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RCE Guidelines Studying > Laflamme- Chapter 8 (Peripheral Vascular Disease) > Flashcards

Laflamme- Chapter 8 (Peripheral Vascular Disease) Flashcards

1
Q

What is the definition of an aneurysm?

A
  • Diameter > 150% of normal for age/gender/BSA
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2
Q

What is the definition of a pseudo-aneurysm?

A

-Rupture of arterial wall contained by hematoma and adjacent tissues

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3
Q

What are 4 infectious causes of TAA?

A
  • Syphilis
  • HIV
  • Salmonella
  • Staphylococcus
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4
Q

Indication for TAA repair in degenerative dx?

A
  • 5.5 cm
  • more than 5mm/yr
  • Compressive symptoms
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5
Q

Repair for TAA if going for AVR?

A

-4.5 cm

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6
Q

3 indications for Aortic repair in BAV?

A
  • 5.5cm
  • > 5 cm if family history of dissection
  • > 5mm/ year
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7
Q

Aortic repair in patients with Marfans, Loeys Deitz and Turners?

A
  • 5 cm
  • 44mm or more
  • > 25mm/m2
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8
Q

Definition of large mediastinum on AP CXR?

A
  • > 8cm at the carina
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9
Q

Follow up by CTA for Dissection treated conservatively?

A

-1, 3, 6, 12, 18, 24 months

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10
Q

What are 3 indications to surgically repair type b dissection when initially managed conservatively?

A

> 55-60mm

> 4mm/year growth

Target organ ischemia or recurrent pain

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11
Q

Definition of AAA?

A

> 30 mm

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12
Q

6 RFs for AAA?

A
  • Age
  • Male
  • Smoking
  • COPD
  • HTN
  • Dyslipidemia
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13
Q

When to screen for AAA?

A

-Male aged 65-80 (updated)

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14
Q

Indications for AAA? (4)

A

> 55 mm

Symptoms

Progression > 10mm/yr

Infectious or inflammatory

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15
Q

Surveillance for AAA based on size?

A

30-39mm: q3 years

40-44mm: q2 years

> 45mm: q1 years

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16
Q

Name 4 genetic aortopathies and their genetic mutations

A

Marfan: FBN1 (AD)

LD: TGFBR1 (AD)

ED Type 4: COL3A1 (AD)

Turners 45XO

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17
Q

4 inflammatory causes of Aortopathy?

A
  • Takayasu’s
  • GCA
  • Bechets
  • Ank Spond
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18
Q

What is 5 year mortality for patients with PAD?

A

10-15%, equal risk to CAD

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19
Q

What is the Fontine classification for PAD?

A
  1. Asymptomatic
  2. Intermittent Claudication
  3. Rest pain
  4. Ulcer/Gangrene
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20
Q

Who should get an ABI? (4)

A

Suspected claudication

Poor wound healing

> 50 years + DM/Smoking

> 65 with intermediate FRS

21
Q

What is subclavian steal syndrome?

A

Claudication of the arm, reversal of flow of the vertebral artery or of a mammay bypass grafts to perfuse the arm

BP difference of 10 mmhg

22
Q

Why does Bilateral Renal Artery Stenosis result in flash pulmonary edema?

A

-Increased BP with salt and water retention in the absence of compensatory sodium excretion -> flash pulmonary edema

23
Q

5 reasons to investigate for RAS?

A

Onset of HTN < 30 or > 55

Severe or refractory HTN

Underlying atherosclerosis

Increase Cr > 30% with ACE/ARB

Recurrent flash pulmonary edema

24
Q

2 trials that support additional ECG monitoring beyond 24h for SCAF in TIA/Stroke?

A
  • Embrace

- Crystal-AF

25
Q

What is NNT for CEA in Symptomatic Carotid Artery Stenosis?

A

6

26
Q

Two class 1 indications for CEA in Carotid artery Stenosis? 1 class II?

A

Symptomatic 70-99% (1a), 50-69% (Ib)

Asymptomatic >70% (2a)

Within 14 days

27
Q

What is the pathology of HIT?

A

Antibodies directed against the neoantigens on proteins PF4 (Proteins released by activated platelets)

28
Q

What should severity and timing of HIT be?

A

> 50% of platelets or thrombosis beginning 5-10 days after the start of heparin

29
Q

What are the 4 components of the 4T score?

A

Thrombocytopenia (> 50% decrease in plt and keep > 20)

Timing (5-10 days post 1st exposure)

Thrombosis

Other causes (no other cause)

30
Q

Definition of Type 1 PHT?

A

mPAP > 20 mmhg

Wedge < 15 mmhg

WU > 3

31
Q

3 meds that cause PAH?

A
  • Anorectics
  • Fenfluramine
  • Dexfenfluramine
32
Q

5 systemic causes of PAH?

A

HIV

Collagen Diseases

Portal Htn

Congenital heart disease/shunt

Schistosomiasis

33
Q

3 classes of etiologies for Group 5?

A

Hematological diseases, Systemic diseases, Systemic diseases

34
Q

7 diagnostic work up for PHTn?

A
  • CXR
  • PFTs
  • Immunologic testing
  • CPAP
  • Right and Left heart cath
  • VQ scan
  • High resolution CT
35
Q

What is definition of positive vasoreactivity testing?

A

Absolute decrease of mPAP > 10mmhg (to mPAP < 40mmHg) in the absence of decreased CO

36
Q

Three drugs that can be used in for vasoreactivity testing?

A

Inhaled NO

Epoprostenol

Adneosine

37
Q

5 conservative managements for PH?

A

Rehabilitation

Avoid high altitude

Vaccination

Smoking cessation

Sodium restriction

38
Q

Name 9 PAH therapies?

A
  • Diuretics
  • CCBs
  • Prostanoids (Epoprostenol)
  • Selexipag
  • Endothelin Receptor Antagonist (Ambrisentan, Bosentan)
  • PDE5 inhibitor: Sildenafil, Tadalafil
  • Guanylase Cyclase stimulator: Riociguat
39
Q

what are 3 histopathologic processes for aortic generation?

A
  • Increase Metalloproteinases
  • Decreased elastic fibers
  • Increased proteoglycans
40
Q

What % of Turner’s syndrome have BAV? Aortic Coa?

A

BAV: 20%

CoA: 10%

41
Q

What are two criteria for critical limb ischemia?

A

-Ischemic pain at rest OR Ischemic lesion (ulcer, gangrene)

42
Q

What is one year mortality for someone presenting with one year mortality?

A

25%

43
Q

Name 5 mechanisms of stroke

A
  • ICH
  • SAH
  • Large vessel disease
  • Lacunar/Small vessel
  • Cardioembolic
44
Q

What is westermarks sign?

A

Segmental oligemia secondary to proximal artery occlusion

45
Q

What is Hampton hump?

A

Triangular hyperdensity adherent to the pleura secondary to pulmonary infarction

46
Q

When to go with Carotid Stenting instead of CEA?

A

-Focal lesion, Radiation therapy previous in area, high operative risk, obesity

47
Q

What is the only PH therapy that has survival benefit?

A

-Epoprostenol

48
Q

What are the main adverse effect of Endothelin antagonists?

A

-Liver injury

RCE Guidelines Studying (52 decks)

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