Nov24 M3-Diseases of the Peripheral Vasculature

Question 1

aneurysm def

Answer 1

increase in vessel size by 50%

Question 2

saccular true aneurysm

Answer 2

outpoutching of a portion

Question 3

fusiform true aneurysm

Answer 3

symmetrical dilation

Question 4

pseudoaneurysm

Answer 4

rupture and blood accum in adventita

Question 5

aneurysm presentation

Answer 5

found incidentally usually.

compression of adjacent structure (recurrent laryngeal nerve, esophagus, bronchus)

Question 6

**how to manage aneurysm

Answer 6

optimize risk factors (smoking, htn, dyslipidemia)
meds in Marfans
surgery

Question 7

dissection def

Answer 7

blood from lumen passes through tear in intima and goes in media and spreads

Question 8

acute intramural hematoma

Answer 8

hemorrhage in wall without intima tear (vasa vasorum)

Question 9

penetrating atherosclerotic ulcer def

Answer 9

erosion of plaque in aortic wall .

sharp calcifications cause bleed in media

Question 10

aortic rupture def

Answer 10

rupture of aorta bc of penetrating ats ulcer, acute hematoma, dissection (usually dissection)

Question 11

most dissections where

Answer 11

ascending aorta

Question 12

type A vs B dissection and proportion

Answer 12

67% type A: ascending + arch

33% type B: descending

Question 13

dissection symptom

Answer 13

tearing sensation in the back

Question 14

diagnose dissection how

Answer 14

CT contrast, transesophageal echo, angiography

Question 15

treatment of dissection type A vs B

Answer 15

A and B: beta blockers and nitropusside to reduce contractility + surgery
B: meds only if uncomplicated

Question 16

peripheral arterial disease main cause + risk factors

Answer 16

ats. same risk factors as CAD

Question 17

claudication def

Answer 17

angina in periphery

Question 18

signs of claudication

Answer 18

discomfort, bruit at stenosis site, cyanosis

Question 19

foot ulcers how form

Answer 19

areas of increased pressure, areas of poor blood supply

Question 20

ankle-brachial index use

Answer 20

to diagnose PAD. 1 or more normal. less 0.9 abnormal. less 0.5 severe

Question 21

treatment of PAD

Answer 21

risk factors, antiplatelet anticoag, angioplasty or CABG

Question 22

acute arterial occlusion def

Answer 22

like MI in periphery

Question 23

AAO 6 symptoms

Answer 23

6 Ps: pain pallor paralysis parasthesia, pulselessness, poikilothermia (cold)

Question 24

AAO treatment

Answer 24

thrombolysis + anticoag

Question 25

origins of arterial emboli

Answer 25

cardiac, arterial and venous (if ASD)

Question 26

vasculitic syndromes

Answer 26

immune rx to vessel wall

Question 27

3 vasculitic syndromes

Answer 27

Takayasu arteritis (aorta and major branches)
Giant cell arteritis (medium to large veins, cranial vesels
thromboangiitis obliterans (inflam of small arteries) = Buerger disease

Question 28

Raynaud’s phenomenon def

Answer 28

vasospastic disease of digital arteries: fingers turn white to blue to red in response to cold or stress

Question 29

primary vs secondary Raynaud’s

Answer 29

primary: benign, in women

secondary, CT disease and arterial occlusive disease

Question 30

Raynaud’s treatment

Answer 30

avoid cold

maybe CCB, alpha blocker, PDE-5 inhibitors