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CORE > IR > Flashcards

IR Flashcards

1
Q

femoral arterial access –> needle enter –> at what location on skin?

A

femoral head –> infmed

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2
Q

femoral arterial access –> needle –> med/lat –> what angle?

A

45 deg

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3
Q

femoral NAVL –> order?

A

lat –> med:

  • N
  • A
  • V
  • Lymphatic
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4
Q

common femoral A –> begin at what landmark?

A

inguinal lig

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5
Q

femoral arterial access –> low access –> potential comp?

A

puncture A & V –> AV fistula

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6
Q

femoral arterial access –> high access –> potential comp?

A

above pelvic brim –> retroperitoneal hemorrhage

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7
Q

differentiate: pseudoaneurysm –> tx –> watchful wait vs US-guided thrombin injection?

A
  • <1cm: watchful wait

- >1cm: US-guide thrombin inject

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8
Q

AVF –> doppler findings? (3)

A
  • V –> arterial flow
  • A –> loss of normal triphasic waveform
  • A –> prox to fistula –> inc diastolic flow
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9
Q

venous access procedure –> #1 dangerous part?

A

catheter –> insert into peel-away sheath

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10
Q

catheter –> insert into peel-away sheath –> pt acute hypoxic –> dx? next step?

A

air embolism:

  • L lat decubitus
  • administer 100% O2
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11
Q

lrg air embolism –> possible tx?

A

aspirate w catheter

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12
Q

angiographic run –> inj rate –> units?

A

cc/sec for total cc

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13
Q

angiographic run –> inj rate:

  • aortic arch
  • abd aorta
  • IVC
  • mesenteric A
  • renal A
  • distal A
A
  • aortic arch: 20 for 30
  • abd aorta: 20 for 20
  • IVC: 20 for 30
  • mesenteric A: 5 for 25
  • renal A: 5 for 15
  • distal A: 3 for 12
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14
Q

artery stenosis –> 1st line tx?

A

perc transluminal angioplasty (PTA)

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15
Q

perc transluminal angioplasty (PTA) –> balloon size –> relative to vessel size?

A

10-20% lrger than vessel diameter

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16
Q

perc transluminal angioplasty (PTA) –> balloon size –> units?

A
  • diameter (mm)

- length (cm)

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17
Q

perc transluminal angioplasty (PTA) –> comp? (3)

A
  • distal embolus
  • vessel rupture
  • dissection
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18
Q

stent –> 2 broad types?

A
  • balloon-expandable

- self-expandable

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19
Q

stent –> balloon vs self - expandable –> pro vs con

A

balloon:
- higher radial force on deploymt
- if crushed –> stay crushed

self:
- more flexible –> more trackable thru vessel

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20
Q

vessels around jts –> preferred stent type?

A

self-expandable

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21
Q

stent –> what size to use?

A
  • 1-2cm longer than stenosis

- 1-2mm wider than normal vessel lumen

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22
Q

stent size –> oversize by what %?

  • arterial stent
  • venous
A
  • art –> 10%

- ven –> 20%

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23
Q

stent –> covered –> used for what conditions? (3)

A
  • pseudoaneurysm
  • dissection
  • TIPS
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24
Q

embolic material –> 2 main categories?

A
  • permanent

- temporary

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25
Q

permanent embolic material? (4)

A
  • coil
  • particle
  • glue
  • sclerosing agent
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26
Q

temporary embolic material? (2)

A
  • gelatin sponge

- autologous clot

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27
Q

embolization coils –> MOA for embolization?

A

vasc stasis

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28
Q

embolization coils –> pro (2) vs con (1)?

A

pro:
- precise & quick
- no distal embolization

con:
- lose distal access

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29
Q

bleed –> embolization coils –> general technique? why?

A

1) coil –> distal to lesion
2) coil –> prox

prevent recurrent bleed from retrograde collaterals

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30
Q

embolic material –> particles –> MOA?

A

flow distal –> occlude small capillaries

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31
Q

embolization particles (2)?

A
  • trisacyl gelatin microspheres

- polyvinyl alcohol

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32
Q

embolic material –> gelatin sponge (Gelfoam) –> last how long?

A

2-6wk

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33
Q

embolic material –> gelatin sponge (Gelfoam) –> CT appearance?

A

embolized organ –> numerous gas locules –> mimic abscess

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34
Q

what is sodium tetradecyl sulfate? use?

A

sclerosing agent:

  • vasc malformation
  • varices
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35
Q

what is cyanoacrylate?

A

glue –> harden when contact blood

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36
Q

embolization –> comp? (2)

A
  • post-embo synd

- non-target embo

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37
Q

what is post-embo synd? when occur after embo?

A

embo –> tissue infarct –> release endovasc inflamm modulators –> 1day after –> pain, cramp, fever, N/V

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38
Q

post-embo synd –> tx?

A
  • NSAID
  • IV fluid
  • +/- opioid
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39
Q

what is non-target embolization?

A

unintentional embo structure other than target

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40
Q

uterine fibroid embo –> non-target embolization site?

A

ovaries

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41
Q

bronchial A embo –> non-target embolization site? (2)

A
  • brain –> stroke

- spinal A –> paralysis

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42
Q

1 Fr = ? mm

A

0.33 mm

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43
Q

catheter size –> measured by internal or external diameter?

A

ext

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44
Q

sheath size –> measured by internal or external diameter?

A

int (luminal)

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45
Q

catheter –> mult sideholes –> type of catheter?

A

high flow (flush)

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46
Q

high flow (flush) catheter –> used for what type of angiography?

A

lrg vessel:

  • aorta
  • IVC
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47
Q

catheter –> single sidehole –> type of catheter?

A
  • selective

- superselective

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48
Q

catheter –> tip shape?

  • C2
  • SOS
  • Berenstein
A
  • C2: reverse curve
  • SOS: reverse curve
  • Berenstein: angled
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49
Q

standard wire vs microwire –> size?

A
  • standard –> 0.035”

- micro –> 0.018”

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50
Q

wire –> size? tip type?

  • Bentson
  • Rosen
A
  • Bentson: standard –> floppy tip

- Rosen: standard –> J-tip

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51
Q

hydrophilic wire –> use? (2)

A
  • cross stenosis

- indwelling device –> routine check & change –> initial cannulation

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52
Q

hydrophilic wire –> 2 examples?

A
  • Roadrunner

- Glidewire

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53
Q

stiff wire –> 1 example?

A

Amplatz

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54
Q

stiff wire –> use?

A

require structural rigidity –> ie. dilate subQ tissue:

  • sheath
  • biliary drain
  • nephrostomy tube
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55
Q

giant cell arteritis –> what size vessels are affected?

A

large & med

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56
Q

giant cell arteritis –> MC location?

A

UE –> med size A:

  • subclavian
  • axillary
  • brachial
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57
Q

giant cell arteritis –> involve aorta –> T/F?

A

rarely

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58
Q

giant cell arteritis –> tx?

A

steroid

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59
Q

SVC –> embryology?

A
  • L ant cardinal V –> regress

- R ant cardinal V –> SVC

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60
Q

L-sided SVC –> embryology?

A
  • L ant cardinal V –> persist

- R ant cardinal V –> regress

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61
Q

L-sided SVC –> drain into –> MC location? rare location?

A

1 coronary sinus –> RA

rarely: –> LA (R–>L shunt)

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62
Q

duplicated SVC –> embryology?

A
  • L ant cardinal V –> persist

- R ant cardinal V –> persist

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63
Q

SVC synd –> MOA? clinical presentation?

A

SVC –> acute obstruct – face & UE –> edema, cyanosis

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64
Q

SVC synd –> vasc emergency –> T/F?

A

T

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65
Q

SVC –> chronic stenosis/occlusion –> ssx?

A
  • asympt

- face edema –> improve w standing

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66
Q

SVC obstruct –> cause? (3)

A
  • thorax malig –> compress SVC
  • catheter-assoc thrombosis
  • histoplasmosis –> mediastinal fibrosis
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67
Q

SVC obstruct –> CT abd –> classic finding? why?

A

collateral flow –> vein of Sappey –> hep segmt IVa –> inc enhance

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68
Q

what is V of Sappey?

A
  • region of falc lig –> drain liver

- comm w internal thoracic V (collaterals in SVC occlusion)

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69
Q

pulm angiogram –> pre-proc eval? why?

A

EKG –> r/o LBBB

pulm A catheter –> can cause temporary RBBB –> LBBB + RBBB –> complete heart block –> can be fatal

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70
Q

pulm angiogram –> pre-proc eval –> EKG –> LBBB –> next step?

A

place temporary pacer before procedure

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71
Q

normal pressure?

  • RA
  • RV
  • pulm A
A
  • RA: 0-8 mm Hg
  • RV: 0-8 dias / 15-30 sys
  • pulm A: 3-12 dias / 15-30 sys
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72
Q

mult pulm AVM –> ddx? (1)

A

hereditary hemorrhagic telangiectasia (HHT) (Osler-Weber-Rendu synd)

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73
Q

hereditary hemorrhagic telangiectasia (HHT) (Osler-Weber-Rendu synd) –> clinical presentation? (3)

A
  • brain abscess
  • stroke
  • recurrent epistaxis
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74
Q

pulm AVM –> embo –> general procedure?

A

single feeding A –> coil

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75
Q

limb AVM –> embo –> general procedure?

A

mult feeding A –> coil entire nidus

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76
Q

pulm AVM –> embo –> contraindicated embo material?

A

particles –> R-L shunt –> brain emboli –> infarct

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77
Q

pulm AVM –> embo –> indication? (1)

A
  • asympt: feeding A –> >3mm

- sympt –> ie infarct, brain abscess

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78
Q

massive hemoptysis –> definition?

A

> 300mL/24hr

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79
Q

massive hemoptysis –> prognosis?

A

very high mortality (asphyxiation)

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80
Q

massive hemoptysis –> 2 MC affected A?

A
  • # 1 bronchial A

- #2 pulm A

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81
Q

massive hemoptysis –> bronchial A normal –> pulm A normal –> next step?

A

eval:
- subclavian
- internal mamm
- inf phrenic
- celiac

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82
Q

USA –> massive hemoptysis –> MC etiology? (2)

A
  • cystic fibrosis

- thoracic malig

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83
Q

global –> massive hemoptysis –> MC etiology? (2)

A
  • TB

- fungal infx

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84
Q

massive hemoptysis –> MOA?

A

chronic inflamm –> bronchial A hypertrophy –> hemoptysis

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85
Q

bronchial A –> origin?

A

thoracic aorta –> T5-6 level

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86
Q

massive hemoptysis –> preferred embo material?

A

distal embolic agent –> #1 particles

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87
Q

massive hemoptysis –> embo –> general procedure?

A
  • eval for L-R shunt –> prevent inadvertent cerebral embo

- embo to near-stasis

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88
Q

massive hemoptysis –> should not use which embo material? why?

A

common to rebleed after tx

coils –> prevent repeat access

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89
Q

massive hemoptysis –> embo –> comp?

A

nontarget embo –> spinal cord:

- ant spinal A –> arise from bronchial A

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90
Q

spine osseous landmark?

  • celiac
  • SMA
  • renal A
  • IMA
A
  • celiac: T12
  • SMA: T12-L1
  • renal A: L1-L2
  • IMA : L2-L3 –> L of midline
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91
Q

celiac trunk –> branches?

A
  • L gastric
  • common hepatic
  • splenic
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92
Q

esophagus –> Mallory-Weiss tear –> possible causative A?

A

L gastric A

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93
Q

gastroepiploic A –> origin?

A
  • splenic A –> L gastroepiploic

- gastroduodenal A –> R gastroepiploic

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94
Q

what is replaced R hepatic A?

A

SMA –> R hep A

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95
Q

cystic A –> origin?

A

R hep A

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96
Q

what is accessory R hep A?

A

1) proper hep A –> normal R hep A

2) SMA –> access R hep A

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97
Q

replaced R hepatic A –> clinical significance? (3)

A
  • lap chole –> prevent inadvertent A injury
  • liver donor –> better anatomosis to recipient
  • liver recipient –> small common hep A –> inc arterial comp
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98
Q

replaced L hep A –> origin?

A

L gastric A

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99
Q

replaced L hep A –> clinical significance? (1)

A

gastrectomy –> resect replaced L hep A –> predispose to liver injury

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100
Q

SMA –> supplies what?

A

distal duodenum –> mid-transverse colon

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101
Q

SMA –> branches?

A
  • inf pancreaticoduodenal A
  • middle colic A
  • R colic A
  • ileocolic A
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102
Q

SMA –> R colic A –> supplies what struct?

A
  • R colon

- hep flexure

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103
Q

SMA –> ileocolic A –> supplies what struct?

A
  • terminal ileum
  • cecum
  • appendix
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104
Q

SMA –> inf pancreaticoduodenal A –> anastomose w what A?

A

celiac A

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105
Q

SMA –> middle colic A –> anastomose w what A?

A

marginal A of Drummond

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106
Q

IMA –> branches?

A
  • L colic A
  • sigmoid A
  • sup rectal (hemorrhoidal) A
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107
Q

internal iliac A –> ant division –> branches?

A
  • inf/middle rectal A
  • uterine A
  • obturator A
  • inf gluteal A
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108
Q

internal iliac A –> post division –> branches?

A
  • lat sacral A
  • iliolumbar A
  • sup gluteal A
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109
Q

internal iliac A –> ant division –> inf/middle rectal A –> anastomose w what A?

A

pathway of Winslow –> IMA

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110
Q

internal iliac A –> post division –> iliolumbar A –> anastomose w what A?

A

deep circumflex iliac A –> external iliac A

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111
Q

ext iliac A –> branches?

A
  • inf epigastric A
  • deep circumflex iliac A
  • femoral A
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112
Q

ext iliac A –> inf epigastric A –> anastomose w what A?

A

sup epigastric A

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113
Q

ext iliac A –> deep circumflex iliac A –> anastomose w what A?

A

iliolumbar A –> int iliac A

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114
Q

what is arc of Buhler?

A

persistent embryologic remnant –> short segment –> connect celiac & SMA

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115
Q

what is pancreatic cascade?

A

1) celiac
2) SMA –> inf pancreaticoduodenoal A

collateral network at pancreatic head

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116
Q

what is arc of Barkow?

A

SMA & celiac anatomosis (via R & L epiploic A)

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117
Q

celiac - SMA anastomoses? (3)

A
  • arc of Butler
  • inf pancreaticoduodenal A –> pancreatic cascade
  • arc of Barkow
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118
Q

SMA - IMA anastomoses? (3)

A
  • # 1 marginal A of Drummond
  • arc of Riolan
  • Cannon-Bohn pt
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119
Q

what is Cannon-Bohn pt? clinical sig?

A

splenic flexure –> pt of transitional blood supply bw SMA & IMA –> watershed zone –> susceptible to ischemia

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120
Q

ext iliac - thoracic aorta anastomosis?

A
  • ext iliac –> inf epigastric A

- thoracic aorta -> internal mammary A

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121
Q

ext iliac - int iliac anastomosis?

A
  • ext iliac –> deep circumflex iliac A

- int iliac –> post div –> iliolumbar A

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122
Q

int iliac - IMA anastomosis?

A

path of Winslow (rectal arcade)

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123
Q

what is polyarteritis nodosa (PAN)?

A

systemic necrotizing vasculitis –> small & med A –> mult small visceral aneurysms

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124
Q

mult renal A aneurysms –> ddx? (4)

A
  • polyarteritis nodosa (PAN)
  • mult septic emboli
  • speed kidney (chronic meth abuse)
  • Ehlers-Danlos
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125
Q

polyarteritis nodosa (PAN) –> MC location? (3)

A

end-arterioles:

  • renal
  • hep
  • mesenteric
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126
Q

polyarteritis nodosa (PAN) –> assoc conditions? (5)

A

CLASH:

  • cryoglobulinemia
  • leukemia
  • rheum arthritis
  • Sjogren synd
  • hep B
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127
Q

polyarteritis nodosa (PAN) –> tx?

A

steroid

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128
Q

MC visceral aneurysm? 2nd MC

A 
#1 splenic A
#2 hep A
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129
Q

splenic A aneurysm –> epidemiology? (2)

A
  • multiparous F

- portal HTN

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130
Q

splenic A pseudoaneurysm –> etiology? (2)

A
  • trauma

- pancreatitis

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131
Q

splenic A aneurysm –> indication for tx? (3)

A
  • ssx –> ie. LUQ pain
  • > 2.5cm
  • expected preg
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132
Q

splenic A aneurysm –> tx?

A

coil embo

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133
Q

hep A aneurysm –> tx –> embo –> general approach?

A

embo distal to cystic A

if prox to cystic A –> inc risk for ischemic cholecystitis

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134
Q

liver cirrhosis –> classic IR finding?

A

hep A branches –> corkscrewing

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135
Q

mesenteric ischemia –> etiology? (4)

A
  • acute A embolus
  • chronic A stenosis
  • V occlusion
  • low-flow state
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136
Q

acute mesenteric ischemia –> MCC?

A

SMA embolus

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137
Q

acute mesenteric ischemia –> MC tx

A

surg:
- embolectomy or bypass –> revasc
- direct inspect bowel
- resect necrotic bowel

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138
Q

acute mesenteric ischemia –> SMA embolus –> highest risk of intestinal ischemia –> what location?

A

distal to middle colic A (few native distal collaterals)

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139
Q

acute mesenteric ischemia –> embolic cause –> no peritoneal signs, no ssx of bowel necrosis –> tx?

A

endovasc therapy:

  • thrombolysis
  • suction embolectomy
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140
Q

what is nonocclusive mesenteric ischemia (NOMI)?

A

mesenteric A –> mult branches –> spasm & narrow –> “intestinal necrosis w patent arterial tree”

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141
Q

nonocclusive mesenteric ischemia (NOMI) –> prognosis?

A

highly lethal (70-100% mortality)

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142
Q

nonocclusive mesenteric ischemia (NOMI) –> tx?

A

vasodilator (papaverine) –> direct art infuse

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143
Q

chronic mesenteric ischemia –> MCC?

A

atherosclerosis

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144
Q

chronic mesenteric ischemia –> how many mesenteric A affected?

A

at least 2 out of 3

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145
Q

chronic mesenteric ischemia –> tx?

A

angioplasty & stent

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146
Q

upper GI bleed –> best initial eval?

A

endoscopy

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147
Q

lower GI bleed –> hemodynamically stable –> best initial eval? why?

A

localize bleed:

  • mesenteric CT angio
  • nuc med tagged RBC scan

more sensitive than IR

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148
Q

GI bleed –> detectable bleeding rate?

  • tagged RBC scan
  • CTA
  • IR angiography
A
  • tagged RBC scan: 0.2-0.4 ml/min
    CTA: 0.35
  • IR angiography: 0.5-1.0
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149
Q

upper GI bleed –> IR –> no visualized extravasation –> next step?

A

empiric –> embo L gastric A

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150
Q

low GI bleed –> active –> alt IR tx?

A

vasopressin (antidiuretic hormone) –> intra-art infuse

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151
Q

low GI bleed –> vasopressin (antidiuretic hormone) –> pro vs con?

A
  • useful if bleed from antimesenteric vessels

- stop infuse –> very high rebleed rate

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152
Q

low GI bleed –> vasopressin (antidiuretic hormone) –> AE? (3)

A
  • arrhythmia
  • pulm edema
  • HTN
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153
Q

low GI bleed –> vasopressin (antidiuretic hormone) –> how long can infuse? why?

A

24hr

tachyphylaxis (lack of further response)

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154
Q

what is angiodysplasia? clinical sig?

A

acquired vasc anomaly –> chronic intermittent LGI bleed

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155
Q

angiodysplasia –> MC location? (2)

A

R colon/cecum

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156
Q

angiodysplasia –> IR appearance?

A

tangle of vessels –> antimesenteric draining vein –> early fill –> parallel A & V opacify simult –> “tram track” appearance

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157
Q

angiodysplasia –> tx?

A

endoscopy:
- electrocoag
- laser therapy
- other

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158
Q

older adult –> MCC LGI bleed?

A

diverticula

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159
Q

differentiate: atherosclerosis –> renal artery stenosis –> tx –> angioplasty + stent vs angioplasty only –> outcome?

A

angioplasty + stent –> greater long-term patency

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160
Q

what is fibromuscular dysplasia? MC location?

A

idiopathic –> vasc dz –> renal & carotid A

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161
Q

fibromuscular dysplasia –> epidemiology?

A

young & middle age F

162
Q

differentiate: atherosclerotic renal A stenosis vs fibromuscular dysplasia –> involved portion of renal A?

A

atherosclerosis –> ostia of renal A

FMD –> mid-distal 1/3

163
Q

fibromuscular dysplasia –> MC subtype? less common subtype?

A

80% –> medial fibroplasia subtype

intimal fibroplasia

164
Q

fibromuscular dysplasia –> medial fibroplasia subtype –> classic IR appearance?

A

“string of pearls/beads”

165
Q

fibromuscular dysplasia –> intimal fibroplasia subtype –> IR appearance?

A

smooth stenosis

166
Q

fibromuscular dysplasia –> intimal fibroplasia subtype –> epidemiology?

167
Q

fibromuscular dysplasia –> tx? how well does it work?

A

angioplasty only –> 9% improved BP ctrl –> high clinical success rate

168
Q

fibromuscular dysplasia –> angioplasty –> restenosis –> common or uncommon?

A

common –> 10-15%

169
Q

fibromuscular dysplasia –> stent –> recommend or not recommend? why?

A

not recommend:

  • complicate retx w angioplasty
  • intimal hyperplasia –> in-stent stenosis
170
Q

child –> renal A stenosis –> etiology? (1)

A

neurofibromatosis

171
Q

RCC –> classic IR appearance?

A

“bizarre neovascularity”

172
Q

CT –> RCC –> ddx? (1)

A

oncocytoma

173
Q

oncocytoma –> classic IR appearance?

A
  • “spokewheel” appearance –> peritumoral halo

- no bizarre neoplastic vessels

174
Q

what is renal angiomyolipoma?

A

hypervasc hamartoma –> blood vessels + smooth muscle + fat

175
Q

CT –> renal angiomyolipoma –> how dx?

A

macroscopic fat

176
Q

renal angiomyolipoma –> IR appearance?

A
  • tortuous feeding A –> parenchymal phase –> sunburst appearance
  • occasional –> small aneurysm
177
Q

renal angiomyolipoma –> inc risk of hemorrhage –> what size?

178
Q

renal angiomyolipoma –> can demonstrate AV shunting –> T/F?

179
Q

RCC –> can demonstrate AV shunting –> T/F?

180
Q

IR angio –> renal mass –> next step? why?

A

CT –> differentiate RCC vs AML

181
Q

horseshoe kidney –> inc risk of traumatic injury –> why?

A
  • not protected by inf ribs

- may be compresses against spine

182
Q

renal trauma –> 3 types?

A
  • # 1 blunt
  • penetrating
  • iatrogenic
183
Q

trauma –> kidney –> AAST classification? tx?

A
  • grade I-III: nonexpanding hematoma/parenchymal lac, no collecting system injury –> conservative
  • IV: deep parenchymal lac –> extend to collecting system
  • V: shattered kidney –> renal hilum avulsion –> surg
184
Q

renal trauma –> injury to renal A/V –> which AAST grade?

185
Q

renal trauma –> endovascular tx –> indication? (3)

A
  • active extrav
  • dissection
  • pseudoaneurysm
186
Q

renal AV fistula –> etiology?

A

acquired:
- trauma
- renal bx

187
Q

renal AV fistula –> clinical presentation? (4)

A
  • # 1 asympt
  • hematuria
  • high output heart fail
  • spont retroperitoneal hemorrhage
188
Q

median arcuate lig synd –> epidemiology?

A

young thin F

189
Q

median arcuate lig synd –> clinical presentation? (2)

A
  • # 1 asympt

- crampy abd pain

190
Q

median arcuate lig synd –> tx?

A

surg –> release median arcuate lig –> enlrg diaphragmatic hiatus

191
Q

what is SMA synd (Wilkie synd)?

A

aorta & SMA –> compress duodenum

192
Q

SMA synd (Wilkie synd) –> epidemiology? (3)

A
  • child
  • burn victim
  • weight loss
193
Q

what is nutcracker synd?

A

aorta & SMA –> compress L renal V

194
Q

what is posterior nutcracker synd?

A

aorta & vertebral body –> compress retroaortic/circumaortic renal V

195
Q

nutcracker synd –> ssx? (5)

A
  • pain
  • hematuria
  • orthostatic proteinuria
  • pelvic congestion
  • varicocele
196
Q

nutcracker synd –> prognosis?

A

resolve w/in 2 yr

197
Q

what is May-Thurner?

A

R common iliac A –> compress L common iliac V –> venous thrombus

198
Q

May-Thurner –> tx?

A

1) endovascular thrombolysis

2) stent

199
Q

how to measure wedged hepatic vein pressure?

A

int jug V catheter –> equal portal V pressure

200
Q

why not measure direct hepatic V pressure?

A

require traverse hepatic parenchyma –> invasive & impractical

201
Q

what is portosystemic gradient (corrected sinusoidal pressure)? formula?

A

actual sinusoidal resistance to portal flow

wedged hepatic V pressure) - (free hep V pressure

202
Q

portal HTN –> definition in portosystemic gradient measuremt?

203
Q

portal HTN –> collateral pathway –> esophageal varices

A

coronary A –> azygos/hemiazygos V

204
Q

portal HTN –> collateral pathway –> gastric varices

A

splenic V –> azygos V

205
Q

portal HTN –> collateral pathway –> splenorenal shunt

A

splenic/short gastric –> L adrenal/inf phrenic –> L renal V

206
Q

portal HTN –> collateral pathway –> mesenteric varices

A

SMV/IMV –> iliac V

207
Q

portal HTN –> collateral pathway –> caput medusa

A

umbilical V –> epigastric V

208
Q

portal HTN –> collateral pathway –> hemorrhoids

A

IMV –> inf hemorrhoidal V

209
Q

transjug intrahep portosystemic shunt (TIPS) –> connect what & what? effect?

A

portal V & R hep V –> lower elevated portal pressure

210
Q

transjug intrahep portosystemic shunt (TIPS) –> indication? (3)

A
  • # 1 variceal hemorrhage –> can’t ctrl endoscopically
  • refractory ascites
  • Budd-Chiari (hep V thrombosis)
211
Q

TIPS –> pre-procedure –> assess hep dysfx –> classification system? (2)

A
  • Child-Pugh

- model for end-stage liver dz (MELD) score

212
Q

Child-Pugh classification –> looks at what factors? (5)

A
  • INR
  • bilirubin
  • albumin
  • ascites
  • hep encephalopathy
213
Q

model for end-stage liver dz (MELD) score –> looks at what lab values? (3)

A
  • INR
  • bilirubin
  • creatinine
214
Q

model for end-stage liver dz (MELD) score –> higher score –> indicates what?

A

higher post-TIPS mortality

215
Q

TIPS –> absolute contraindications? (3)

A
  • R heart fail (worsened by TIPS)
  • severe active hep fail (worsen liver fx)
  • severe hep encephalopathy
216
Q

TIPS –> pre-procedure –> need to assess portal V for what?

A

cross-sectional or US –> portal V –> patent

217
Q

TIPS –> covered or uncovered stent?

A

covered –> uss self-expanding

218
Q

TIPS –> portosystemic gradient reduce –> goal?

219
Q

TIPS –> cannulate R hep V –> next step?

A

wedged balloon occlusion venography –> retrograde opacify portal V

220
Q

TIPS –> wedged balloon occlusion venography –> preferred contrast?

A

CO2 –> less viscous than iodinated contrast –> easily pass thru hep sinusoids

221
Q

TIPS –> stent-graft placed –> completion portal venogram performed –> next step?

A

embolize varices

222
Q

IVC filter –> indication? (3)

A
  • DVT + anticoag CI
  • anticoag –> recurrent PE
  • anticoag –> high risk of DVT/PE (ie multi-trauma)
223
Q

IVC filter –> MC comp? 2nd MC?

A
  • # 1 access site thrombosis

- #2 IVC thrombosis

224
Q

duplicated IVC –> IVC filter –> general procedure? (2)

A
  • above IVC confluence –> 1 IVC filter

- each IVC –> IVC filter

225
Q

duplicated IVC –> clue on initial cavography?

A

injection –> contralat side –> absence of iliac V influx

226
Q

IVC filter –> “bird’s nest” type –> for IVC diameter of?

227
Q

IVC filter: IVC >40mm –> general procedure?

A

IVC filter –> each common iliac V

228
Q

what is circumaortic L renal V?

A

L renal V –> 2 componts –> ant & post to aorta

229
Q

what is retroaortic L renal V?

A

single L renal V –> post to aorta

230
Q

what is interruption of IVC w azygos continuation?

A

lower IVC –> azygos/hemiazygos V –> thorax –> RA

231
Q

interruption of IVC w azygos continuation –> assoc condition? (2)

A
  • polysplenia

- congenital heart dz

232
Q

interruption of IVC w azygos continuation –> embryology?

A

R subcardinal V –> fail to join –> intrahep venous complex

233
Q

what is varicocele?

A

pampiniform venous plexus –> dilation

234
Q

1ary varicocele –> MOA?

A

prox gonadal V –> absent/incompetent valves –> venous reflu

235
Q

2ary varicocele –> MOA?

A

mass –> obstruct venous return

236
Q

1ary varicocele –> can cause infertility –> T/F?

237
Q

solitary R varicocele –> next step?

A

eval for obstructing retroperitoneal mass

238
Q

varicocele –> US appearance?

A

> 2mm dilated venous plexus –> “bag of worms” appearance –> worse w Valsalva

239
Q

varicocele –> tx?

A

gonadal V:

  • coil embo
  • surg ligate
240
Q

perc transhep cholangiography (PTC) –> indication? (4)

A
  • relieve biliary obstruction
  • ductal injury –> biliary diversion
  • trt biliary calculi
  • adjunctive pre-surg tx prior to biliary anastomosis
241
Q

perc transhep cholangiography (PTC) –> prophylactic abx required –> T/F? why?

A

T

biliary stasis –> risk of bact overgrowth

242
Q

perc transhep cholangiography (PTC) –> prophylactic abx?

A

levofloxacin (gram neg coverage)

243
Q

rib –> neurovasc bundle –> location –> sup or inf ribs?

244
Q

perc transhep cholangiography (PTC) –> R biliary tree –> how to access?

A

R midaxillary line –> 2 puncture approach

245
Q

perc transhep cholangiography (PTC) –> L biliary tree –> how to access?

A

L subxiphoid approach

246
Q

perc transhep cholangiography (PTC) –> biliary drain placed –> ok to forward flush? ok to aspirate?

A

Ok to forward flush

NEVER aspirate: aspirate bowel contents into biliary system –> cholangitis

247
Q

differentiate: biliary stent –> metal vs plastic?

  • placemt technique?
  • removable?
  • how long last?
A

metal:
- IR place
- can’t be removed
- avg patency of 6-8mo

plastic:
- endoscopy
- can be exchanged regularly

248
Q

metal biliary stent –> indication?

A

life expectancy –> <6mo –> biliary stricture

249
Q

biliary stent placement –> alternative?

A

int/ext biliary drain

250
Q

perc biliary drainage –> comp? (5)

A
  • sepsis
  • hemorrhage
  • bile leak
  • arterial-biliary fistula –> hemobilia
  • abscess
251
Q

perc transhep cholangiography (PTC) –> relative CI? (2) how to bypass these CI?

A
  • intrahep tumor –> direct access an accessible bile duct

- ascites –> therapeutic paracentesis before procedure

252
Q

bile duct injury –> MCC? less common cause?

A
  • # 1 lap chole –> iatrogenic injury

- orthotopic liver transplant

253
Q

bile duct injury –> tx?

A

biliary diversion –> drainage bag

allow leak to heal

254
Q

what is sclerosing cholangitis?

A

chronic –> inflamm & fibrose –> intra & extra-hep bile duct –> multifocal stricture

255
Q

sclerosing cholangitis –> clinical presentation? (3)

A
  • obstructive jaundice
  • malaise
  • abd pain
256
Q

sclerosing cholangitis –> assoc condition?

A

ulcerative colitis

257
Q

sclerosing cholangitis –> natural progression of dz?

A

biliary cirrhosis

258
Q

sclerosing cholangitis –> inc risk of what malig?

A

cholangioCA

259
Q

sclerosing cholangitis –> tx?

260
Q

cholangiogram –> multifocal biliary stricture –> ddx? (5)

A
  • sclerosing cholangitis
  • 1ary biliary cirrhosis
  • multifocal cholangioCA
  • chronic bact cholangitis
  • AIDS cholangitis
261
Q

unilat biliary obstruction –> cause? (2)

A
  • mets

- 1ary biliary malig

262
Q

hilar biliary obstruction –> cause? (1)

A

hilar cholangioCA (Klatskin tumor)

263
Q

perc GB drainage (cholecystostomy) –> indication?

A

acute cholecystitis –> not surg candidate

264
Q

cholecystostomy –> cures calculous cholecystitis? acalculous?

A
  • temporary tx for calculous cholecystitis before cholecystectomy
  • can cure acalculous cholecystitis
265
Q

cholecystostomy –> prophylactic abx required?

266
Q

cholecystostomy –> 2 percutaneous approaches? MC approach?

A
  • # 1 transhep

- transperitoneal

267
Q

cholecystostomy –> transhep approach –> pro vs con?

A
  • inc risk liver lac

- dec risk peritoneal bile leak

268
Q

cholecystostomy –> transhep approach –> gen procedure?

A

midaxillary line –> intercostal/subcostal –> US –> toward GB fossa bare area

269
Q

cholecystostomy –> transperitoneal approach –> pro vs con?

A
  • dec risk liver damage
  • inc risk peritoneal bile leak
  • penetrate GB fundus (most mobile portion)
270
Q

cholecystostomy –> drainage tube can be removed –> criteria? (3)

A
  • 6wk –> allow fibrous tract form
  • pt improved
  • repeat cholangiogram –> cystic & common bile duct –> patent
271
Q

cholecystostomy –> risk if drainage tube remv before 6wk?

A

bile peritonitis

272
Q

perc nephrostomy (PCN) –> MC indication? emergent indication? less common indication?

A
  • # 1 stone/malig/stricture –> kidney obstructed –> urinary diversion
  • emergent –> pyonephrosis
  • can’t place retrograde ureteral stent –> place anterograde
273
Q

kidney –> what is zone of Brodel?

A

kidney –> plane bw ventral & dorsal renal A branches –> relatively avascular zone

274
Q

perc nephrostomy (PCN) –> optimal renal entry site?

A

postlat kidney –> zone of Brodel –> post calyx

275
Q

perc nephrostomy (PCN) –> MC comp? (2)

A
  • bleed

- infx

276
Q

perc nephrostomy (PCN) –> pre-existing infx –> comp?

277
Q

gastrostomy –> MC indication? less common indication?

A

1 dz:

  • esophageal
  • head/neck
  • neurologic

less common –> long term bowel decompress:

  • malig bowel obstruct
  • prolonged ileus
278
Q

gastrostomy –> absolute CI? (3)

A
  • lack of approp window (ie. colonic interposition)
  • extensive gastric varices
  • uncorrectable coagulopathy
279
Q

gastrostomy –> general procedure?

A

1) NG tube –> insufflate stomach
2) fluoro –> T-fastener gastropexy clips –> pexy ant gastic wall to ant abd wall
3) contrast into stomach –> confirm intra-gastric position
4) definitive gastrostomy puncture –> serial dilate

280
Q

gastrostomy –> when can be used after placemt?

A

24hr eval for peritoneal signs

281
Q

gastrostomy –> how long to form mature transperitoneal tract?

A

at least 1mo

282
Q

common femoral A –> branches? (3)

A
  • deep femoral
  • superficial circumflex iliac
  • superficial femoral
283
Q

superficial femoral A –> become popliteal –> at what landmark?

A

adductor hiatus

284
Q

popliteal A –> branches? (3) which is most medial? most lateral?

A

medial –> lateral:

  • post tibial
  • peroneal
  • ant tibial
285
Q

post tibial A –> branch?

286
Q

ant tibial A –> branch?

A

dorsalis pedis

287
Q

what is Leriche synd?

A

chronic atherosclerosis –> distal abd aorta –> occlude

288
Q

Leriche synd –> synd? (4)

A
  • impotence
  • buttock claudication
  • absent femoral pulse
  • cold LE
289
Q

Leriche synd –> over time –> aorta –> extensive collaterals –> ext iliac A –> ant pathway?

A

thoracic aorta –> int thoracic A –> sup epigastric –> inf epigastric –> ext iliac

290
Q

Leriche synd –> over time –> aorta –> extensive collaterals –> ext iliac A –> middle pathway?

A

abd aorta –> SMA –> IMA –> sup rectal –> path of Winslow -> mid/inf rectal –> int iliac –> ant division –> ext iliac

291
Q

Leriche synd –> over time –> aorta –> extensive collaterals –> ext iliac A –> post pathway?

A

abd aorta –> intercostal & lumbar A –> sup gluteal & iliolumbar –> int iliac A post division –> deep circumflex iliac –> ext iliac

292
Q

atherosclerosis –> aortoiliac & infrainguinal occlusive dz –> TransAtlantic Inter-Society Consensus (TASC-II) classification? recommended tx?

A
  • type A: iliac –> <3cm –> concentric stenosis –> noncalcified –> perc transluminal angioplasty (PTA)
  • B/C: 3-10cm –> PTA or surg
  • D: >10cm –> surg
293
Q

atherosclerosis –> iliac –> angioplasty –> stent placemt –> indication? (2)

A
  • > 30% residual stenosis

- rest –> >10 mm Hg systolic pressure gradient

294
Q

iliac A aneurysm –> definition by measuremt?

295
Q

iliac A aneurysm –> tx at what size?

296
Q

iliac A aneurysm –> epidemiology?

297
Q

iliac A aneurysm –> assoc w AAA –> T/F?

298
Q

iliac A aneurysm –> MC RF? another RF?

A
  • # 1 atherosclerosis

- Marfan dz

299
Q

IR angio –> iliac A –> narrowing –> next step? why?

A

cross-sectional imaging:

  • atherosclerosis
  • iliac aneurysm –> intra-luminal thrombus
300
Q

iliac A aneurysm –> preferred tx?

A

endovasc stent-graft

301
Q

iliac A aneurysm –> surg –> indication?

A

aneurysm –> mass effect –> neuro/urologic ssx

302
Q

what is persistent sciatic A?

A

very rare –> vasc anomaly –> fetal sciatic A –> persist –> major blood supply to leg

303
Q

persistent sciatic A –> origin?

A

int iliac A –> usu inf gluteal A

304
Q

persistent sciatic A –> how far does it go down?

A

to popliteal A

305
Q

persistent sciatic A –> inc risk for what condition?

306
Q

trauma –> pelvic fx –> active pelvic bleeding –> next step?

A

IR angio –> ctrl bleed

307
Q

trauma –> active pelvic bleeding –> IR angio –> general procedure?

A

1) nonselective pelvic angio

2) selective bilat int iliac angio –> ant & post divisions

308
Q

trauma –> active pelvic bleeding –> IR angio –> embo site? embo material?

A

gelfoam –> nonselective –> int iliac –> entire ant or post division

309
Q

uterine A embo –> indication? (2)

A
  • uterine fibroids –> sympt

- postpartum hemorrhage

310
Q

uterine A embo –> embo material?

A

polyvinyl chloride particles

311
Q

uterine fibroids –> uterine A embo –> goal?

A
  • hypervasc fibroids –> hemorrhagic infarction

- endometrium/myometrium –> maintain adeq perfusion –> preserve futility

312
Q

uterine A embo –> serious comp? (3)

A
  • abscess
  • endometritis
  • non-target embo –> ovary –> necrosis –> premature menopause
313
Q

LE –> atherosclerosis –> stenosis –> MC location? (5)

A
  • common iliac
  • superficial femoral
  • popliteal
  • tibioperoneal trunk
  • tibial A origins
314
Q

atherosclerotic stenosis –> Doppler waveform?

A
  • normal: triphasic waveform
  • mod stenosis: biphasic
  • severe stenosis/occlusion: flat
315
Q

what is blue toe synd?

A

toe –> acute thromboembolism

316
Q

acute limb ischemia –> MC source of embolus?

A

LA –> thrombus

317
Q

acute limb ischemia (acute thromboembolic dz) –> IR angio appearance?

A

affected vessel –> acute cutoff & “meniscus” sign

318
Q

acute limb ischemia (acute thromboembolic dz) –> tx? (3)

A
  • surg –> embolectomy
  • surg –> bypass graft
  • endovasc –> thrombolysis
319
Q

acute limb ischemia (acute thromboembolic dz) –> endovasc thrombolysis –> general procedure?

A

1) hydrophilic wire –> cross lesion
2) multi-sidehole infusion catheter –> place across thrombus
3) ICU –> tPA for 48-72 hr
4) monitor hematocrit, fibrinogen

320
Q

acute limb ischemia (acute thromboembolic dz) –> endovasc thrombolysis –> fibrinogen level –> decrease tPA infusion? stop tPA?

A

fibrinogen:
- <150 –> dec tPA infusion
- <100 –> stop tPA

321
Q

popliteal A aneurysm –> size criteria?

322
Q

popliteal A aneurysm –> tx –> indication? (2)

A
  • sympt

- >2cm

323
Q

popliteal A aneurysm –> tx? (2)

A
  • endovasc –> stent-graft

- surg –> bypass

324
Q

popliteal A aneurysm –> assoc w other aneursyms –> T/F?

325
Q

what is Buerger dz?

A

occlusive vasculitis –> med & small vessel

326
Q

Buerger dz –> MC location? less common location?

A
  • # 1 LE

- hands

327
Q

Buerger dz –> epidemiology?

A

adult M –> smoke

328
Q

Buerger dz –> IR angio appearance?

A

leg:
- med/small A –> segmental stenosis
- vasa vasorum –> “corkscrew” collaterals

329
Q

Buerger dz –> tx?

A

smoke cessation

330
Q

what is popliteal entrapmt synd?

A

calf muscle or fibrous band –> compress popliteal A

331
Q

popliteal entrapmt synd –> MC involved muscle?

A

aberrant med head of gastrocnemius

332
Q

popliteal entrapmt synd –> epidemiology? clinical presentation?

A

healthy young M –> exercise-induced claudication

333
Q

popliteal entrapmt synd –> can be bilat –> T/F?

334
Q

what is cystic adventitial dz?

A

popliteal A –> adventitia –> mucoid cyst –> compress lumen

335
Q

cystic adventitial dz –> epidemiology? clinical presentation?

A

mid age M –> distal claudication

336
Q

cystic adventitial dz –> best imaging modality?

337
Q

cystic adventitial dz –> tx? (2)

A

surg:
- resect cyst
- bypass

338
Q

axillary A –> landmarks?

A
  • rib 1 –> lat margin

- teres major –> inf margin

339
Q

thoracic outlet synd –> clinical presentation?

A

UE:

  • paresthesia
  • pain
  • numb
  • cool
340
Q

interscalene triangle –> contains what struct? (2)

A
  • brachial plexus

- subclavian A

341
Q

thoracic outlet synd –> MC type?

A

neurogenic

342
Q

subclavian A compression –> clinical presentation? what worsens ssx?

A

hand/finger:

  • pain
  • numb/parethesia
  • cool
  • Raynaud phenomenon

arm abduct

343
Q

what is Adson’s maneuver?

A

test for subclavian A compress at thoracic outlet:

1) palpate radial pulse
2) pt inhale –> turn head contralat
3) radial pulse reduce

344
Q

subclavian A compression –> MC etiology?

A

mechanical compress:

  • # 1 cervical rib
  • access scalene muscle
  • ant scalene enlrg
  • well-developed muscles
345
Q

subclavian A compression –> potential comp?

A

arterial:
- thrombus
- aneurysm
- distal embolus

346
Q

subclavian A compression –> preferred tx?

A

surg –> decompress thoracic outlet

347
Q

what is Paget-Schroetter synd?

A

thoracic outlet –> subclavian V –> compress & thrombosis

348
Q

Paget-Schroetter synd –> epidemiology?

A

young M muscular

349
Q

Paget-Schroetter synd –> clinical presentation?

A

UE –> pain/swell –> worse w effort

350
Q

Paget-Schroetter synd –> usu unilat or bilat?

351
Q

Paget-Schroetter synd –> IR venography –> general procedure?

A

bilat:
- neutral position
- abduct

352
Q

Paget-Schroetter synd –> tx?

A

1) thrombolysis

2) surg –> thoracic outlet decompress

353
Q

what is subclavian steal synd?

A

1) subclavian A –> prox –> stenosis/occlusion

2) vertebral A –> retrograde flow –> distal subclavian A

354
Q

subclavian steal synd –> clinical presentation?

A

arm exercise:

  • vertebrobasilar insuff
  • syncope
355
Q

subclavian steal synd –> best imaging modality for dx?

356
Q

subclavian steal synd –> tx?

A
  • surg –> bypass

- angioplasty

357
Q

dialysis AV fistula –> % fail to mature?

358
Q

dialysis AV fistula –> when “mature”?

A

several mo –> V enlrg –> allow dialysis high flow rate

359
Q

dialysis AV fistula –> 2 MC location?

A
  • radial A –> cephalic V at wrist

- brachial A –> variable V at forearm

360
Q

dialysis AV fistula –> late failure –> 2 MCC?

A

V –> stenosis:

  • outflow
  • perianastomotic
361
Q

dialysis –> what is polytetrafluoroethylene (PTFE) graft?

A

synthetic graft material –> bridge bw A & V

362
Q

differentiate: AV fistula vs graft

  • start use
  • patency at 2yr
  • flow rate to remain patent
A

fistula:
- start use later
- 2yr –> 85% patency
- remain patent at low flow rate

graft:
- start use sooner
- 2yr –> 50% patency
- require higher flow rate to remain patent

363
Q

dialysis –> graft –> fail –> 2 MCC?

A

V stenosis:

  • anastomosis
  • outflow
364
Q

AV fistula –> pulsatile, no thrill –> dx?

A

venous outflow obstruct

365
Q

AV fistula –> dialysis –> high access recirculation –> dx?

A

venous outflow stenosis

366
Q

AV fistula –> weak pulse, poor thrill –> dx?

A

arterial inflow stenosis

367
Q

AV fistula –> pulseless –> dx?

A

thrombosed fistula

368
Q

dialysis site –> venous stenosis –> tx?

A

angioplasty –> high pressure or cutting balloon

369
Q

dialysis site –> venous stenosis –> angioplasty –> goal? (2)

A
  • restore palpable thrill & pulse

- <0.4 venous to brachial A pressure ratio

370
Q

dialysis site –> thrombosis –> MCC?

A

venous stenosis

371
Q

what is hypothenar hammer synd?

A

ulnar A –> cross hamate bone –> injury

372
Q

hypothenar hammer synd –> MOA?

A

chronic repetitive trauma –> ulnar A:

  • intimal injury
  • thrombus
  • aneurysm
  • pseudoaneurysm
373
Q

hypothenar hammer synd –> epidemiology? clinical presentation?

A

jackhammer operator –> 4th & 5th digit –> ischemia

374
Q

hypothenar hammer synd –> IR appearance?

A
  • ulnar A –> occlusion

- distal embolic occlusions –> usu 4th & 5th digits

375
Q

hypothenar hammer synd –> tx?

376
Q

Raynaud dz –> assoc condition?

A

connective tissue disorders:

- scleroderma

377
Q

UE –> thromboembolic dz –> MC source? less common?

A
  • # 1 cardiac embolus

- subclavian A aneurysm

378
Q

arc of Riolan –> anasmotosis what to what?

A
  • SMA –> middle colic

- IMA –> L colic

379
Q

leg –> most medial A?

380
Q

pancreatic duodenal arcade –> dilated & pseudoaneurysm –> dx?

A

celiac A stenosis

381
Q

PPD pos –> hemoptysis –> bronchial A angio –> neg –> next step? dx?

A

pulm A angio –> rasmussen aneurysm –> coil embo

382
Q

HD AV fistula vs graft –> flow rate –> what is “slow” flow?

A
  • fistula –> <500 ml/min

- graft –> <600 ml/min

383
Q

megacava –> size criteria?

384
Q

aortic arch –> angle of view?

385
Q

common femoral bifurcation –> angle of view?

A

ipsilat

R –> RAO

386
Q

iliac bifurcation –> angle of view?

A

contralat

R –> LAO

387
Q

hemoptysis –> bronchial A angio –> embo material?

A

lrg particle

NEVER coil!

388
Q

injection rate:

  • renal A
  • IVC
  • aorta
A
  • renal A: 5cc/sec for 10ml
  • IVC: 15cc/sec for 3ml
  • aorta: 30cc/sec for 30ml
389
Q

percutaneous biliary drainage –> indication? (3)

A
  • cholangitis
  • pruritis
  • hyperbili + need to lower for ctx

obstruction alone is NOT an indication!

390
Q

dialysis acess –> normal flow rate?

A

800-1000 ml/min

391
Q

required margin for adequate tumor ablation?

392
Q

ablation type to avoid in liver? why?

A

cryoablation –> cryoshock

393
Q

pseudoaneurysm –> thrombin –> what concentration to use?

A

1000 IU/ml

394
Q

renal collecting system –> obstruct –> place perc nephrostomy –> pt dev rigors –> tx?

A

demerol (meperidine)

395
Q

eval required prior to pulm arteriography? why?

A

EKG –> look for LBBB

catheter into R heart –> can induce RBBB ==> RBBB + LBBB ==> complete heart block

396
Q

Budd-Chiari –> tx?

A

TIPS or DIPS

397
Q

central venous line –> malpositioned in artery –> next step?

A

do NOT remv!

surgical repair or endovasc stent-graft placement

398
Q

components of MELD score?

A
  • Cr
  • INR
  • bili
399
Q

what MELD score? –> TIPS –> high risk death?

400
Q

normal TIPS velocity?

A

90-190 cm/s

401
Q

Yttrium-90 –> what type of emission?

A

Beta emission

402
Q

hemoptysis –> not treat –> cause of death? (2)

A
  • resp compromise

- asphyxiation

CORE (33 decks)

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