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RRC Cards > IR > Flashcards

IR Flashcards

1
Q

phlegmasia cerulea dolens

A

uncommon complication of DVT
extensive thrombotic occlusion of major & collateral veins

triad:
acute limb swelling
cyanosis
severe acute pain

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2
Q

pheochromocytoma biopsy prophylaxis

A

phenoxybenzamine (alpha blocker) to prevent catecholamine release & hypertensive crisis

α-blockade before β-blockade is essential
-lone β-blockade is dangerous: allows unopposed α-receptor vasoconstriction

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3
Q

why is gonadal vein embolization performed at multiple levels in pelvic congestion syndrome?

A

to prevent collateral pathway formation

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4
Q

treatment for pulmonary arteriovenous malformation

A

pulmonary artery coil embolization

particulate embolization is dangerous (non target embolization to brain, other organs)

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5
Q

medication, dose & route for reversing midazolam for moderate sedation

A

flumazenil, 0.2 mg IV

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6
Q

endoleak types

A

type I: leak at graft attachment site (prox=1a, dist=1b)
type II: aneurysm sac filling via branch vessel (MC IMA, lumbar a)
type III: leak through defect in graft
type IV: graft porosity
type V: endotension; continued expansion of sac w/o demonstrable leak on imaging

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7
Q

May-Thurner syndrome

A

chronic compression of LEFT common iliac VEIN (LCIV) against lumbar vertebrae by overlying RIGHT common iliac ARTERY (RCIA)

predisposes to DVT

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8
Q

Paget-Schroetter syndrome

A

thoracic outlet syndrome + venous thrombus in subclavian vein
“effort thrombosis”: assoc w athletes who raise arms a lot (weightlifters, pitchers)
tx: catheter directed lysis, surgical release

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9
Q

cisterna chyli

A

dilated inferior aspect of thoracic duct
formed by confluence of intestinal & lumbar lymphatic trunks
receives fatty chyle from intestines, drains superiorly through thoracic duct
posterior to abdominal aorta, between T12-L2 levels
does not cross midline

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10
Q

advantage of hemodialysis grafts over hemodialysis fistulas

A

grafts can be used sooner (2-3 weeks) than can fistulas (8-12 weeks)

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11
Q

vertebroplasty contraindications

A 
asymptomatic compression fractures
chronic fractures
prophylactic vertebroplasty for osteopenic patients WITHOUT acute fractures
uncorrectable coagulopathy
systemic infection with elevated WBC
significant spinal canal compromise
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12
Q

causes of blocked nephrostomy tube

A

tube problem:

  • tube blocked (flush & aspirate: blood, debris, etc)
  • tube dislodged (no longer in collecting system, “drained well then had some blood then tube stopped draining entirely”)

kidney problem:
- AKI (renal or pre-renal)

next step: neph tube check in IR, less commonly CT

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13
Q

major arteries in CT angio runoff

A

common iliac
int iliac a. (post): pelvic & gluteal arteries
ext iliac a. (ant): lat circumflex iliac, inf epigastric
common femoral a. (begins at inf epigastric a., divides into profounda femoris & SFA)
profounda femoris (perforated branches to thigh)
superficial femoral a. (terminates at adductor hiatus)
popliteal a. (terminates at anterior tibial origin
3 primary arteries in calf (3 vessel runoff):
- ant tibial (lateral), post tibial (medial), peroneal (middle)
at foot: ant tibial (➡ dorsalis pedis), post tibial (➡ plantar a.)

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14
Q

resistive indices of non-transplant renal artery Doppler

A

RIs typically between 0.5-0.7
higher RI: downstream problem (kidney or beyond)
lower RI: upstream problem (typical renal artery stenosis)

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15
Q

post op complications of liver abscess drainage

A 
Hepatic artery pseudoaneursym, 
biliary injury, 
portal vein injury, 
post procedure sepsis, 
pneumothorax
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16
Q

needle used for perc gastrostomy/gastrojejunostomy

A

gastropexy
T fastener
anchor suture

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17
Q

contraindications for perc gastrostomy/gastrojejunostomy

A 
Ascites
gastric tumour/mass
peritoneal disease
prior gastric surgery
large hiatus hernia
coagulopathy
varices
high transverse colon
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18
Q

how to elicit popliteal artery entrapment syndrome?

what muscle?

A

plantar flex

medial head gastroc

19
Q

Measurements by outer vs inner diameter

A

OUTER:

  • puncture needle
  • catheter
  • dilator

INNER:
- sheath

20
Q

3 Fr = ____ mm?

A

3 Fr = 1 mm

Diameter in mm = Fr / 3

Sheath outer layers = 1 Fr x 2 (6Fr sheath is 8Fr hole in skin)

21
Q

Wire thickness measured in ?

Wire length measured in?

A

Thickness in inches

  • 0.039 inch = 1 mm
  • 0.035 inch wire conventional

Length in cm

22
Q

Needle size conversions: 16G, 20G

What G for 0.035 inch guidewire?

A 
16G = 1.65 mm = 5 Fr catheter
20G = 0.97 = 3Fr

19 G for 0.035 *standard
18 G for 0.038

23
Q

Most common cause of upper G.I. bleed?

Duodenal ulcer bleeding vessel?

A

85% left gastric
If source cannot be identified, left Gastric can be taken down prophylactically

Ulcer - GDA

24
Q

Particle size for GI bleed

A

300-500 microns

Smaller = bowel infarct

25
Q

Drain sizes:

  • clear fluid
  • thin pus
  • thick pus
  • collection with debris
A
  • 6-8F clear fluid
  • 8-10 F thin pus
  • 10-12 F thick pus
  • 12F + Collection with debris
26
Q

Bronchial artery embolization choice

A 
Particles >325 micrometers 
NOT coils (likely rebleed & need access)
27
Q

Rasmussen aneurysm bleed tx choice

A

Coils

Exception in hemoptysis- bronch art = particles

28
Q

Air embolus

A

Left side down

Head down

29
Q

Max lido dosing

A

4-5 mg/kg
With epi 7 mg/kg

Most 1% plain epi 10 mg per 1 mL - max dose 0.5 mL/kg

30
Q

Ascending aorta calcifications

A

Takayasu

Syphilis

31
Q

Most common type FMD

Most common vessels

A

Medial

Renal, carotid, iliac

32
Q

Popliteal aneurysm % with AAA
AAA % with popliteal aneurysm
% popliteal aneurysm bilateral

A

30-50%
10%
50-70%

33
Q

Micro aneurysm formation kidneys

A
  • polyarteritis nodosa

- crystal meth

34
Q

Unilateral versus bilateral parvus tardus in carotids

A
  • unilateral = innominate

- bilateral = aortic stenosis

35
Q

Normal carotid:
Velocity
ICA/CCA
ICA end diastolic

A

<125 cm/s
<2
<40 cm/s

Less than 50% stenosis doesn’t affect peak systolic velocity

36
Q

What size do these fit into?

  1. 0.035 wire into what Fr
  2. 0.038 wire into what G
  3. 0.035
  4. 0.018
  5. 4 Fr into what size sheath?
A
  1. 4 Fr or larger
  2. 0.038 to 18 G
  3. 0.035 to 19 G
  4. 0.018 to 21 G
  5. 4 Fr to 4 Fr sheath or up
37
Q

Greater risk of dissection - short or long floppy tip?

A

Short floppy higher risk

38
Q

Ankle brachial index values

A 
1 normal no symptoms 
0.75-0.95 mild, mild claudication
0.5-0.75 moderate, claudication 
0.3-0.5 moderate-severe, severe claudication
<0.3 severe or critical, rest pain
39
Q

Portal HTN definition

A 
Portal vein >10 mmHg
Portosystemic gradient (PSG) >5 mmHg
40
Q

Yttrium 90

  1. Particle type
  2. Half life
  3. Max range
  4. Key points prior to using
A
  1. High energy beta (no gamma)
  2. T1/2 = 64 hours (94% delivered after 11 days, 4 t1/2)
  3. 1.1 cm
  4. MAA lung shunt: >30 Gy too much, embolise right gastric and GDA
41
Q

internal iliac artery branches

A

3 urinary: umbilical, superior vesical, inferior vesical
3 visceral: uterine, vaginal, middle rectal
3 parietal: obturator, internal pudendal, inferior gluteal

42
Q

external iliac artery branches

A

iliolumbar, lateral sacral, superior gluteal

43
Q

subclavian artery branches

A 
VIT CD
vertebral
internal thoracic
thyrocervical
costocervical
dorsal scapular

RRC Cards (17 decks)

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