Exam Questions Flashcards

1
Q

Name histological findings of scalene muscle in TOS?

A

a. Predominance of Type I fibres
b. Increase in connective tissue
c. Endomysial fibrosis
d. Mitochondrial changes

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2
Q

List causes of emboli in ALI.

A
Cardiac (80-90%)
	Atrial fibrillation
	Post MI
	Valvular prosthesis
	Intracardiac tumour
       Septic embolus
Non-cardiac (10%)
	Atheroembolism from    aneurysm or proximal aortic disease
        Non-cardiac tumour
        Paradoxical embolism
	Foreign body
Microemboli
	Most commonly femoral artery origin
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3
Q
  1. Name 3 groups that should be screened for AAA according to the vascular society
A

All men 65-75 years of age
Women over 65 years with high risk (smoking, family history, CVD)
Men below 65 years with family history

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4
Q

Name 3 studies that support surgery for symptomatic stenosis

A

NASCET
ECST
VAST

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5
Q

Name 2 studies that support surgery for asymptomatic stenosis

A

ACAS

VA asympto trial

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6
Q

About carotid artery stenting. Name 4-5 studies on carotid stenosis and their results (inferior, superior, similar or results pending)

A
ICSS (inferior)
CREST (inferior or same)
EVA-3S (inferior)
SPACE (inferior or similar)
SAPPHIRE (superior) 
CAVATAS (similar, poor study)
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7
Q

What are side effects of scelrotherapy.

A
Anaphylaxis, allergic reaction
Thrombophlebitis (superficial and DVT)
Cutaneous necrosis
Pigmentation
Neoangiogenesis
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8
Q

List ways to avoid hyper pigmentation after sclerotherapy.

A

Use weaker concentration of sclerosing solution
Minimize intravascular pressure during injection
Remove postsclerotherapy coagula (use No 21 or 18 needle to allow expulsion of entrapped blood under pressure)

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9
Q

List technique to salvage stent deployment if balloon ruptures after 50% deployment.

A

a. Maintain wire access, replace balloon and deploy stent at original target
b. Maintain wire access, replace smaller balloon, “capture” stent and deploy in safe location (external iliac artery)
c. Snare stent and remove percutaneously or from surgically accessible location

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10
Q

List anomalies of IVC and renal vein.

A

retroaortic renal vein
cirumaortic renal vein
duplicated IVC
absent infrarenal IVC
Double IVC with Retroaortic Right Renal Vein and Hemiazygos Continuation of the IVC
Double IVC with Retroaortic Left Renal Vein and Azygos Continuation of the IVC
Azygos Continuation of the IVC

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11
Q

List causes of IC other then atheromatous.

A
Popliteal entrapment
Popliteal aneurysm
Cystic adventitial disease of popliteal artery
Pseudoxanthoma elasticum
Thromboangiitis obliterans
Peripheral emboli
Aortic coarctation
Takayasu's disease
Remote trauma or radiation injury
Arterial fibrodysplasia
Persistent sciatic artery
Iliac syndrome of the cyclist
Primary vascular tumors
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12
Q

Pseudoaneurysm with AVF (hemodialysis) List 4-5 reasons to repair

A

o Increase in size
o Distal ischemia
o Overlying skin changes (may predispose pseudoaneurysm rupture)
o Persistent bleeding from puncture site
o Rupture
o Cosmesis (if AV fistula no longer needed, ie post renal transplant)

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13
Q

List 5 pathogens involved in infected aneurysm

A
o	Salmonella spp (30%)
o	Staphylococcus spp (19%)
o	Streptococcus spp (9%)
o	E Coli (9%)
o	Bacteroides spp (5%)
o	Enterococcus group (3%)
o	Clostridium spp (3%)
candida
mycobacterium
treponema pallidum
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14
Q

Name different types of infected aneurysm.

A

o Mycotic aneurysm (gr + cocci: Strep viridans and faecalis, Staph aureus and epidermidis, )
o Microbial arteritis (Salmonella, Staph spp, E Coli and Bacteroides fragilis)
o Infection of existing aneurysm (Staph spp)
o Post-traumatic infected false aneurysm (Staph aureus, polymicrobial – Staph aureus, e Coli, Strep fecalis, Pseudomonas, various Enterobacter)

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15
Q

List 6 ways to predict success of a profundaplasty

A

a. Significant profunda stenosis or occlusion
b. Rest pain or minimal tissue loss
c. Good inflow
d. Occluded SFA
e. Healthy distal profunda
f. Good collaterals to tibial vessels (preferably 2 out of 3)

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16
Q

List facts that favour AKA over BKA.

A

i. Physical exam (ie. lack of femoral pulse)
ii. Skin temperature < 90°F
iii. Absolute ankle pressure < 60 mmHg
iv. Skin perfusion pressure < 20 mmHg at BKA level
v. Trans-cutaneous O2 below 30 mmHg at BKA level

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17
Q

Name clinical differences b/w primary and secondary Raynauds

A
Primary
female
teens-20s
family history
live in colder climates
Attacks triggered by exposure to cold and/or stress
Symmetric bilateral involvement
Absence of necrosis
Absence of a detectable underlying cause
Normal capillaroscopy findings
Normal laboratory findings for inflammation
Absence of antinuclear factors
Secondary
male or female
40s
Single digit involved
Abnormal pulse examination
Vascular laboratory abnormalities
Positive autoantibodies
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18
Q

Renal artery aneurysm.
Most common presentation
Most common location
Most common morphological characteristic.

A

incidental
90% extraparynchymal
75% saccular

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19
Q

What is indication for intervention on RAA?

A
>2-3cm 
pregnancy
rupture
HTN (DBP >90 despite 3 antihtn
dissection if viability treatened
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20
Q

What is the difference between first and second generation fibrinolytics?
List 2nd generation.

A

2nd are fibrin selective
avoid systemic depletion of circulating fibrinogen and plasminogen

tPA (alteplase)
pro-urokinase

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21
Q

What is a type I error?

A

Incorrect rejection of a true null hypothesis

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22
Q

What is a type II error?

A

Failure to reject a false null hypothesis

23
Q

What is alpha error?

A

type I error

24
Q

What is beta error?

A

type II error

25
How do you calculate Odds ratio?
AD/BC
26
How do you calculate PPV?
true positives/(#true positives + number of false positives)
27
How do you calculate NPV?
of true negatives/(# of true negatives + # of false negatives)
28
How to calculate NNT?
1/ARR
29
How to calculate ARR?
control event rate-experimental event rate
30
What is the definition of primary assisted patency?
time from access placement to access thrombosis with intervention designed to maintain functionality of an access
31
What is functional patency?
indicate patent start date of first successful cannulation
32
List the seven roles of the CanMEDS framework.
``` medical expert scholar professional health advocate manager communicator collaborator ```
33
What are symptoms of delirium tremens?
``` hallucinations fever HTN sweating tachycardia tremors anxiey confusion seizure ```
34
List large-vessel vasculitis.
Giant cell arteritis takayasu PMR
35
List medium vessel vasculitis.
Polyarteritis nodosa Burgers kawasaki
36
List small vessel vasculitis.
bechets churg strauss henoch-scholein
37
How is PAN divided?
``` idopathic secondary (hep B) ```
38
What vasculidities have circulating ANCA?
wegners | microscopic polyangitis
39
What are three clinical features of coogans?
interstitial keratitis vestibular dysfunction sensorineural hearing loss
40
What are clinical features of Bechets?
recurrent mucocutaneous lesion genital ulcers opthalmic complications
41
What is the most common cause of death in kawasaki?
MI
42
what are clinical features of Giant cell?
H/A modularity of temporal artery constitutional symptoms TIA
42
What are criteria to reopen a CEA on intra-op duplex?
Wall irregularity or small flap <3mm Stenosis PSV >150cm/s and turbulent flow spectra Lumen thrombosis
43
What are duplex criteria of carotid occlusion?
No flow distal ICA on low PRF settings CCA low velocity high resistance pattern, possible reverse flow in diastole Low flow resistance in ECA internalization of ECA(collaterals) Flow thump recorded at prox ICA Increased contralateral velocities in ICA CCA
44
What are components of metabolic syndrome?
``` Central obesity Elevated BP Elevated fasting glucose High serum cholesterol Low HDL ```
45
What are the branches of the external iliac?
Inferior epigastric | Deep circumflex iliac
46
What are the branches of the common femoral?
Superficial epigastric Superficial iliac circumflex Superficial external pudendal Deep external pudendal
47
What are the branches of the internal iliac?
``` Obturator Superior vesical Inferior vesical Middle rectal Internal pudendal Inferior gluteal Superior gluteal Lateral sacral ```
48
What are key elements for cholesterol embolization syndrome?
``` Plaque in large arteries Spontaneous, traumatic plaque rupture Embolization of material Lodging of emboli in small artery Foreign body inflammatory response End organ damage ```
49
What are clinical manifestations of cholesterol emboli?
``` Purple toes Gangrenous digits Ulcerations Renal failure Htn Tia Stroke Hollenhorst plaque Mi GI bleeding Ischemic bowel ```
50
What is medical therapy for cholesterol emboli syndrome?
Corticosteroids Statins Iloprost Anti PLT
51
What are the phases of growth of infantile hemangiomas?
Growth <8 Resting 8-14 Involution 1-5
52
What are findings on thoracic aorta on TEE that indicate high risk for atheroembolism?
Thickness >4mm Lack of plaque Mobile plaque
53
What is the blood supply to the spinal cord?
Vertebrals-one anterior spinal artery PICA-paired posterior spinal artery Spinal arteries supplied by radicular artery