Chapter 41: Vascular Disorders

Question 1

two risk factors for thromboangiitis obliterans (Buerger’s disease)

Answer 1

men younger than 45 years
long history of tobacco and/or marijuana use
(without other CVD risk factors)

Question 2

treatment for peripheral artery disease involves _____________ modification, ______ therapy, __________ therapy, ______________ therapy, and sometimes __________.

Answer 2

risk factor, drug, exercise, nutrition, surgery

Question 3

surgery that involves opening the artery and removing the obstructing plaque

Answer 3

endarterectomy

Question 4

peripheral artery disease or venous disease: ulcer drainage moderate to large amount

Answer 4

peripheral venous disease

Question 5

three examples of complimentary alternative medicines used for peripheral artery disease

Answer 5

DHEA omega 3 fatty acids
black cohosh
garlic supplements

Question 6

peripheral artery disease or venous disease: ankle-brachial index >0.90

Answer 6

peripheral venous disease

Question 7

severe, life-threatening complication of acute ascending aorta dissection that occurs when blood escapes from dissection into pericardial sac

Answer 7

cardiac tamponade

Question 8

in diagnosing aneurysms, ___________ may reveal abnormal widening of the thoracic aorta, and ________________ may show calcification within the aortic wall

Answer 8

chest X-ray, abdominal X-ray

Question 9

Manifestations of peripheral artery disease: pallor develops when the leg is ____________

Answer 9

elevated

Question 10

peripheral artery disease or venous disease: dermatitis often occurs

Answer 10

peripheral venous disease

Question 11

Aortic surgery patients with a history of CVD should receive a drug from this class

Answer 11

beta blocker

Question 12

disorder that involves the formation of a thrombus with vein inflammation

Answer 12

venous thrombosis

Question 13

type of aneurysm that is typically asymptomatic or mimic pain associated with abdominal or back disorders; a pulsatile mass in periumbilical area slightly to the left of the midline may be present on physical assessment

Answer 13

abdominal aortic aneurysm (AAA)

Question 14

in diagnosing aneurysms, _______________ gives helpful information by using contrast imaging to map the entire aortic system

Answer 14

angiography

Question 15

peripheral artery disease or venous disease: hair may be present or absent

Answer 15

peripheral venous disease

Question 16

condition characterized by chronic ischemic rest pain lasting more than 2 weeks, nonhealing arterial leg ulcers, or gangrene of the leg from PAD

Answer 16

critical limb ischemia (CLI)

Question 17

potentially lethal complication in emergency repair of AAA is development of this impaired organ perfusion caused by IAH and resulting multisystem organ failure

Answer 17

abdominal compartment syndrome

Question 18

episodic vasospastic disorder of small cutaneous arteries, most often involving the fingers and toes

Answer 18

Raynaud’s phenomenon

Question 19

results from the creation of a false lumen between the intima and the media of arterial wall

Answer 19

aortic dissection

Question 20

type of aneurysm that is circumferential and relatively uniform in shape

Answer 20

fusiform aneurysm

Question 21

Manifestations of peripheral artery disease: ______ pain can occur with progression and worsening of disease

Answer 21

rest

Question 22

seepage of blood back into the old aneurysm

Answer 22

endoleak

Question 23

Aortic aneurysm surgery: Adequate _____ is important to maintain graft patency. Give __________ and _________________ to maintain blood flow.

Answer 23

blood pressure (BP), IV fluids, blood components

Question 24

Educating patients with critical limb ischemia involves ____________, ____________, and _________________ the feet to prevent skin cracking and infection, keeping the affected foot ________ and ______, wearing ______, ________, and ___________ footwear, and avoiding ____ and _____ extremes

Answer 24

inspecting, cleansing, lubricating, clean, dry, soft, roomy, protective, hot, cold

Question 25

non-atherosclerotic, segmental, recurrent inflammatory disorder of the small and medium arteries and veins of the arms and legs

Answer 25

thromboangiitis obliterans (Buerger's disease)

Question 26

five risk factors of peripheral artery disease (PAD)

Answer 26

age over 60 hypertension hyperlipidemia smoking diabetes

Question 27

peripheral artery disease or venous disease: capillary refill <3 seconds

Answer 27

peripheral venous disease

Question 28

In diagnosing aortic dissection, this may show a widening of the mediastinum and pleural effusion

Answer 28

chest X-ray

Question 29

peripheral artery disease or venous disease: edema is absent unless leg is constantly in dependent position

Answer 29

peripheral artery disease

Question 30

peripheral artery disease or venous disease: ulcer tissue: yellow slough or dark red, "ruddy" granulation

Answer 30

peripheral venous disease

Question 31

may occur in isolation but could occur with thyroid, scleroderma, SLE, environmental factors (vibratory or cold machinery, exposure to heavy metals)

Answer 31

Raynaud's phenomenon

Question 32

peripheral artery disease or venous disease: ulcer often painful

Answer 32

peripheral venous disease

Question 33

formation of a thrombus in a superficial vein

Answer 33

superficial vein thrombosis

Question 34

in diagnosing aneurysms, a(n) ________ may rule out an MI

Answer 34

ECG

Question 35

conservative management for patient with critical limb ischemia involves protecting the extremity from ___________, decreasing ______________, preventing and controlling ____________, and improving ___________

Answer 35

trauma, ischemic pain, infection, perfusion

Question 36

peripheral artery disease or venous disease: loss of hair on legs, feet, toes

Answer 36

peripheral artery disease

Question 37

type of aneurysm that is a disruption of all arterial wall layers with bleeding that is contained by surrounding anatomic structures

Answer 37

false aneurysm or pseudoaneurysm

Question 38

if acute arterial ischemia is present, immediate intervention is needed to avoid these three things

Answer 38

ischemia, necrosis, gangrene

Question 39

represents the spectrum from deep vein thrombosis to pulmonary embolism

Answer 39

venous thromboembolism (VTE)

Question 40

type of aneurysm in which the wall of the artery forms the aneurysm with at least 1 vessel layer still intact

Answer 40

true aneurysm

Question 41

peripheral artery disease or venous disease: skin color bronze-brown pigmentation

Answer 41

peripheral venous disease

Question 42

these two diagnostic tests show the location and extent of peripheral artery disease (PAD)

Answer 42

angiography magnetic resonance angiography

Question 43

in diagnosing aneurysms, a ______ or ________ can diagnose and assess the location and severity of aneurysms

Answer 43

CT, MRI

Question 44

potentially lethal complication in emergency repair of AAA is development of this reduction of blood flow to the viscera

Answer 44

intraabdominal hypertension (IAH)

Question 45

six manifestations of acute arterial ischemia

Answer 45

pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

Question 46

peripheral artery disease or venous disease: ulcer located near medial malleolus

Answer 46

peripheral venous disease

Question 47

this type of aneurysm surgical repair involves a large abdominal incision through which the surgeon cuts into the diseased aortic segment, removes any thrombus or plaque, sutures a synthetic graft to the aorta proximal and distal to the aneurysm, and sutures the native aortic wall around the graft to act as a protective cover

Answer 47

open aneurysm repair (OAR)

Question 48

peripheral artery disease or venous disease: decreased or absent peripheral pulses

Answer 48

peripheral arterial disease

Question 49

these are expandable metallic devices that are placed in the artery after balloon angioplasty

Answer 49

stents

Question 50

this type of aortic dissection affects the ascending aorta and arch

Answer 50

Type A

Question 51

peripheral artery disease or venous disease: dermatitis rarely occurs

Answer 51

peripheral artery disease

Question 52

peripheral artery disease or venous disease: ankle-brachial index ≤0.90

Answer 52

peripheral artery disease

Question 53

type of aneurysm that is asymptomatic or manifests as deep, diffuse chest pain that may extend to the interscapular area

Answer 53

thoracic aortic aneurysm (TAA)

Question 54

combination of percutaneous transluminal angioplasty (PTA) and cold therapy

Answer 54

cryoplasty

Question 55

peripheral artery disease or venous disease: ulcer margin irregularly shaped

Answer 55

peripheral venous disease

Question 56

peripheral artery disease or venous disease: ulcer tissue: black eschar or pale pink granulation

Answer 56

peripheral artery disease

Question 57

health promotion for PAD and aneurysms involves

Answer 57

reducing CVD risk factors (controlling BP, ceasing tobacco use, maintaining normal body weight and serum lipids)

Question 58

peripheral artery disease or venous disease: intermittent claudication or rest pain in foot

Answer 58

peripheral artery disease

Question 59

peripheral artery disease or venous disease: capillary refill >3 seconds

Answer 59

peripheral artery disease

Question 60

In diagnosing aortic dissection, this rules out cardiac ischemia

Answer 60

ECG

Question 61

PAD: long-term ____________ therapy is used after surgery with one of these two drugs

Answer 61

antiplatelet, aspirin, clopidrogel

Question 62

type of aneurysm that is pouchlike with a narrow neck connecting the bulge to one side of the arterial wall

Answer 62

saccular aneurysm

Question 63

involves thickening of artery walls, resulting in a progressive narrowing of the arteries of the upper and lower extremities

Answer 63

peripheral artery disease (PAD)

Question 64

classic symptom of lower extremity peripheral artery disease (PAD)

Answer 64

intermittent claudication

Question 65

peripheral artery disease or venous disease: skin temperature cool, temperature gradient down the leg

Answer 65

peripheral artery disease

Question 66

in diagnosing aneurysms, _____________ is useful for aneurysm screening and to monitor aneurysm size

Answer 66

ultrasound

Question 67

Aortic aneurysm surgery: reason to keep continuous ECG monitoring

Answer 67

myocardial ischemia/infarction or dysrhythmias may occur

Question 68

treatment not indicated for PAD and why

Answer 68

anticoagulant therapy; no benefit and increased risk for bleeding

Question 69

peripheral artery disease or venous disease: dull ache or heaviness in calf or thigh

Answer 69

peripheral venous disease

Question 70

this type of surgery is used to treat acute type A aortic dissections

Answer 70

open aneurysm repair (is a surgical emergency)

Question 71

most frequent cause of acute arterial occlusion

Answer 71

embolization of a thrombus from the heart

Question 72

peripheral artery disease or venous disease: ulcer drainage minimal

Answer 72

peripheral artery disease

Question 73

Aortic aneurysm surgery: to prevent infection, give ___________________ as prescribed

Answer 73

broad-spectrum antibiotic

Question 74

acute inflammation of the walls of small, cannulated veins

Answer 74

phlebitis

Question 75

peripheral artery disease or venous disease: lower leg edema present

Answer 75

peripheral venous disease

Question 76

peripheral artery disease or venous disease: pruritus rarely occurs

Answer 76

peripheral artery disease

Question 77

These three tests are equally reliable for diagnosing aortic dissection

Answer 77

MRI 3D CT scanning transesophageal echocardiography (TEE)

Question 78

peripheral artery disease or venous disease: normal or thickened nails

Answer 78

peripheral venous disease

Question 79

peripheral artery disease or venous disease: pruritus often occurs

Answer 79

peripheral venous disease

Question 80

Manifestations of peripheral artery disease: _________________ develops when the limb is in a dependent position, also known as ________________

Answer 80

reactive hyperemia, dependent rubor

Question 81

Aortic aneurysm surgery: Assess bowel sounds every ___________

Answer 81

4 hours

Question 82

Aortic surgery patients have a __________ preparation and _______ cleansing with a(n) _______________ agent the day before surgery.

Answer 82

bowel, skin, antimicrobial

Question 83

peripheral artery disease or venous disease: skin temperature warm, no temperature gradient

Answer 83

peripheral venous disease

Question 84

manifestations include hypotension, narrowed pulse pressure, distended neck veins, muffled heart sounds, and pulsus paradoxus

Answer 84

cardiac tamponade

Question 85

After surgical or radiologic intervention for PAD, check the operative extremity every ________ and later every _______. Assess these six things

Answer 85

15 minutes, 1 hour color, temperature, capillary refill, peripheral pulses, sensation, movement

Question 86

this type of surgery is a treatment option for acute and chronic type B aortic dissections with complications

Answer 86

endovascular aortic repair (EVAR) (alternative is thoracic EVAR or TEVAR)

Question 87

peripheral artery disease or venous disease: varicose veins may be visible

Answer 87

peripheral venous disease

Question 88

removal of obstructing plaque

Answer 88

atherectomy

Question 89

PAD: Postoperative ankle brachial index (ABI) measurements place the patient at risk for this

Answer 89

graft thrombosis

Question 90

most common complication of AAA repair

Answer 90

endoleak

Question 91

characterized by vasospasm-induced color changes from white to blue to red

Answer 91

Raynaud's phenomenon

Question 92

peripheral artery disease or venous disease: skin color dependent rubor, elevation pallor

Answer 92

peripheral artery disease

Question 93

peripheral artery disease or venous disease: skin texture thick, hardened, and indurated

Answer 93

peripheral venous disease

Question 94

The initial goals of therapy for acute aortic dissection without complications are _____ and _____ control and ________ management

Answer 94

HR, BP, pain

Question 95

involves a thrombus in a deep vein (most often iliac and/or femoral)

Answer 95

deep vein thrombosis (DVT)

Question 96

peripheral artery disease or venous disease: ulcer located on tips of toes, foot, or lateral malleolus

Answer 96

peripheral artery disease

Question 97

peripheral artery disease or venous disease: thickened, brittle nails

Answer 97

peripheral artery disease

Question 98

phlebitis usually resolves quickly after this intervention

Answer 98

IV catheter removal

Question 99

optimal therapy for patient with critical limb ischemia

Answer 99

revascularization via bypass surgery using autologous vein

Question 100

this type of aortic dissection, when without complications, can be treated conservatively

Answer 100

Type B

Question 101

peripheral artery disease or venous disease: skin texture thin, shiny, taut

Answer 101

peripheral artery disease

Question 102

six modifiable risk factors for aortic aneurysms

Answer 102

hypertension, CAD, tobacco use, high cholesterol, previous stroke, obesity

Question 103

this type of aortic dissection begins in the descending aorta

Answer 103

Type B

Question 104

in treating aortic dissection, this drug is titrated to a target HR under 60 bpm or SBP between 100-110

Answer 104

IV beta blocker

Question 105

peripheral artery disease or venous disease: ulcer may or may not be painful

Answer 105

peripheral artery disease

Question 106

conservative medical therapy is used to treat aneurysms of this size (risk factor modification)

Answer 106

<5.4 cm

Question 107

Aortic aneurysm surgery: When the descending aorta is involved perform a _______________ assessment

Answer 107

neurovascular

Question 108

three nonmodifiable risk factors for aortic aneurysms

Answer 108

age, male gender, family history

Question 109

peripheral artery disease or venous disease: ulcer margin rounded, smooth, looks "punched out"

Answer 109

peripheral artery disease

Question 110

how the ankle-brachial index is calculated

Answer 110

(ankle SBP/brachial SBP)

Question 111

peripheral artery disease or venous disease: peripheral pulses present, may be hard to palpate with edema

Answer 111

peripheral venous disease

Question 112

Aortic aneurysm surgery: Avoid heavy lifting for _________

Answer 112

6 weeks

Question 113

surgical repair is used to treat aneurysms of this size

Answer 113

>5.4 cm

Question 114

in diagnosing aneurysms, _____________________ assesses the function of the aortic valve

Answer 114

echocardiography

Question 115

those with small aneurysms of ________ cm should have monitoring of aneurysm size using ultrasound or CT every _______ months

Answer 115

4.0-5.4; 6-12 months

Question 116

three key factors that cause venous thrombosis

Answer 116

Virchow triad: venous stasis, damage of endothelium, hypercoagulability

Question 117

Aortic aneurysm surgery: When the ascending aorta and aortic arch are involved, perform a ____________ assessment

Answer 117

neurologic (LOC, pupil size and responsiveness to light, facial symmetry, tongue position, speech, upper extremity movement, quality of hand grasps)

Question 118

this type of aneurysm surgical repair is a minimally invasive procedure that involves the placement of a sutureless aortic graft into the abdominal aorta inside the aneurysm via the femoral artery

Answer 118

endovascular graft procedure (EVAR)