Cardiovascular- Vascular disease & DVT

Question 1

Fibromuscular dysplasia (FMD)

Answer 1

Systemic noninflammatory disease that typically affects the renal and internal carotid arteries and leads to arterial stenosis, aneurysm or dissection.

Question 2

S&S Fibomuscular dysplasia (FMD)

Answer 2

Headache (mc symptom)
Pulsatile tinnitus 
Neck/ flank pain 
Symptoms of TIA
Hypertension 
Abdominal bruit 
Subauricular systolic bruit (highly suggestive)

Question 3

Diagnosis of FMD

Answer 3

Vascular imaging (duplex u/s, CT or MRI angiography)

Question 4

Management of FMD

Answer 4

Antihypertensive medication

Percutaneous transluminal angioplasty or surgery for renal artery stenosis

Question 5

S&S venous insufficiency

Answer 5

Leg discomfort
Hemochromatosis 
Aching or heavy feeling in legs 
Swelling 
Skin changes (dermatitis, ulceration)

Question 6

S&S low limb PAD

Answer 6

Dull pain in legs (claudication)

Worse with walking improves with rest

Question 7

S&S restless leg syndrome

Answer 7

Dysesthesia (crawling/ itching feeling)
Irresistible urge to move
Relieved by movement
Onset with inactivity or at night

Question 8

Risk factors/ Associated conditions Restless leg syndrome

Answer 8

Iron deficiency 
Uremia
Pregnancy
DM
MS, Parkinson 
Drugs: antidepressants, antipsychotics, antiemetics

Question 9

Diagnosis restless leg syndrome

Answer 9

Diagnosed clinically

However serum iron studies should be obtained in all patients

Question 10

Management restless leg syndrome

Answer 10

Supplemental iron
Mild intermittent symptoms: carbidopa-levodopa
Frequent: gabapentin, pregabalin

Question 11

Types of aortic dissection?

Answer 11

Type A: involving the ascending aorta

Type B: Only the defending aorta

Question 12

Managements of type A aortic dissection

Answer 12

High mortality–> immediate surgical intervention

Question 13

Management of type B aortic dissections

Answer 13

Type B that do not result in malperfusion to thoracic or abdominal organs can be managed with pain and BP control.

Type B with organ malperfusion need urgent surgical repair.

Question 14

Diagnosis of aortic dissection

Answer 14

Widened cardiac silhouette (mediastinum) on CSR

confirm diagnosis: CT angio reveals double lumen

D-dimer elevation

Question 15

Mixed cryoglobulinemia syndrome

Answer 15

Small vessels vasculitis with production of cryoglobulins (Ig precipitate at <37*C). Mixture is IgG and IgM with RF

Question 16

S&S mixed cryoglobulinemia syndrome

Answer 16

Palpable purpura 
Glomerulonephritis 
Peripheral neuropathy 
Hep C (mcc) / HIV
Autoimmune

Question 17

Labs mixed cryoglobulinemia

Answer 17

+ cryoglobulins
+RF
low compliment