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Vascular Flashcards

1
Q

Classifications for aortic dissection

A

DeBakey and stanford

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2
Q

Classification for Peripheral Arterial Disease

A

Rutherford or Fontaine classification

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3
Q

Classification for Chronic Venous Insufficiency

A

CEAP

Clinical
Etiology
Anatomy
Pathophysiological

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4
Q

Scoring of Clinical of CEAP classification

A

CVI

1: Telengiectasia
2: Varicose veins
3: Venous Edema
4a: Venous stasis eczema
4b: Lipodermatosclerosis or atrophie blanche
4c: Corona phlebetatica
5: Healed Venous Ulcer
6 Active venous ulcer

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5
Q

Rutherford classification

A

0: Asymptomatic
1: Mild claudication
2: Moderate claudication
3: Severe claudication
4: Rest pain
5: Ischemic ulcers of digits
6: Severe ischemic ulcers or Major tissue loss

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6
Q

Fontaine classification

A

1 Asymptomatic
2a: Mild claudication
2b: Moderate- Severe claudication
3: Rest pain
4: Ischemic ulcers or tissue loss

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7
Q

Mx of CVI

A

Conservative
1) Graduated pressure stockings

Surgical
1) Sclerotherapy
2) Venoseal
3) RFA
4) Stripping
5)
6)

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8
Q

Difference in stanford aortic dissection mx

A

A usually surgical
B usually medical

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9
Q

Skin changes in PAD

A

Pallor from hypoperfusion
Cyanosis from deoxyhemoglobin
Red from vasodilation
Black from gangrene

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10
Q

Trophic changes of PAD

A
  1. Shiny and dry atrophic skin
  2. Hair loss
  3. Brittle and ridged nails
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11
Q

Duration to ddx acute limb ischemia and chronic limb threatening ischemia

A

2 weeks

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12
Q

Aorto iliac disease causes

A

Buttock and Hip claudication and erectile dysfunction(Leriche syndrome)

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13
Q

Femoral popliteal vascular disease causes

A

Thigh and calf claudication

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14
Q

Tibial and peroneal vascular disease causes

A

Foot claudication

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15
Q

WIFI classification for CLTI dx

A
  1. Ischemic rest pain
  2. Confirmed hemodynamic study
  3. Diabetic foot ulcer
  4. Non healing LL or foot ulcer >2/52
  5. LL gangrene

Wounds: Diabetic ulcer and gangrene
Ischemic rest pain
Foot ulcer >2/52
Ix: confirmed hemodynamic study

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16
Q

Invx for Chronic Limb Threatening Ischemia

A

BC
-FBC
-RP
-BMP/Lipids
-hba1c
-Coagulation panel

Imaging
#1 US duplex
#2 CT/MR angiography for aortoiliac disease

17
Q

Risk factor modification for CLTI mx

A
  1. Smoking cessation
  2. Diet modification and exercise
  3. Statins
  4. Glycemic control
  5. Antiplatelets
  6. Anti HTN
18
Q

Diagnosis of PAD using exercise testing

A

ABPI decrease by 15-20%

19
Q

Arterial exam wishlist

A
  1. Auscultate arteries for bruits
  2. Palpate rest of arteries
  3. Perform abdo exam for AAA
  4. Full CVS exam for murmurs
  5. Measure ABPI bilaterally
  6. Check LL sensation & proprioception
20
Q

Arterial exam look

A
  1. Scars
  2. Skin changes
  3. Ulcers BEDD
  4. Gangrene
  5. Edema
  6. PAD trophic changes
21
Q

Arterial exam feel

A
  1. Temperature and tenderness
  2. Capillary refill
  3. palpate around ulcers
  4. Distal limb pulses
  5. Buerger’s test
22
Q

Definition of Critical Limb Ischemia

A

Persistent rest pain requiring regular analgesia for >2 weeks
Tissue loss eg gangrene/ulceration at lower limb
Objective hemodynamic parameters of Ankle Pa <50mmHg or Toe Pa <30mmhg

23
Q

Severity based on ABPI

A

0.9-0.7 Mild
0.7-0.4 Moderate
0.4> Severe

> 1?3 Calcification due to DM

24
Q

What is a false lumen

A

Year between intima and media that blood flows into

25
Q

Severity based on TBI

A

CLTI : <30mmHg

0.5-0.2 mild-moderate
0.2> severe

26
Q

Indications for amputation

A

3Ds

Dead: excess necrotic tissue
Deadly: overwhelming infection
Damn nuisance: intractable rest pain

27
Q

Indication for exercise testing

A

Claudication but with palpable pulses and normal ABPI

28
Q

Drugs for PAD management

A

1) Cilostazol
2) Pentoxifylline

29
Q

Layers of a compression bandage

A

Non adherent orthopedic wool
Crepe,elastic and adherent bandages

30
Q

Principles for Arteriovenous fistula creation

Rules of 6

A
  1. BB,BC or RC usually in non dominant arm
  2. Aim 6/12 before ESRF
  3. Takes 6 weeks to mature
  4. Diameter should be >=6mm
  5. Depth should be =<6mm
  6. Length should be about 6cm
  7. Blood flow rate >=600ml/min
31
Q

Complications of an AVF

A
  1. Infection
  2. Thrombosis
  3. Stenosis
  4. Arterial steal syndrome
  5. Venous hypertension
  6. Bleeding
  7. High cardiac output heart failure
32
Q

Drug for treating CVI

33
Q

Risk factors for AAA

A

Non modifiable
Male
Connective Tissue Disease
Marfan’s
Ehler Danlos
Family Hx
Age >60
COPD
Hyperhomocysteinemia( Hereditary thrombophilia)

Modifiable
SMOKING (9/10 of AAA pts are smokers)
Hypertension
Hyperlipidemia

34
Q

High risk features for AAA rupture

A
  1. Female
  2. Saccular Morphology
  3. AAA growing at >10% a year
  4. COPD
35
Q

Cutoff between mild and moderate severe claudication in Fontaine’s classification of CLTI

36
Q

4 compartments of the calf

A
  1. Anterior
  2. Lateral
  3. Deep Posterior
  4. Superficial Posterior

GS (11 decks)

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