Carotid Artery Disease

Question 1

CAD is a buildup of what in the carotid arteries?

Answer 1

atherosclerotic plaques

Question 2

what artery does the right CCA arise from?

Answer 2

right brachiocephalic trunk (splits into RCC and right subclavian)

Question 3

what artery does the left CCA arise from?

Answer 3

arch of the aorta

Question 4

name the arteries coming off the arch of the aorta from right to left

Answer 4

brachiocephalic trunk
LCCA
right subclavian artery

Question 5

the CCAs split at what spinal level?

Answer 5

C4

splits into 4 diff arteries

Question 6

the carotid sinus exists at what spinal level?

Answer 6

carotid sinus

Question 7

the internal artery is most posterior T/F

Answer 7

T

Question 8

a fatty streak in the artery forms a ___ core and ___ cap

Answer 8

lipid

fibrous

Question 9

some patients with CAD are asymptomatic - why is this?

Answer 9

may have unilateral disease. collateral supply from the other carotid + circle of willis will compensate.

Question 10

main cause of CAD?

Answer 10

atherosclerosis

Question 11

a young patient presents with CAD - what 2 causes should you consider?

Answer 11

carotid dissection

connective tissue disease

Question 12

non-atheromatous hypertrophy of the vessel wall that eventually causes stenosis and focal neuro deficit….

Answer 12

fibromuscular dysplasia (FMD)

Question 13

vasculitis can cause CAD - why is this?

Answer 13

can cause stenosis of blood vessels

Question 14

who gets FMD?

Answer 14

women <50

Question 15

Sx of CAD?

Answer 15

1. STROKE Sx eg face drooping, weakness, speech issues, transient visual loss)
2. headache

Question 16

a TIA becomes a stroke after __ hours

Answer 16

24

Question 17

bloods Ix CAD

Answer 17

FBC
U+Es
clotting screen 
lipid profile - cholesterol?
glucose - diabetes PMH

Question 18

signs on examination of CAD?

Answer 18

carotid bruit

stroke signs eg loss of movement/speech/vision

Question 19

gold standard Ix for suspected stroke in CAD

Answer 19

urgent NON-CONTRAST CT head

Question 20

Ix for CAD

Answer 20

bloods

1. urgent CT head NC
2. duplex USS
3. CT angio

Question 21

why is duplex USS done in CAD?

Answer 21

to confirm carotid diameter %

Question 22

why is CT angio done in CAD?

Answer 22

to assess carotid arteries in more depth to confirm the diagnosis (NB CAD cannot be diagnosed without an USS and CTA)

Question 23

carotid diameter >__% puts you at high risk of stroke

Answer 23

50

Question 24

immediate Mx symptomatic CAD?

Answer 24

high flow O2
optimise glucose levels
swallow screen

Question 25

Mx ischaemic stroke

Answer 25

thrombolysis

Question 26

Mx haemorrhagic stroke

Answer 26

correct coagulopathy

Question 27

carotid artery stenosis > __% warrants surgery

Answer 27

70

Question 28

surgical Mx CAD

Answer 28

carotid endarterectomy

Question 29

medical Mx CAD

Answer 29

antiplatelet
anticoagulant
statin
manage cause eg diabetes

Question 30

indications for surgery?

Answer 30

previous stroke

carotid stenosis >70%

Question 31

carotid endarterectomy is curative T/F

Answer 31

F

only reduces risk of stroke, doesn’t stop the problem

Question 32

complications of endarterectomy?

Answer 32

bleeding/haematoma
damage to hypoglossal n
damange to recurrent laryngeal n
death
stroke