 DeBakey: Graft Repair 3. Grade 3 DeBakey: ✨ Progressive symptoms: Surgery ✨ Chronic: Conservative Management
53
POPLITEAL ANEURYSM 🧑🏻‍⚕️ CLINICAL FEATURES
1. Pulsating Swelling of Knee 2. Loss of Contour in the KNEE Behind 3. Pain & Distal Emboli
54
Identify
Popliteal Aneurysm
55
🩺 IOC for POPLITEAL ANEURYSM
CT ANGIOGRAPHY
56
INDICATION for INTERVENTION in POPLITEAL ANEURYSM
1. ASYMPTOMATIC with DIAMETER > 2 cm 2. All SYMPTOMATIC PATIENTS
57
Cause of FEMORAL ARTERY ANEURYSM
Puncture of the vessels
58
Critical Diameter for FEMORAL ANEURYSM
3cm
59
Identify
Femoral aneurysm
60
💊💉 MANAGEMENT of FEMORAL ANEURYSM
< 3cm: Thrombin Injection (USG Guided) ≥ 3cm: Surgical Repair
61
DOC for Raynaud's Phenomenon
Calcium Channel Blockers
62
Difference BETWEEN Raynaud's Phenomenon & Acrocyanosis
63
1° RAYNAUD'S vs 2° RAYNAUD'S
64
Cause of SUBCLAVIAN STEAL SYNDROME
Stenosis in 1st PART of SUBCLAVIAN ARTERY ⬇️ On EXERCISING, Retrograde flow from VERTEBRAL Artery to side of Lesion ➡️ To SIDE of LESION ⬇️ Less Blood Flow to Brain ⬇️ Syncope & DIZZINESS
65
🩺 IOC of SUBCLAVIAN STEAL SYNDROME
CT ANGIOGRAPHY
66
💊💉 MANAGEMENT of SUBCLAVIAN STEAL SYNDROME
Angioplasty of stenosed segment
67
⚡⚡ MOST COMMON SITE OF CAROTID ARTERY STENOSIS
Bifurcation
68
⚡⚡ MOST COMMON CAUSE OF CAROTID ARTERY STENOSIS
Atherosclerosis
69
🧑🏻‍⚕️ Clinical Features of CAROTID ARTERY STENOSIS
1. Asymptomatic 2. Amaurosis Fugax 3. Dysphasia 4. TRANSIENT ISCHEMIC ATTACK
70
🩺 IOC for CAROTID ARTERY STENOSIS
Duplex scan
71
INDICATION for Surgery in CAROTID ARTERY STENOSIS
≥ 70% Stenosis ➕ any of the following 1. Amaurosis fugax 2. C/L Facial Paralysis 3. Arms/Legs Paralysis 4. Hemianopia 5. Dysphasia
72
💊💉 MANAGEMENT of CAROTID ARTERY STENOSIS
⭐ CAROTID END-ARTERECTOMY ⭐ Angioplasty or GRAFTING
73
Thoracic OUTLET SYNDROME
Blockage of outlet of thoracic outlet ⭐ Subclavian ARTERY ➡️ Cold fingers, Pallor, Raynaud's Phenomenon ⭐ Subclavian VEIN ➡️ Swelling ⭐ BRACHIAL PLEXUS
74
CAUSE OF THORACIC OUTLET SYNDROME
1. Cervical Rib 2. Arthritis 3. Tumours
75
🧑🏻‍⚕️ Clinical Features of THORACIC OUTLET SYNDROME
Arterial: Distal Gangrene & Claudication Venous: SUBCLAVIAN or Axillary Vein Thrombosis Neural symptoms: Symptoms of ULNAR aspect of hand
76
🩺 IOC for THORACIC OUTLET OBSTRUCTION
CT ANGIOGRAPHY
77
PROVOCATIVE TESTS FOR THORACIC OUTLET SYNDROME 🧠⚡ WAR-HAL⚡
1. Wright / Hyper-abduction Test 2. ADSON Test 3. ROOS Test 4. HALSTEAD's maneuver
78
➕ ADSON'S TEST
⬇️ or ⛔ I/L RADIAL PULSE
79
Identify
ADSON'S TEST
80
Identify
WRIGHT TEST
81
Identify
ROOS TEST (OR) EAST test (Elevated Arm Stress Test)
82
Identify
Elvey or ULTT (Upper Limb Tension Test)
83
💊💉 MANAGEMENT of THORACIC OUTLET SYNDROME
1. If Cervical Rib ➕ ➡️ RESECTED 2. Physiotherapy 3. Arterial Blockade: Angioplasty & Stenting 4. Venous Thrombosis: Anticoagulants
84
Identify
CRISCOID ANEURYSM
85
CRISCOID ANEURYSM
AV Malformation involving the SUPERFICIAL TEMPORAL VESSELS
86
Vascular Pulsatile Swelling ➕ Compressible
CRISCOID ANEURYSM
87
💊💉 MANAGEMENT of CRISCOID ANEURYSM
Surgical management (OR) EMBOLIZATION
88
AV Fistula Causes
1. Traumatic 2. Iatrogenic 3. Congenital
89
⚡⚡ MOST COMMON AV FISTULA
Iatrogenic AV Fistula ⬇️ Dialysis
90
Renal DIALYSIS AV FISTULA
Cimmino-fistula Radio-cephalic fistula BETWEEN Radial Artery & Cephalic Vein
91
Congenital AV FISTULA seen in ⭐️BSP⭐️
1. Parke Weber Syndrome 2. Beckwith Wiedmann Syndrome 3. Sturge Weber Syndrome
92
If CONGENITAL FISTULA ➕ in LIMB, leads to
HYPERTROPHY OF LIMB
93
🧑🏻‍⚕️ Clinical Features of CONGENITAL AV FISTULA
1. Pulsatile Swelling 2. Palpable Thrill 3. Bruit ➕
94
AV FISTULA in long term leads to development of
High OUTPUT CARDIAC FAILURE
95
NICOLADONI (OR) BRANHAM SIGN Seen in
⭐ AV FISTULA ⭐ BP HIGH ➕ LOW HEART RATE ⭐ Press the feeding vessel of Av fistula ⬇️ Size of fistula ⬇️ Pulse rate ⬇️ Thrill/Bruit ⬇️ Systolic BP ⬆️⬆️
96
🩺 IOC of AV FISTULA
MR ANGIOGRAPHY > Digital subtraction ANGIOGRAPHY
97
💊💉 MANAGEMENT of AV FISTULA
1. Embolization 2. Surgical Ligation
98
Chest X-RAY findings of AORTIC DISSECTION 🧠⚡D WEEBS ⚡
D: Dilated aortic arch W: Widened mediastinum E: Effusion (pleural) E: Effusion (pericardial) B: Blurring of aortic contour S: Separation of intimal calcification

VASCULAR SYSTEM (5 decks)

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