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Cardio > Arteriopatii > Flashcards

Arteriopatii Flashcards

1
Q

Etiologie arteripatii

A

Ateroscleroza
Marfan, ehler dantos
Displazie fibromusculara
Vasculite(arterie temporale, takayasu, kawasaki, granulomatoza werner, trombangeita obliteranta

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2
Q

Factori de risc arterite

A 
Dz
Dislipidemii
Fumat
Hta
Lpa, fibrinogen, homocisteina, pcr
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3
Q

Manifestari clinice arterite

A

Asimptomatic

Claudicatie intermitenta-echiv angor(discomfort, durere, crampe la efort)-apare ischemie pe mb

Durere in repaus-ameliorat in pozitie decliva(durere intens mare si cu parestezii)

Ulceratie ichemica si gangrena(marg curate si fund curat)

Afectare Funcționalitate(viteza scazuta si tulb de mers)

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4
Q

Clasificare fontaine

A 
1 asimptopmatic
2 apeste 200 m
B sub 200 m
3 in repaus
4 necroza gangrena
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5
Q

Bap tipuri

A 
Artere carotide si vertebrale
Mb superioare
Mb inf
Mezenterice
Renale
Multivascular

NU CAROTIDE SI NU INTRACRANIENE

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6
Q

Prevalenta bap la cn e frecv

A

Fumator
Diabetic
Peste 50 ani

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7
Q

Etiologie bap

A

Ats
Ehler danlos marfan
Displazie fibromusculara
Kawasaki takayasu arterita temporala poliarterita nodoasa trombangeita obliteranta

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8
Q

Dc e imp bap

A

Ptc e risc crescut de afectare tricoronariana si risc crescut de mortalitate(si cerebrovasc)
Ptc afectarile aterosclerotice se asociaza intre ele

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9
Q

Factiri de risc bap

A 
Dz 
Dislipidemie
Fumat
Hta
Lpa homocitestina fivrinogen prot c react
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10
Q

Ischemie critica

A

Durere in repaus
Ulceratie de tip ischemic
Gangrena

(3 sau 4 fontaine)

Are nev de dg si terapie rapida pt a nu avea mb amputat
Nu e acut dar nu i cronic

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11
Q

Pseudoclaudicatie

A

Stenoza de canal spinal

Neuropatie periferica

Durere cauzata de nerv periferic

Osteoartita sold

Claudicatie venoasa

Sdr compartiment

Spasm muscular

Picioare reci

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12
Q

Evaluare clinica bap

A

Puls bilateral
Carotida radial femural popliteu
Dorsalis pedis, tibial posterior

Auscult
Carotid femural

Suflu
Art renale, art vertebrale interscapulo superior, subclavie

+palpare abd pt anevrism

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13
Q

Tipic afectare mb inf arteriala

A

Palid rece
Pilozitate redusa
Hipotrofie
Leziuni distale!

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14
Q

Explorari dg

A 
Neinvazive 
Igb 
Doppler
Treadmill test
Presiuni/volume segm
Pletismografie
Evaluare transcutana pres o2
Angioct
Angio rm

Invaziv
Angiografie cu substractie digitala rezervata pt evaluare preinterventionala

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15
Q

Igb

A

Se mas pree sistolica
In repaus
Post efort

Cu doppler(flux art=>semnal sonor)
Palpez brahiala in plica cotului in 1/3 intern
Tibiala post-retromaleolar intern
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16
Q

Interpretare igb

A 
>1,3 artere nevompresibile
0,9-1,3 normale
<0,9 bvp
0,7-0,9 usoar0,4-0,69 moderata
<0,4 ischemie critica

Scadere >20% dupa efort=patologic

17
Q

Limitari igb

A

Artere necompresibile(varstnic, diabetic, irc)
Igb repaus are mica sens pt obstr aortooliaca usoara
Nu e conceput pt caract limitare fct
Val de rep normale devin patologice postefort
Nu face dg dif intre stenoza si ocluzie

18
Q

Exo pt bap

A 
Obstructie prepoplitee
Viteza flux
Elimina flux retrograd
Scde varful sistolic
Creste flux diastolic
Sens scazuta la <0,3m/s
19
Q

Rmn bap

A

Fara iradiere
Fara subst cu iod

NU LA CLAUSTROFOBI NU LA DEFIBRILATOR NU LA OBEZI

20
Q

Angioct

A

Iradiaza si are subst de ct

El si rmn nu se fac de rutina

21
Q

Abordare bap nonfaacologic

A 
Sport
Fumat
Dz
Dislipidemie
Hta
ANTIAGREGANTE LA PAC SIMPtomatici
DE LUAT IN CONSIDERARE TERAPIE DUALA ANTITROMBOTICA(asa+rivaroxaban)
Aco daca are si fia si chadsvasc>2

Clopidogrel
Statine la toti
Tratament antihta cu iec sau sartan

22
Q

Tratamentul claudicatiei

A

Ameliorarea calitatii vietii prin cresterea dustantei maxime

Terapia prin efort fizic(stimulare prin colaterale)-prin hipoxie
Cilostazol
Pentoxifilina

23
Q

Indicatii pt reperfuzie bap

A

Claudicatie persistenta
Durere repaus
Ulcer care nu se vindeca
Gangrena

2b,3,4

Endovasculara(dilatare si stentare)
Reconstructie
Amputatie

24
Q

Anevrism

A 
Creste cu varsta
Dilatare localizata >1,5 ori
Comprima 
Se rupe 
Laplace zice ca creste
Form trombi 
Afectare ats coronariana si carotidiana
Mai frecv barbat
25
Q

Etiologie anevrism

A 
Ats
Defecte colagen
Hta
Fumat
Infectii
Arterite
Traume
Sarcina
26
Q

Clinic anevrism

A 
Asimptomatic
Compresie(durere, dispnee, disfagie, raguseala , tuse, laringieni recurenti)
Compresie venoasa
Ic
Embolii periferice
27
Q

Imagistica anevrism

A 
Rx
Ct angio
Rmn angio
Tte si tee
Aortografie
28
Q

Complicatii anvrism

A

Fisura
Durere
Ruptura-intrapleural stang, intrapericar, esofag(hematemeza)

29
Q

Control anevrism

A

Betabloc(scade sheer stress)
Urmarire 6-12 luni
Chir >5
Chir desc >5,5(percutan) sau 6 chirurgical

30
Q

Anevrism aorta abd

A

Infrarenal
Ats
Anevrism micotic
Traumatism

Asimpt
Dureere abd
Durere limbara joasa
Semne embolie distala
Masa pulsatila palpabila
31
Q

Complicatii anevrsism abd

A

Durere hipotens si masa abd

Ruptura

Iritatie peritoneala uripatie ic cid

32
Q

Disectie de aorta

A

Lez de continuitate

Aterom hematom intramural

33
Q

Sindrom aortic acut

A

Hematom intraparietal
Ulcer penetrant
Dusectie acuta

Nu uitam ca exista si iatrogen

34
Q

Debakey standfort

A

Aorta asc-mai sever
Stanfird:a aorta asc(posibil si desc)
B-doar aorta desc

Debakey
1 tiracica
2 doar ascendenta
3 doar descendenta

Tipul 1 si 2 se opereaza
3 nu

35
Q

Fr disectie

A 
Hta
Feocromocitom
Cocaina
Ridicare de greutati sau valvalva
Traume
Lez prin decelerare say tirsiune
Coarct aorta

Marfan ehler loeys dietz
Bicuspidie

Sarcina
Vasculite

36
Q

Clinic disectie

A 
Ischemie oe organe
Durere mare migratirie
Defucut de pul perif
Sincopa
Hipotens
37
Q

Scor risc disectie-risc inalt

Risc inalt daca are 2 crit

A 
Marfan
Boli de tes conjunctiv
Istoric familial
Valva aortica
Interventii recente pe aorta
Anevrism cunoscut aorta tiracica
Afectiuni genetice

+caract durere de risc inalt
Debut brusc intensitate f mare
Rippung tearing stabing
La torace ant sau post sau abd

+exam clinic
Hipoperfuzie(deficit puls diferenta ta intre membre deficit neurologic) suflu de ia
Hipotens sau soc

38
Q

Daca i instab hemodinamic

A

Ecografie tee si tte

Cardio (25 decks)

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