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COMAT - Surgery > Vascular > Flashcards

Vascular Flashcards

1
Q

In what patient population are AAA the most common?

A

Older men with a smoking history

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2
Q

What are the signs of a AAA?

A

Pulsatile abdominal mass
Back pain

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3
Q

What diagnostic test should be ordered if you suspect a AAA?

A

Ultrasound

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4
Q

When is surgery the correct treatment for a AAA?

A

When the size is > 5.5 cm or it is growing very fast

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5
Q

If the AAA is smaller than 5.5 cm and not growing very fast, what is the treatment?

A

Frequent ultrasounds and observation

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6
Q

What is the common complaint with aortic dissection?

A

Tearing chest pain that radiates to the back

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7
Q

What will be found on physical exam with an aortic dissection?

A

Unequal blood pressures between arms

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8
Q

What will be seen on imaging with an aortic dissection?

A

Widened mediastinum

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9
Q

What diagnostic measure should be obtained for an aortic dissection?

A

CTA

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10
Q

Treatment for an ascending aortic dissection? Descending aortic dissection?

A

Ascending = surgery
Descending = beta blockade

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11
Q

Peripheral vascular disease is atherosclerosis in the lower extremities. How may it present?

A

LE claudication
Shiny shins
Loss of hair

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12
Q

If PVD is severe, what symptoms can be present?

A

Pain with rest
Pain changes with position of lower extremities

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13
Q

What test should be obtained if PVD is suspected?

A

Ankle-Brachial Index
– compares blood pressures between UE and LE

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14
Q

If the ABI is > 1.4, what should be obtained? If it is between 0.9-1?

A

> 1.4 = Toe-Brachial index
0.9-1 = Exercise ABI

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15
Q

Normal range of ABI?

A

1-1.4

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16
Q

When do you use a stent for PVD?

A

Lesions above the knee or small lesions

17
Q

When do you use bypass for PVD?

A

Lesions below the knee or bigger lesions

18
Q

What 2 drugs are for symptoms of PVD only?

A

Cilostazol
Pentoxyphylline

19
Q

What can cause Acute Limb Ischemia?

A

Cholesterol or Afib embolus/thrombus

20
Q

What are the 6 P’s of Acute Limb Ischemia?

A
  • Pulselessness
  • Pallor
  • Poikilothermia (cold)
  • Pain
  • Paresthesias
  • Paralysis
21
Q

Acute Limb Ischemia presents with?

A

6 P’s
- Pulselessness
- Pallor
- Poikilothermia (cold)
- Pain
- Paresthesias
- Paralysis

22
Q

What test can diagnose Acute Limb Ischemia?

A

US doppler or CTA

23
Q

Treatment for Acute Limb Ischemia?

A

Embolectomy or Intra-arterial tPA

24
Q

What often causes Aortic Stenosis? What are some presenting signs?

A

Calcifications
= chest pain, syncope, CHF

25
Q

What murmur will be heard with Aortic Stenosis?

A

Systolic
= CRESCENDO-DECRESCENDO that radiates to the carotids

26
Q

What often causes Mitral Regurgitation?

A

Infection
Rupture of papillary/chordae heart muscles

27
Q

What murmur will be heard with Mitral Regurgitation?

A

Systolic
= Holosystolic and radiates to axilla

28
Q

Where is Aortic Regurgitation heard best at?

A

Left 4th ICS

29
Q

What murmur will be heard with Aortic Regurgitation?

A

Diastolic
= Descrescendo and blowing murmur

30
Q

What classically causes Mitral Stenosis?

A

Rheumatic heart disease

31
Q

What murmur will be heard with Mitral Stenosis?

A

Opening snap and rumbling murmur

32
Q

How are these heart murmurs diagnosed?

A

Echo

33
Q

What is the treatment for most of the heart murmurs in this deck?

A

Valve replacement

34
Q

When you replace a heart valve with a mechanical valve, what is necessary?

A

Lifelong anticoagulation

35
Q

Name that murmur:
1. Opening snap and rumbling
2. Decrescendo and blowing
3. Holosystolic with axilla radiation
4. Crescendo-Decrescendo with carotid radiation

A
  1. Mitral Stenosis
  2. Aortic Regurgitation
  3. Mitral Regurgitation
  4. Aortic Stenosis

COMAT - Surgery (13 decks)

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