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Patho > Test three c > Flashcards

Test three c Flashcards

1
Q

Risk factors for AA

A

age
male
tobacco
high cholesterol
obesity
htn
CAD
lower extremity artery disease
fam history

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2
Q

Causes of AA

A

degenerative
congenital
mechanical
inflammatory
Infectious

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3
Q

True vs False aneurysms

A

True
-at least one vessel layer is in tact
-fusiform = circular; saccular = pouch-like

False/pseudo
-bleeding into surrounding structures
-usually from trauma, infection, bypass graft surgeries

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4
Q

Manifestaton of thoracic, abdominal, and arch aneurysms

A

Thoracic= usually asymptomatic, but might have deep chest pain

Abdominal = back pain, epigastric stuff, bowel issues, claudication, mass, bruits, blue toe syndrome

Arch =
- coronary artery issues = angina and TIA
-laryngeal nerve issues = cough, dyspnea, hoarse, dysphagia
-venous return issues = JVD, edema

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5
Q

Complication of aneurysms

A

rupture with severe pain and maybe ecchymosis
-patient can die if rupture happens into thoracic or abdominal cavity

hypovolemic shock

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6
Q

Aortic dissection: type A vs Type B

A

A = ascending aorta and arch
B = descending aorta

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7
Q

Predisposing factors for Aortic dissection

A

male
age
vascular disease
trauma
tobacco
coke/meth
fam history
pregnancy
htn
marfan

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8
Q

Etiology of aortic dissection

A

degenerated elastic fibers in arterial wall
tear in inner layer of aorta
blood goes thru tear –> rupture is fatal

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9
Q

Manifestation of Aortic dissection

A

-Worst pain ever, tearing, ripping, stabbing
- Type A = LOC change, weak carotid/temporal pulse, dizziness/syncope

Old ppl have vague symptoms like hypotension

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10
Q

Complications of aortic dissection

A

Cardiac tamponade (into pericardial sac)
Hemorrage into body cavities
Spinal cord ischemia
renal ischemia
mesenteric ischemia
rupture leading to death

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11
Q

How often should aneurysms be monitored

A

every 6-12 months
2-3 yrs for smaller ones

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12
Q

Surgeries for aneurysms

A

Endovascular Aneurysm Repair –> uses femoral artery

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13
Q

post surgical complications for aorta stuff

A

Intraabdominal htn w/ associated abdominal compartment syndrome

Endoleak –> from inadequate seal in graft

Ischemia below graft site

Aneurysm growth above or below graft

Aneurysm rupture

Aortic dissection and bleeding

Renal artery occlusion

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14
Q

Preop aneurysm surgery

A

Monitor for rupture, intraabdominal htn, compartment syndrome –> signs are diaphoresis, pallor, weakness, tachycardia, hypotension, pain, LOC change, pulsating ab mass

Get baseline data

NPO, antibiotics, BBs, bowel prep, skin cleaned

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15
Q

Virchow’s triad

A

venous stasis
damage of endothelium (direct or indirect)
hypercoagulability

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16
Q

Pathophysiology of VTE

A

thrombus forms and gets bigger and forms a tail that occludes vein

if only partial blockage, is covered by endothelial cells

If doesn’t detach, undergoes lysis or becomes adherent within 5-7 days

May become PE

17
Q

weird venous stasis risks

A

old age
afib
stroke

18
Q

weird endothelial damage risks

A

hypertonic IV drugs
IV drug abuse
indwelling catheters

19
Q

weird hypercoagulability risks

A

high altitudes
HRT
Pregnancy and post partum
anemia
protein C and S deficiency
tobacco

20
Q

Superficial vein thrombosis manifestation

A

cordlike vein
surrounding area is itchy, tender, red, and warm
mild temp elevation
leukocytosis
edema of extremeties

21
Q

lower extremity venous thromboembolism

A

unilateral leg edema, pain, tenderness, dilated superficial veins
paresthesia
systemic temp over 100.4
if IVC i involved, both legs could be edema and blue
if SVC is involved - similar stuff in arms and face

22
Q

Pulmonary embolism manifestation

A

dyspnea
hypoxia
tachypnea, cough, chest pain, hemoptysis, crackles, wheezing, fever, tachycardia, syncope

Big ones = mental changes, hypotension, impending doom

23
Q

Diagnostic studies for TE

A

ACT, aPTT, INR, bleeding time, platelet count

D-dimer –> elevation suggests VTE

venous compression ultrasound –> bad if veins don’t collapse with pressure

Duplex ultrasound: determines location and extent of thrombus

CT venography (contrast)

MR venography

24
Q

preventing VTE (positioning)

A

reposition every 2 hrs
flex/extend feet, knees, and hips every 2 hrs while awake
sit in chair for meals and walk around 4-6 times a day
wear compression stockings

Intermittent pneumatic compression devices`

25
Q

VTE drugs: vit K antagonists

A

warfarin PO

use INR to monitor

26
Q

VTE drugs: thrombin inhibitors (indirect)

A

UH (IV or subq) and
LMWH (subq) –> don’t rub site after injection

use aPTT or ACT to monitor
watch for heparin-induced thrombocytopenia (HIT)

27
Q

VTE drugs: synthetic thrombin (direct)

A

administered all the ways

aPTT or ACT to monitor
used for those at high risk for HIT

28
Q

VTE drugs: Factor Xa inhibitors

A

PO or subq
dont need routine coagulation tests
monitor CBC and creatinine
can cause thrombocytopenia

29
Q

interventional radiology for occluded vein

A

mechnical thrombectomy
insertion of pharmacomechanical device
postthrombus extraction
angioplasty
stenting

vena cava interruption devices inserted percutaneously thru right femoral or right internal jugular vein

30
Q

what substances are bad for VTE?

A

nicotine and caffeine

31
Q

special considerations for warfatin

A

eat lots of vit K, but don’t take vit K supplements
hydration is important
blood monitoring

32
Q

varicose veins

A

vein walls weaken and then the leaflets don’t fit together and blood pools backwards

-achy and heavy

-seen with duplex ultrasound

33
Q

CVI

A

chronic venous insufficiency
-functional abnormalities of venous system which can lead to venous ulcers
-can be caused by varicose veins or PTCs
-serous fluid and RBCs leak from capillaries into the tissue
-enzymes break down the RBCs and release hemosiderin, causing brown skin
-skin and tissue replaced with fibrous tissue

34
Q

CVI ulcers

A

usually above medial malleolus
irregular shape
yellow or ruddy with granulation
drainage

35
Q

Varicose vein treatment

A

sclerotherapy
compression stockings
transcutaneous lasers
surgery if recurrent superficial vein thrombosis

36
Q

CVI treatment

A

compression of all sorts
healthy food (including good glucose for DM)

37
Q

CVI ulcer treatment

A

Pentoxifylline ointment- minimizes WBC activation

micronized purified flavonoid - acts on WBC to decrease inflammation and edema

antibacterials

38
Q

surgery for CVI

A

for ulcers that don’t get better in 4-6 weeks
-need skin grafts
-will need lifelong compression therapy

Patho (44 decks)

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