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TrueLearn Review > Vascular > Flashcards

Vascular Flashcards

1
Q

s/p ablation with Numbness along th posteriorlateral aspect of the lower leg and foot. Which nerve?

A

Sural nerve – bc this surgery was along the small saphenous vein

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2
Q

Absolute Indications for IVC placement

A
  1. Contraindication for anticoagulation (intracranial hemorrhage, active bleed, pregnancy, mal HTN, brain/eye/SC surgery)
  2. recurrent thromboemb despite anticoagulation
  3. Anticoagulation related complication
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3
Q

s/p endo AAA POD1 with bloody diarrhea and abdominal pain… Next step?

A

Sigmoidoscopy - eval ischemic colitis caused by coverage of IMA by the endograft
(if free air or HDU, ex lap)

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4
Q

CAD, PAD and Afib with acute diffuse abdominal pain, CT-A with occlusion in the SMA.
location and distribution of the intestinal ischemia

A 
Distal SMA (embolic)
Ischemia of mid jejumun through the ascending colon
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5
Q

4 categories of Acute Mesenteric ischemia

A
  1. Embolic (distal - usu the middle colic so mid jejunum to ascending colon)
  2. Thrombotic (proximal)
  3. Non occ Mes Ischemia (NOMI)
  4. Mesenteric venous
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6
Q

Thromboxane 2 roles

A
  1. platelet aggregation

2. local VC to dec flow to an injured vessel

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7
Q

40 yo w h/o Left leg DVT has swollen extremity and medial mallelous ulcer , U/S of the left venous system shows insufficiency ext from the ileofem segment into the pop… whats the next step in management?

A

Left lower extremity venogram

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8
Q

Pregnant women with severe abdo pain with HDU and CT showing splenic artery aneurysm with extra… whats the treatment?

A

IR embolization - high success and low morbity

other options are open or lap surgery

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9
Q

s/p hip surgery with DVT, how long therapy?

A

Anticoagulation for 3 months

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10
Q

acute Type B dissection from distal to SCA to the Right ext iliac with abdominal tenderness. Tx?

A

TEVAR - thoracic endovascular aortic repair to cover the entry tear and redirect to the true lumen.
Need a 2.5 cm landing zone

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11
Q

POD4 sleeve now tachy/tachy with PE, how long tx

A

12 weeks anticoagulation

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12
Q

SVT tx based on location

A

Usu tx is compression and NSAIDs but if its within 3 cm of the saphenofem Jon ; may benefit from fondaparinux for 45 days

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13
Q

refractory HTN with String of beads on CT scan

A

Fibromuscular dysplasia

Balloon angioplasty

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14
Q

psuedoaneurysm sp endovasc procedure

A

When it threatens the overlying skin, immediate operative rapir with proximal and distal control

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15
Q

HDS UGI with h/o AAA repair, what do you think of?

A

Aortoenteric fistula - Fistula repair, graft excision, aorta overswen, and distal perfusion is restored with extra anatomic bypass

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16
Q

h/o Factor V leiden with left leg massively swollen and cyanotic, tight compartments, nd pedal pulses palpable

A

Phlegmasia cerulea dolens - Surgical emergency!

Tx pharmacomechanical thrombectomy with locally administered thrombolysis with fasciotomy.

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17
Q

Pregnant + DVT Tx

A

low molecular weight heparin -

18
Q

Rutherford classification ; which ones w operative mgmt?

A

IIB

19
Q

lower extremity fasciotomy with dec sensation in the skin over the lateral two thirdsof the leg

A

Superficial Peroneal nerve

20
Q

forearm compartment measures 35mmHg, what to do?

A

Compartment syndrome > 30 so fasciotomy via the dorsal and volar incision

21
Q

contrast induced nephropathy s/p angiogram, treatment

A

pre-tx w/ NS 1ml/kg/hour for 12 hours prior and after

22
Q

Dabigatran ( Non Vit K oral anti/direct thrombin inhibitor) PRE OP mgmt depends on

A

Cr Clearance!
If CrCl>50 then1-2 days before
If < 50 then 3-5 days prior
Restart 1-2 days

Emergent:
Idarucizumab or PCC

23
Q

Order of AV access operations:

A
  1. radiocephalic
  2. brachiocephalic fistula
    3.brachiobasilic fistula
  3. opposite arm
  4. Brachioaxillary(graft) UE
    Graft of LE
24
Q

Indications for Urgent Dialysis

A 
A - Acidosis<7.1
E- Refractory hyperkalemia
I - Intoxication(SLIME)
O - volume overload refractorytodiuretics
U - Uremia
25
Q

AAA repair for 5.7 juxtarenal aneurysm –> right foot is cold with nopalpable pulses.. Next step

A

Right femoral cutdown and embolectomy

26
Q

Preop Eval for AAAelevtice repair - 4 METS

A

1 MET - 1 flight of stairs

27
Q

Access Related HandIschemia (ARHI)

A

Banding, RUDI (revision using distal inflow),PAI (proximalizaition of arterial inflow, DRIL (distal revs interval ligation), DRAL (distal radial artery ligation)
*DRIL #1 choice

28
Q

DM with oozing left toe. Tx?

A

Second toe amp (source control) and then revascularization

29
Q

gangrene foot with palp popliteal pulse.. sx?

A

AKA - palpable pulse immediately above the level of amputation predicts successful healing nearly 100% time

30
Q

Reasons AVF doesn’t mature? 1st step?

A

Steal, aneurysm, infection, inflow or outflow

1st: US duplex

31
Q

60F DM s/p AVF. 3 hours after OR, severe pain. Nerve conduction shows axonal damage

A

Ischemic monomeric neuropathy

NOT steal, as that is associate w loss of pulse

32
Q

ideal vein for AVF

A

3mm diameter, no signs of stenosis/thrombus,

33
Q

Ideal exposure of the femoral artery during vasc procedure is…

A

is the transverse incision

34
Q

Calculation ABI

A

higher pedal pulse/higher brachial pulse

<0.9 inc in CV mortality

35
Q

Sclerotherapy position?

A

trendelenberg to prevent refilling

36
Q

Acute onset of paralysis of both lower extremities and cyanosis of the umbilicus down

A

occlusion artery of Adamkiewicz

37
Q

CEA complete, what order do you unclamp the vessels?

A

External first, then common carotid, then the internal carotid. the internal carotis is reomoved last to avoid cerebral embolization and stroke after carotid

38
Q

Penetrating injury to the thigh, 50% transection of artery with expanding hematoma. whats the order of reconstruction?

A 
Lateral anteriorrhaphy
Lateral suture patch angioplasty
Resection and end/end anastomosis
Resection and saphenous interposition graft
ligation
39
Q

The decision to start dialysis. in pts w CKD include: ESRD, uremic sis, GFR and rate ofGFR decline… although no set cut off, what is the general rule for initiation?

A

SYMPTOMATIC pts w GFR 10-15 ml/min/1.3m2

40
Q

carotid duplex US - peak systolic velocity to measure stenosis, EDV,

A

ICA PSV
125cm/sec= 50% occlusion
125-230cm/sec = 50-69%
>230cm/sec = >70% stenosis

TrueLearn Review (19 decks)

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