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Absite Review > Fiser Ch 27: Vascular > Flashcards

Fiser Ch 27: Vascular Flashcards

1
Q

most common acquired hypcoagulable disorder

A

smoking

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2
Q

1st branch off internal carotid artery?

A

ophthalmic aa

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3
Q

1st brach off external carotid artery?

A

superior thyroid aa

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4
Q

indications for CEA?

A
  1. Asymptomatic with >70% stenosis

2. Symptomatic with >50% stenosis

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5
Q

what part of vessel do you remove in CEA?

A

intima and part of media

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6
Q

why do 20% of ppl get hypertensive after CEA?

A

injury to carotid body, tx w nipride

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7
Q

what are the three aortic arch vessels?

A
  1. innominate aa (branches to right subclavian and right common carotid)
  2. left common carotid
  3. left subclavian
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8
Q

whats DeBakey Classification for AAAs?

A

Type I: ascending and descending
Type II: Ascending only
Type III: Descending only

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9
Q

where do dissections normally occur? (layer)

A

medial layer of blood vessel wall

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10
Q

how do you get paraplegia after a thoracic AAA repair? how can you prevent it?

A
  • spinal cord ischemia due to occlusion of intercostal arteries and artery of Adamkiewicz
  • reimplant intercostal arteries afte T8
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11
Q

most likely location of rupture of abdominal AAA?

A

left lateral wall 2-4cm below renals

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12
Q

when do you reimplant the IMA? indications (4)

A
  1. If backpressure <40mmHg
  2. Previous colonic surgery
  3. Stenosis at the SMA
  4. Flow to colon appears inadquate
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13
Q

1 causes of acute and late death after AAA repair?

A

acute: MI
late: renal failure

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14
Q

5 types of endoleaks

A

Type I: Proximal or distal attachment sits
Type II: Collaterals (observe)
Type III: Overlap sites of multiple grafts (secondary endograft to cover)
Type IV: Graft wall porosity or suture holes (observe)
Type V: expansion of aneurysm without evidence of leak (back to OR)

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15
Q

top 2 organisms that cause mycotic aneurysms and tx

A
  1. Staph
  2. Salmonella
    extra-anatomic bypass (ax fem) and resection of infected aorta
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16
Q

top 2 organisms that cause aortic graft infections

A
  1. staph

2. E. Coli

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17
Q

whats leriche syndrome? tx?

A
  • aortoiliac occlusive disease causing:
    1. no femoral pulses
    2. Buttock o thigh claudication
    3. impotence
    tx: aorto-bifem bypass
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18
Q

ABI: claudication

A

0.7-0.9

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19
Q

ABI: rest pain

A

0.5

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20
Q

ABI: ulcers

A

0.4

21
Q

ABI gangrene

A

<0.3

22
Q

when to use gortex (PTFE) vs saphenous v.

A

PTFE above the knee

saphenous below the knee bypasses

23
Q

when do you use dacron graft?

A

aorta or large vessels

24
Q

when do you use PTA?

A

percutaneous transluminal angioplasty, use:

  • common iliac artery stenosis
  • short stenoses
25
Q

diagnosis of compartment syndrome

A

pressures >20-30mmHg

26
Q

diagnosis of popliteal entrapment syndrome? tx?

A

loss of pulses with plantarflexion

tx: resection of head of gastroc

27
Q

what arteries are used in CABG?

A

arterial autografts:
radial aa
IMA

28
Q

most common site of peripheral obstruction from emboli

A

common femoral artery

29
Q

management of acute arterial embolus

A

embolectomy

30
Q

most common site of atheroma embolism

A

renals

31
Q

management of acute arterial thrombus

A

threatened limb: give heparin and OR thrombectomy

nonthreatened limb: angiography for thrombolytics

32
Q

renal artery stenosis, management if due to atherosclerosis or FMD

A

athero: PTA w stent

Fibromuscular dysplasia: PTA without stent

33
Q

difference in presentation of renal artery stenosis between atherosclerosis and FMD

A

athero: left, proximal 1/3, men
FMD: right, distal 1/3, women

34
Q

indications for nephrectomy w renal HTN

A

atrophic kidney <6cm with persistently high renin levels

35
Q

most common site of upper extremity stenosis

A

subclavian artery

36
Q

describe anatomy of thoracic outlet

A

subclavian v. and phenic n. lay anterior to anterior scalene, then subclavian a. and brachial plexus lie between ant and middle scalene muscles

37
Q

what is Paget-von Schrotter disease

A

effort induced thrombosis of subclavian vein, acutely painful, swollen, blue limb

38
Q

whats adsons test?

A

absent radial pulse with head turned to ipsilateral side of subclavian artery compression 2/2 ant. scalene hypertrophy

39
Q

what is the arc of riolan?

A

collateral between SMA and IMA

40
Q

most common visceral aneurysm

A

splenic artery aneurysm

41
Q

when do you repair a splenic artery aneurysm? (3)

A
  1. if symptomatic
  2. If pt is pregnant or in childbearing age
  3. > 3-4cm
42
Q

treatment of splenic artery aneurysm?

A

covered stent

43
Q

treatment of popliteal artery aneurysm

A

exclusion and bypass

44
Q

difference in collateral system between right and left renal vein

A

RIGHT has NO collaterals, thus you can ligate LEFT renal vein

45
Q

migrating thrombophlebitis indicates what pathology?

A

pancreatic cancer

46
Q

AEIOU of dialysis

A 
A: acidosis
E: electrolyte imbalances
I: intoxication
O: overload
U: uremia
47
Q

which artery has the highest patentcy after angioplasty?

A

iliac aa (decreases as you mov distally)

48
Q

MC organism causing: early graft infection v late graft infection

A

early: staph aureus
late: staph epidemidis

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