diseases of the veins - Sheet1

Question 1

What are varicose veins?

Answer 1

Visible veins where blood has pooled, causing distortion, leakage, increased pressure, and inflammation.

Question 2

What causes varicose veins?

Answer 2

Incompetent venous valves, venous obstruction, epithelial muscle pump dysfunction, or a combination of these.

Question 3

What is the mechanism behind varicose veins?

Answer 3

Increased venous pressure leads to thickening of the basement membrane, capillary elongation, and visible skin changes.

Question 4

What percentage of varicose veins involve superficial veins?

Answer 4

88% of cases involve superficial veins alone or both superficial and deep veins.

Question 5

What are the manifestations of varicose veins?

Answer 5

Visible distention of veins, itching, burning/throbbing pain, and leg fatigue.

Question 6

How are varicose veins diagnosed?

Answer 6

History and physical examination, venous duplex scan.

Question 7

What is chronic venous insufficiency?

Answer 7

A severe form of venous hypertension characterized by edema, skin changes (erythema/ulceration), and poor wound healing.

Question 8

What worsens the symptoms of chronic venous insufficiency?

Answer 8

Prolonged standing or walking.

Question 9

What is Deep Vein Thrombosis (DVT)?

Answer 9

A clot in a deep vein that obstructs blood flow, leading to increased hydrostatic pressure.

Question 10

What are the risk factors for DVT?

Answer 10

Sedentary lifestyle, obesity, cancer, smoking, hypertension, long-haul air travel, estrogen contraceptives, pregnancy, hormone replacement, surgery, trauma, and others.

Question 11

What is Virchow’s triad?

Answer 11

Venous stasis, venous epithelial damage, and hypercoagulable state.

Question 12

What can happen if a DVT thrombus detaches?

Answer 12

It can become a thromboembolus and lead to pulmonary embolism.

Question 13

What are the manifestations of DVT?

Answer 13

Unilateral leg edema, pain/cramping (often in the calf), red/purple skin color changes, warmth on the affected leg.

Question 14

How is DVT diagnosed?

Answer 14

History and physical exam, D-dimer test, venous duplex Doppler study.

Question 15

What is Superior Vena Cava Syndrome (SVC)?

Answer 15

Obstruction of venous drainage from the upper body, causing increased venous pressure and dilation of collateral circulation.

Question 16

What are the causes of SVC syndrome?

Answer 16

Venous compression from malignant tumors or a large clot at the tip of a central line.

Question 17

What are the manifestations of SVC syndrome?

Answer 17

Edema and venous distention in the face, neck, trunk, and upper extremities; dyspnea, cerebral edema (headaches, confusion, vision changes), dysphagia.

Question 18

How is SVC syndrome diagnosed?

Answer 18

History and physical exam, CT scan to identify the cause.

Question 19

What is Coronary Artery Disease (CAD)?

Answer 19

A vascular disorder that narrows or occludes coronary arteries, leading to an imbalance between coronary blood supply and myocardial oxygen demand.

Question 20

What is the most common cause of CAD?

Answer 20

Atherosclerosis.

Question 21

What are the nonmodifiable risk factors for CAD?

Answer 21

Advanced age, family history, male gender, or women after menopause.

Question 22

What are the modifiable risk factors for CAD?

Answer 22

Dyslipidemia, hypertension, smoking, diabetes, obesity, sedentary lifestyle, atherogenic diet.

Question 23

What is dyslipidemia?

Answer 23

An imbalance of lipids, including very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL).

Question 24

What is the role of VLDL?

Answer 24

VLDL carries triglycerides and lipoproteins, delivering triglycerides to tissues.

Question 25

What is the role of LDL?

Answer 25

LDL delivers cholesterol to tissues and contributes to plaque formation in arteries.

Question 26

What is the role of HDL?

Answer 26

HDL removes excess cholesterol from arterial walls and transports it to the liver for elimination.

Question 27

What is myocardial ischemia?

Answer 27

Insufficient blood flow to the heart muscle, leading to oxygen supply not meeting demand.

Question 28

What causes myocardial ischemia?

Answer 28

Atherosclerosis, coronary spasming, hypotension, dysrhythmias, anemia, and hypoxemia.

Question 29

What are the manifestations of myocardial ischemia?

Answer 29

Angina (chest pain).

Question 30

What are the classifications of angina?

Answer 30

Stable angina (predictable, relieved by rest), unstable angina (unpredictable, may need medication or intervention), Prinzmetal angina (unpredictable, often at night due to SNS activity or other factors).

Question 31

What is Acute Coronary Syndrome (ACS)?

Answer 31

Sudden coronary obstruction due to thrombosis over a ruptured atherosclerotic plaque.

Question 32

What happens if ACS is not treated in time?

Answer 32

It can result in a myocardial infarction (MI).

Question 33

What is the difference between reversible and irreversible damage in ACS?

Answer 33

Ischemic tissue is potentially salvageable, but infarcted tissue has irreversible damage.

Question 34

What is unstable angina?

Answer 34

A red flag for a potential infarction, with increased risk of progression to MI.

Question 35

What are the two types of myocardial infarction (MI)?

Answer 35

NSTEMI (non-ST elevation MI) and STEMI (ST elevation MI).

Question 36

What is the mechanism behind myocardial infarction (MI)?

Answer 36

Prolonged ischemia causes irreversible damage (myocyte necrosis) to the heart muscle.

Question 37

What are the classic manifestations of an MI?

Answer 37

Sudden, severe chest pain radiating to the jaw, shoulder, or back, nausea, vomiting, diaphoresis, agitation, confusion, and "I am going to die" feeling.

Question 38

What are the key diagnostic indicators for MI?

Answer 38

History and physical (H&P), elevated troponin levels, and 12-lead EKG changes.

Question 39

What are the structural and functional changes after an MI?

Answer 39

Myocardial stunning, hibernating myocardium, and myocardial remodeling.

Question 40

What is myocardial stunning?

Answer 40

Temporary loss of contractile function that persists for hours to days after perfusion restoration.

Question 41

What is hibernating myocardium?

Answer 41

Persistently ischemic tissue that adapts metabolically to prolong survival.

Question 42

What is myocardial remodeling?

Answer 42

Inflammatory process leading to myocyte hypertrophy, scarring, and loss of contractile function after MI.

Question 43

How does angiotensin II contribute to MI complications?

Answer 43

It increases myocardial work, peripheral vasoconstriction, and fluid retention, exacerbating damage.

Question 44

What are the complications after an MI (DARTH VADER)?

Answer 44

Death, arrhythmias, rupture, tamponade, heart failure, valve disease, aneurysm, Dressler’s syndrome (pericarditis), embolism, recurrence.

Question 45

What is acute rheumatic fever?

Answer 45

A diffuse inflammatory disease caused by a delayed immune response to group A beta-hemolytic streptococci infection.

Question 46

What can acute rheumatic fever lead to if untreated?

Answer 46

Rheumatic heart disease, characterized by inflammation of the endocardium, myocardium, and pericardium.

Question 47

What causes valve damage in rheumatic heart disease?

Answer 47

Inflammation of the endocardium causes swelling of the valve leaflets, frequently leading to heart valve damage.

Question 48

What are the common manifestations of rheumatic fever?

Answer 48

Fever, lymphadenopathy, and heart murmurs.

Question 49

How is rheumatic fever diagnosed?

Answer 49

History and physical exam (H&P), echocardiogram (ECHO), and transesophageal echocardiogram (TEE) for better visualization of heart valves.

Question 50

What is infective endocarditis?

Answer 50

Infection caused by microorganisms that circulate in the bloodstream and attach to the endocardial surface, often affecting heart valves.

Question 51

Which heart valve is most commonly affected by infective endocarditis?

Answer 51

The mitral valve.

Question 52

What are vegetations in infective endocarditis?

Answer 52

Infectious lesions on the heart valves.

Question 53

What are the risk factors for infective endocarditis?

Answer 53

IV drug use, prior prosthetic heart valve implantation, rheumatic fever.

Question 54

Which pathogens are commonly responsible for infective endocarditis?

Answer 54

Staphylococcus aureus and Streptococcus.

Question 55

What are the classic manifestations of infective endocarditis?

Answer 55

High fever, chills, night sweats, cough, weight loss, fatigue, new heart murmurs, signs of heart failure, septic emboli, hemorrhagic lesions on palms/soles, red-purple lesions on fingers/toes, retinal hemorrhages.

Question 56

How is infective endocarditis diagnosed?

Answer 56

History and physical exam (H&P), blood cultures, transthoracic echocardiogram (TTE) or transesophageal echocardiogram (TEE) for better visualization of vegetations.