Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med 2 - CARDS > Peripheral Vascular Disease - fiore > Flashcards

Peripheral Vascular Disease - fiore Flashcards

1
Q

What is a ballooning of the aorta

A

aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a true aneurysm

A

all three layers are involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a pseudoaneurysm

A

does not involve all 3 layers
hematoma with fibrous covering
blood swirls inside
rare
most common in arteries due to trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what makes someone at higher risk for thoracic aortic aneurysm

A

Family history (20%)
atherosclerosis
smokers
HTN
hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the genetic connections to thoracic aortic aneurysm

A

connective tissue diseases (Ehlers-Danlos, Marphans, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the two types of aortic aneurysms

A

thoracic aortic aneurysm
abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the most common aortic aneurysm

A

abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what makes you at higher risk for abdominal aortic aneurysms

A

family hx (12-25%)
atherosclerosis
men
caucasian pts
age > 65
smokers
HTN
hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the subtypes of TAA

A

ascending - 60%
descending - 35%
aortic arch - <10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the possible presentations for aortic aneurysms

A

may be asymptomatic until dissection/rupture
+/- pulsatile abdominal mass
+/- abdominal bruits (AAA)
+/- back/abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the presentation of a rupture/dissection

A

Thoracic: sever, tearing back pain; hypotension; shock
Abdominal: severe abdominal pain, flank pain, hypotension, syncope and potential leg ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the test of choice for the diagnosis of TAA

A

CTA for initial assessment/screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what classifies the diagnosis of TAA

A

increase in diameter of the aorta by > 50%
around 4.5 cm for thoracic aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the test of choice for the diagnosis of AAA

A

Ultrasound - initial assessment/screening
CTA more reliable for sizing, pre-operative assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how are aortic aneurysms managed

A

manage modifiable risk factors (BP, lipids, smoking cessation)
surveillance for growth
operative intervention when indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how often are TAA assessed

A

every 2-3 years without underlying condition
every 6 months to 1 year if TAA with underling condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when is operative intervention indicated for aortic aneurysm

A

when symptomatic
size of >5.5 cm or rapid growth (0.5+cm per year)
typically graft repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the management for dissection/rupture of aortic aneurysms

A

emergent surgical intervention for TAA
medical management -> surgery for AAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

who is at a greater risk for aortic dissection

A

men (3:1)
50+ yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the risks for developing aortic dissections

A

complication of TAA/AAA
HTN
Abrupt, significant BP increases
genetic connective tissue disease
trama
Family history
pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the most common locations for aortic dissection

A

aortic root
aortic arch
just distal to subclavian artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how are aortic dissections classified

A

Standford:
Type A - ascending orta (surgery)
Type B - does not involve ascending aorta
DeBakey: I-III
I - originates in ascending aorta - arch or descending aorta
II - confined to ascending aorta
III - originated below subclavian artery (A: thoracic; B: propagates to abdomen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the presentation of aortic dissection

A

acute onset, severe ripping, tearing chest pain
pain radiating to the back
other end organ hypoprofusion
arterial occlusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is seen on physical examination with aortic dissection

A

hypertension-> hypotension
tachycardia
new aortic regurgitation murmur
pericardial tamponade, hemothorax
difference in pulses between UE and LE
different in UE BP (>20mmHg)

25
how do you work up aortic dissections
EKG and CXR is initial studies Bedside Echo (POCUS) CT or TEE test of choice for diagnosis
26
what is POCUS
point of care ultrasound
27
how do you manage aortic dissection
CT surgery and vascular surgery consult if involves ascending aorta - surgical emergency type B dissections - try medical management first
28
what is medical management for aortic dissection
blood work analgesia frist, HR control and BP control - BB or CCBs +/- judicious IV/vasopressors PRN to maintain perfusion may require transfusions
29
What is PAD
peripheral arterial disease vessel disease leading to decreased LE arterial profusion
30
What are risk factors for PAD
smoking HTN Hyperlipidemia atherosclerosis DM obesity FH vascular disease
31
what population are at risk for peripheral arterial disease
common in older patients Black > Hispanic > Caucasian
32
what is the presentation of PAD
intermittent claudication - Pain, ache, cramping, weakness, fatigue etc may progress to rest pain - pain in distal metatarsal area (foot) - gravity helps
33
what is found on PE with PAD
cool, pale skin +/- erythema when dependent hairlessness muscle atrophy reduced or absent peripheral pulses delayed capillary refill ulcerations - painful, lateral malleolus, dry, punched out
34
how is PAD worked up
high suspicion based on hx and PE confirm with ankle-brachial index (ABI) Doppler US or MRA provides additional information
35
what is the ABI
ankle brachial index systolic BP in the ankle / highest systolic BP in the arm normal = 0.9-1.3
36
how do we treat PAD
control modifiable risk factors foot care exercise pharmacologic tx (antiplatelet, cilostazol = vasodilators) Procedural intervention
37
what are the pharmacologic treatments for PAD
antiplatelets - ASA = first line and prevents further atherosclerosis treatment of claudication with Cilostazol = vasodilators - SE of diarrhea and HA, avoid in HF
38
what are the surgical options for PAD treatment
PTA (percutaneous transluminal angioplasty) +/- stenting Endarterectomy (removal of thrombus) Bypass grafting (revascularization) amputation (infxn, gangrene, severe pain, critical limb ischemia)
39
what is acute arterial occulusion
aka acute limb ischemia EMERGENCY LE>UE
40
what is the presentation of acute arterial occlusion
acute onset eventually pale- mottled - cyanotic demarcation
41
what are the 5Ps of Acute arterial occulsion
pain pallor pulselessness polar sensation paresthesias
42
what is the workup for acute arterial occulsion
primarily clinical doppler to confirm absent peripheral pulses confirm occlusion location with CTA
43
what is the treatment for acute arterial occulsion
emergent vascular consult heparin until surgery needs re-perfusion for limb salvage (bypass, endarterectomy, embolectomy) in severe - amputation
44
what is a common name for venous insufficiency
varicose veins
45
what populations are more likely to have venous insufficiency
W>M incidence increases with age starts younger in women then men
46
what causes venous insufficiency
incompetent valves - venous dilation
47
what increases the risk of venous insufficiency
anything that increases stress/pressure on valves increases risk normal 'wear and tear' reduced mobility prolonged sitting/standing obesity pregnancy smoking HTN contraception
48
what is the presentation of Venous insuffiiciency
initially, LE pitting edema, pain/achiness, LE fatigue/heaviness symptoms improve with rest or elevation MEDIAL MALLEOLUS laceration NO claudication development of varicose veins later, chronic skin changes (stasis dermatitis)
49
how to you diagnose/work up venous insufficiency
primarily clinical diagnosis ABIs to rule out arterial insufficiency venous reflux testing - duplex ultrasound
50
what is the treatment for venous insufficiency
conservative management first -Elevation, exercise, weight loss, compression surgery if conservative fails - sclerotherapy, ablation, vein stripping, valvuloplasty
51
what is the #1 cause of rectal bleeding
hemorrhoids
52
what are hemorrhoids
essentially, varicose veins in the rectum
53
what increases risk of hemorrhoids
increased venous pressure in the rectum straining with defecation low fiber diet enlarged prostate other pelvic space occupying lesions ascites pregnancy
54
what is the presentation of internal hemorrhoids
discomfort (itching, burning) bleeding may prolapse may thrombose
55
what is the presentation of external hemorrhoids
discomfort, bleeding, may prolapse, painful more likely to thrombose
56
what is the workup for hemorrhoids
mostly clinical dx PE digital rectal exam (DRE) anoscopy (visualization)
57
what is the first line treatment for hemorrhoids
conservative management - reduce straining increase fluid intake, fiber, stool softeners, sitz baths, topical creams
58
what are procedural interventions for hemorrhoids
rubber band ligation sclerotherapy photocoagulation refractory disease - hemorrhoidectomy

Clin Med 2 - CARDS (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions