Cardiovascular (9%) Flashcards

1
Q

Leriche’s Syndrome

A
Seen with claudication
Aortic bifurcation/common iliac involvement
1. Claudication (buttock, thigh pain)
2. Impotence
3. Decreased femoral pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In order to be considered aneurysmal, an AAA must be at least > ________

A

3 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk Factors for AAA

A

Atherosclerosis (MC)
Age > 60 y/o
Smoking
Males, Caucasians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Classic presentation of AAA (when not asymptomatic):

A
Older male > 60 y/o
Severe back or abdominal pain
Presents with hypotension/syncope
Tender, pulsatile abd mass
May complain of unilateral groin/hip pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis of AAA

A
  1. Abdominal Ultrasound - initial test of choice
  2. CT Scan - especially for thoracic aneurysm
  3. Angiography - gold standard
  4. MRI/MRA
  5. Abdominal radiograph
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of an AAA >5.5 cm

A

Immediate surgical repair even if asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of an AAA with expansion of > 0.5 cm in 6 months

A

Immediate surgical repair even if asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of AAA > 4.5 cm

A

Vascular surgeon referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of AAA 4-4.5 cm

A

Monitor by US every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of AAA 3-4 cm

A

Monitor by US every year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Medicational management of AAA

A

Beta blockers

Also decrease risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

65% of aortic dissections are ________

A

Ascending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

__________ aortic dissections are associated with a high mortality

A

Ascending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most important risk factor for aortic dissection

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk factors for aortic dissection

A
HTN
Marfan Syndrome
Age 50+
Men
Cocaine use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Signs/symptoms of aortic dissection

A

Chest pain - severe, tearing, ripping, knife-like
N/V
Diaphoresis

17
Q

Physical exam sign of aortic dissection

A

Decreased peripheral pulses –> radial, carotid or femoral

18
Q

Diagnosis of aortic dissection

A
  1. CT Scan w/ contrast - TOC
  2. MRI angiography - gold standard
  3. TEE
  4. CXR
19
Q

What will show on CXR with aortic dissection?

A

Widening of the mediastinum

20
Q

Management of Stanford A / DeBakey I and II aortic dissections, or type III with complications

A

Involve the ascending aorta / aortic arch

Surgery!

21
Q

Management of Stanford / DeBakey III aortic dissections

A

Are limited to descending aorta
Esmolol, Labetalol - 1st line
Sodium nitroprusside, nicardipine if needed

22
Q

How often should aortic dissection be imaged if not surgically fixed?

A

3, 6, and 12 mo to look for progression, redissection and/or new aneurysm formation

23
Q

Atherosclerotic disease of the lower extremities

A

Peripheral arterial disease

24
Q

Stages of peripheral arterial disease

A
  1. Intermittent Claudication (MC)
  2. Resting leg pain - advanced dz
  3. Acute arterial embolism
  4. Gangrene
25
Q

The 6 P’s of acute arterial embolism

A

Caused by sudden occlusion

  1. Pain
  2. Pallor
  3. Pulselessness
  4. Poikilothermia
  5. Paralysis
  6. Paresthesias
26
Q

Signs on physical exam of peripheral arterial disease

A
  1. Decreased pulses, bruits, capillary refill
  2. Atrophic skin changes
  3. Dependent rubor
27
Q

Diagnosis of peripheral arterial disease

A
  1. ABI (<0,90)
  2. Arteriography - gold standard
  3. Duplex B mode ultrasound
  4. Hand held doppler
28
Q

Management for peripheral arterial disease - revascularization

A
  1. Percutaneous Transluminal angioplasty
  2. Bypass grafts fem-pop bypass
  3. Endarterectomy
29
Q

Management of acute arterial occlusion in peripheral arterial disease

A

Heparin for acute embolism
Thrombolytics for thrombus
Embolectomy

30
Q

Supportive management of peripheral arterial disease

A

Exercise, foot care, lower risk factors (DM, HTN, HLD)

31
Q

Livedo reticularis

A

Mottled appearance of leg

Seen with arterial ulcer disease

32
Q

Stasis dermatitis

A

Eczematous rash, thickening of skin

Seen with venous ulcer disease

33
Q

Varicose veins usually involve the ________ _________ veins

A

Superficial saphenous

34
Q

Management of varicose veins

A
  1. Conservative - leg elevation, compression stockings, avoid prolonged standing/sitting
  2. Sclerotherapy, radiofrequency or laser ablation and ambulatory phlebectomy commonly used