Peripheral Vascular Disease Flashcards
Syncope occurs with rapid arm flexion and extension in…
subclavian steal sdr.
A systemic illness with claudication, angina, TIAs and CVAs, visual disturbances and skin lesions resembling erythema nodosum or pyoderma gangrenosum is
Takayasu arteritis features or the pulseless dz
Treatment of Takayasu consists of … but in the acute phase … can be added.
high-dose steroids AND AND methotrexate
Typical features of … include “creepy-crawly” sensations, itchiness, pain, or paresthesias in the legs that occur primarily at rest and especially at night, motor restlessness, and urge to move the legs and resulting transient alleviation of sensations
Restless legs syndrome (RLS)
…(motor dz) can occur secondary to a number of disorders including iron deficiency, uremia, diabetes mellitus, rheumatic disease, and venous insufficiency.
Restless legs syndrome (RLS)
… is more effective then pentoxiphylline for the Rx of claudication.
Cilostazol (Pletal)
In an ischemic stroke, if TEE failed to find a source of emboli by day three, a… should be obtained.
MRA, CT angiography or catheterization angiography
The new duration for a TIA is now…, rarely more than an hour.
5-20 minutes
IV t-PA is of use only when given within… after the stroke onset.
three hours
If a stroke patient received t-PA, ASA administration should be delayed for at least…
24 hours.
t-PA is not indicated in patients younger than…
18 years.
HTN in… (disease) should not be treated unless the patient has another condition (AMI, CHF, aortic dissection, ARF) that necessitates lowering the BP.
ischemic stroke
In an ischemic stroke, if the non-invasive evaluation failed to find a source of emboli by day two, a… should be obtained.
TEE
A higher BP can be acceptable as long-term in a patient with ischemic stroke and…
high-grade intracranial artery stenosis.
… are zinc paste-impregnated bandages placed in patients with venous ulcers to reduce edema and encourage healing.
Unna boots
The first appropriate test for subarachnoid hemorrhage is a… .
noncontrast CT of the head
A negative noncontrast CT of the head in a patient with high pre-CT probability of subarachnoid hemorrhage has to be followed by … (test).
LP
An increase in serum creatinine of >20% after starting an ACEI is highly suggestive of…
RAS (renal artery stenosis)
An … sufferer can feel normal sensation in the hand, but believe that it is not part of their body and that they have no control over its movements. This disorder is best documented in cases where a person has had the two hemispheres of their brain surg
Alien Hand
… is the most sensitive test to diagnose necrotizing fasciitis.
MRI
In an ischemic stroke with accompanying HTN, BP correction by aggressive treatment in order to qualify for t-PA use is…
contraindicated.
All patients with TIA should undergo immediately… (test)
brain CT to r/o tumor or hemorrhage as the cause of neurological defect.
In PROGRESS, patients with recent… even when not hypertensive, benefited from an ACEI (perindopril) and indapamide (diuretic) having less strokes, AMI, or death.
stroke or TIA
… is an aneurysm of the pulmonary artery that slowly expands into an adjacent cavity because of inflammatory erosion of the external vessel wall until it bursts. There is some uncertainty about whether these aneurysms also can arise from bronchial arter
Rasmussen’s aneurysm
To qualify for the diagnosis of… dementia, CV dz has to be documented by signs and imaging and an onset at less than 3 months following a stroke or stroke-like course (abrupt onset or stepwise deterioration) have to be present.
vascular
The most common complication of giant cell arteritis is…
anterior ischemic optic neuropathy with permanent visual loss.
The therapy is recommended to be started in all Kawasaki disease children in the US within … days of illness.
7
Kawasaki is diagnosed most of the time before age …
5.
… (lifestyle change) has a protective effect against stroke (OR 0.3; 0.1-0.7 95%CI).
Regular moderate exercise
This toxic consumption causes a 50% increase in the risk of stroke than non-consumers…
alcohol.
Indications for introduction of… in acute stroke are: HTN encephalopathy, HTN cardiac or renal failure, aortic dissection and AMI; arbitrary, a SBP>200 or DBP>120.
anti-HTN therapy
The U.S. Preventive Services Task Force (USPSTF) now recommends screening for abdominal aortic aneurysm (AAA) in older men (age range, 65–75) who…
have ever smoked.
The strongest risk factor for aortic aneurysms is … with OR=5.6 according to ADAM study.
smoking
… (infection) causes aneurysms of the aortic arch.
Syphilis
All dissections not involving the ascending aorta are defined as…
type B.
… (infection) causes aneurysms of the abdominal aorta.
TB
Marfan syndrome patients should be considered for elective surgical repair when their aorta diameter is between… times normal.
1.3-1.5
The indications for… in type B acute aortic dissection are: rupture or progression of dissection, uncontrollable BP, organ compromise and intractable pain.
surgery
GI bleed in a patient with aortic reconstruction is… until proven otherwise.
aortoenteric fistula
Open surgical repair is indicated in AAA when diameter… , tender AAAs and AAAs growing at a rate > 1 cm/year.
> 5.5 cm
The term… describes a localized aortic dissection without intimal disruption.
intramural hematoma
… is the extensive thrombosis of the deep venous system with severe congestion that causes limb ischemia.
Phlegmasia cerulea dolens
Acute aortic dissection is defined as a clinical onset under…
2 weeks.
The most commonly involved coronary in aortic dissection is the… with ECG changes in the… leads.
right one / inferior
… should be considered whenever there is simultaneous acute involvement of multiple diverse organ systems without an obvious common explanation.
Acute aortic dissection
Marfan syndrome patients should speed up their annually TEE exam to every 6 months when their aorta diameter is more than… times normal.
1.3
Follow-up after… (Ao dz) include regular exams and CXR q3 months x4 and then q6 months thereafter.
acute aortic dissection
Patients with intramural hematoma of the ascending aorta should receive treatment with…
early surgery.
Patients with intramural hematoma of the descending aorta should undergo imaging… later and surgery if it demonstrates progression.
2-4 days
… is an uncommon aortic condition in which the microscopic appearance suggests an infectious etiology, but culture studies are negative.
Granulomatous aortitis
The treatment in patients with ascending penetrating aortic ulcer consists of…
immediate surgery.
AAA is defined as dilatation of the infrarenal aorta of more than …cm in diameter.
3
… should undergo AAA repair at a smaller diameter then the opposite sex.
Females
The need for surgery in AAA with a diameter in the 4-5.5 cm range will occur in… % of patients within 5 years of diagnosis.
54
The ankle-brachial index (ABI) has to be measured every… in DM patients as recommended by a joint AHA-ADA workshop.
one year
If the ankle-brachial index (ABI) is <0.5 the patient has to… (2 measures).
be referred to a vascular specialist and intensive risk factor modification started.
Systematic reviews and subsequent RCTs in people with… (symptom) have found that regular exercise at least three times weekly for between 3 and 6 months improves total walking distance and maximal exercise time after 3–12 months compared with no exercis
chronic stable claudication
The disease process of atherosclerosis is restricted to the… layer of the arterial wall, which becomes infiltrated with lipids and inflammatory cells leading to fibrosis.
intimal
If the ankle-brachial index (ABI) is >0.9 the test needs to be redone every…
2-3 years
There is a strong association between… and bicuspid aortic valve.
coarctation of the aorta
The underlying pathological condition in Marfan syndrome is… , which results in characteristic dilation of the proximal aorta, most prominent in the sinuses of Valsalva.
cystic medial necrosis
Data suggest that while detection rates from the transthoracic approach are less than 30 percent, sensitivity for detecting an abscess in the aortic root with TEE exceeds …
95 percent.
… evaluation of aortic root dilatation is key in the treatment of patients with Marfan syndrome.
Periodic echocardiographic
Elevated body temperature early after the onset of stroke is associated with…
worse outcome
All dissections involving the ascending aorta regardless of the site of entry are defined as…
type A.
Aortic aneurysm is an abnormal aortic dilation above… % larger than normal.
50
… (test) can be a prerequisite to surgical intervention in aortic aneurysm.
Contrast angiography
… disease is a chronic cerebrovascular disease characterized by severe bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent collateral circulation.
Moyamoya. “Moyamoya” is a Japanese word meaning puffy, obscure, or hazy like a puff of smoke in the air. Thus, the term was used to describe the smoky angiographic appearance of the vascular collateral network.
A… (amount) lowering of elevated DBP reduces the risk of stroke by 50% and AMI by 25%.
10mmHg
… is an acute cerebrovascular event with symptoms or signs persistant after 24 hours but with no functionally important impairments at one week.
Minor stroke
Antihypertensive therapy in a patient with… (condition) should be started if the BP in the first 24 hours is >175/100, BP should not be reduced with more than 20% and not below the level the patient had before the event.
intracranial hemorrhage
Takayasu’s arteritis occurs more often in… (9:1 sex ratio).
women than man
The treatment for Buerger’s disease is…
strict smoking cessation.
… is characterized by intense ischemia of the distal extremities (wrist and ankle) that is out of proportion to ischemia elsewhere.
Buerger’s disease
… occurs nearly exclusive in patients younger than 6 years and is associated with adenopathy, high fevers, erythema of the mucous membranes and – in severe cases – aneurysms of the coronaries.
Kawasaki’s disease
Sustained-release calcium channel blockers can be useful in scleroderma with Raynaud’s phenomenon and can retard the progression to… (complication).
digital ulcers
… could be useful in patients with recurrent digital ulceration or digital ischemia.
Long-term anticoagulation
… presents with postprandial abdominal pain, fear of eating because of anticipated pain, and weight loss.
Chronic mesenteric ischemia (intestinal angina)
The combination of… and aspirin may prevent twice as many vascular events and may reduce the risk of stroke by more than 23% over aspirin alone.
dipyridamole (Agrenox)
… (dz) should be considered in any patient older than 50 years of age presenting with new-onset headache.
Giant cell arteritis
Many stroke experts in North America recommend… mg of aspirin as an initial daily dose for stroke prophylaxis.
325
