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Health Assessment (Spring 2023) > Exam 3 Cardiovascular disease > Flashcards

Exam 3 Cardiovascular disease Flashcards

1
Q

What is the most common cause for PVD?

A

Atherosclerosis

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2
Q

What are the treatments for PVD?

A

Pharmacologic & Surgical (transluminal angioplasty, endarterectomy, thrombectomy, bypass)

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3
Q

What is the primary goal in PVD surgery monitoring?

A

Detection of cardiac ischemia

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4
Q

What is warranted in PVD surgery monitoring?

A

An art-line.

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5
Q

How is the ABPI calculated?

A

Dividing the ankle’s SBP by the arm’s SBP

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6
Q

An ABI of <0.25 means, what?

A

Impending gangrene

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7
Q

Where is the most common atherosclerotic plaque buildup?

A

At the carotid bifurcation

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8
Q

What happens to the vessel in a dissection?

A

Blood enters media layer from tear in intima

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9
Q

How does cross-clamping affect the body?

A
  • LV afterload increases,
  • severe HTN
  • compromises perfusion to distal organs & spinal cord
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10
Q

What happens after d/c of cross clamping & how can this be alleviated?

A

Systemic hypotension & by preloading with volume

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11
Q

What 2 lesions require cardiopulmonary bypass?

A

Ascending aorta & transverse aorta

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12
Q

What is a Stanford type A dissection?

A

Dissection in the ascending aorta that may or may not extend into the descending aorta

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13
Q

What is a Stanford type B dissection?

A

Dissection limited to descending aorta

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14
Q

What is the source for aortic issues in someone with Marfan’s?

A

Medial cystic necrosis

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15
Q

What is the difference between a true & false aneurysm?

A
  • True involves dilation of all 3 layers.
  • False is caused by disruption of 1 or more layers
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16
Q

What is the leading cause of abdominal aortic aneurysms?

A

Medial cystic necrosis

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17
Q

Most aortic aneurysms are due to?

A

Atherosclerosis

18
Q

How does a pseudoaneurysm form?

A

The intima & media layers are ruptured & only the adventitia or blood clot form the outer layer

19
Q

What is the hallmark sign of aortic trauma?

A

Wide mediastinum on CXR

20
Q

What is the most common cause for postoperative renal failure?

A

Preoperative renal dysfunction

21
Q

What is the difference between a saccular & fusiform aneurysm?

A
  • Saccular is an eccentric dilation.
  • Fusiform includes the entire circumference of aorta
22
Q

What are the S/S of acute dissection?

A
  • Sharp, tearing pain
  • hypo/hypertension,
  • absent peripheral pulses
  • paraplegia/paraparesis
23
Q

Which aneurysm has a strong genetic link & usually relates to?

A
  • Abdominal aneurysm.
  • Atherosclerosis
24
Q

At what size does an abdominal aneurysm needs to be repaired?

A

Starting at 5-6cm

25
Q

What are the classic symptoms of Abd aneurysm rupture?

A

Hypotension, back pain, pulsatile mass

26
Q

What do we have to be very cautious with in someone with a ruptured abd aneurysm?

A

Raising their BP

27
Q

What are the best intraoperative BP meds?

A

Meds that are fast on & fast off like nitroprusside

28
Q

What is a Cooley Type D?

A

Fusiform aneurysm from ascending to renal arteries (entire aorta)

29
Q

What is a Cooley Type B?

A

Fusiform aneurysm from ascending to proximal arch

30
Q

What is a Cooley Type A?

A

Saccular aneurysm in the transverse arch

31
Q

What is a Cooley Type C?

A

Fusiform aneurysm from ascending to proximal descending

32
Q

What is a major complication of thoracic aorta clamping?

A

Spinal cord ischemia & paraplegia

33
Q

What are the S/S of anterior spinal artery syndrome?

A

Loss of motor function & pinprick sensation but preserved vibration & proprioception

34
Q

In 60% of people the artery of Adamkiewicz is located where?

A

Left side of T9-T12

35
Q

What are 4 protective measures for paraplegia?

A
  • Methylprednisone
  • Mild hypothermia
  • Mannitol
  • CSF drainage
36
Q

How is Spinal cord perfusion pressure calculated?

A

MAP – CSF

37
Q

Giving Mannitol before cross-clamping can lead to what?

A

Renal failure

38
Q

What can be given to someone with elevated creatinine pre & post a procedure involving contrast?

A

Mycomyst BID

39
Q

At what cross-clamping time do paraplegia & ARF increase drastically?

A

> 30 mins

40
Q

What opioids are preferred in vascular cases?

A

Fast acting like Remifentanil

Health Assessment (Spring 2023) (11 decks)

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