Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VASCULAR > VASCULAR > Flashcards

VASCULAR Flashcards

1
Q

Antithrombotic intrinsic properties of vascular tissue

A
  1. Endothelium surface
  2. Protein C
  3. Protein S
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Layers of vessel from inside out

A
  1. Intima
  2. Media
    a Internal elastic lamina
    b External elastic lamina
  3. Adventisia (what you grab with pickups
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

First signs of atherosclerosis

A

FATTY streak

lidi and macrophage

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

Progression of atherosclerosis

A 
fatty streak
Fibrous plaques (encapsulated by collagen and elastin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most common site of atherosclerotic plaques

A

Coronary arteries
Carotid bifurcation
Proximal ilicac arteries
Adductor canal region

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

Pathophys mechanics of where / why plaques dvlp

A

LOW shear stress

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

Main constituent responsible for extrinsic pathway coag

A

TISSUE FACTOR

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

Most common cause of occult bleeding risk

A

vonWillibrands (pTT)

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

Tx of most VWD

A

DDAVP

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

Most common hypercoagulability

A

Factor V Leiden

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

Why is there transient hypercoagulability with coumadin

A

Protein C is taken out first (short T1/2) and this is a natural anticoagulant in endothelium

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

Where is factor 8 found

A

endothelium

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

Most severe clotters of any hypercoagulability

A

hyperHOMOCYSTEIN

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

Tx of hyperhomocysteinemia

A

Folic acid

Vit B 6 and 12

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

Define aneurysm

A

More than 1.5 normal diameter

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

Fusiform aneurysm

A

diffusely dilated

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

Saccular aneurysm

A

eccentric outpuch

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

Most common sites of aneurysm

A 
Infrarenal aorta
Icliac arteries
Splenic
Renal, Hepatic, SMA, Celiac
Popliteal arteries
Femoral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risk of popliteal aneurysm

A

pop aneurysm on one side has 60% chance of contralateral

50% chance of AAA

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

What is biochem associated with aneurysm

A

MMP

Matrix-metalloproteinase

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

Syndroms associated inherited connected tissue aneurysms

A

Marfan’s
Ehler-Danlos
Cystic medial necrosis

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

Aneurysm associated with pregancy

A

Pregnancy (SPLENIC, mesenteric, Renal)

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

Aneurysms associated with arteritis

A

Takayau’s disease
Giant cell arteritis
Polyarteritis nodosa
Systemic lupis

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

Best screening for aortic and peripheral aneurysms

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When to tx AAA

A

greater than 5.5 cm males 5.0 female
(smaller if sx / syndrome)
Incr size greater than 0.5 cm / 6 mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Most common organism for mycotic AAA

A

MOST common staph AURUS

Most common spont bug salmonela

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is special about staph eip

A

slime layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When do you fix popliteal aneurysm

A

greater than 2 cm
evidence of thrombus in wall
sx of showering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do you fix pop aneurysm

A

saph graft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do you watch for with colon post repair of AAA

A

Colon ischemia:
ligation of IMA, periop hypotention,
Sigmoid scope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Type I endoleak

A

Bad seal btw wall and graft

Fix right away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Type II endoleak

A

Leak from collateral

Watch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Type III endoleak

A

bad seal between components

Fix right awy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Type IV endoleak

A

Leaking through pores of material

Watch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Type V endoleak

A

Gradual build-up of thrombus pushes graft away from wall

Watch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What manuever is needed to clamp the super celiac

A

Must take down triangular ligament down

Free esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Two options to approach infected graft

A

Sick: excise graft
Stable: Abx and in situ graft replacement (but most will undergo graft excision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Prognosis of pop aneurysm that is showering thrombi

A

50% amputation rate!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Stanford type A dissection

A

A is for Assending

ANY dissection that involves the ascending aorta (even if it goes right down the groin..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Stanford type B dissection

A

B is for below - BELOW ascending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What defines distal aorta dissection

A

distal to SUBCLAIVAIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tx of Aortic dissection sx

A

Nitropruside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Aortoiliac occlusive disease

A

YOUNG:

40-60 yo, smokers, hyperlipid,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Leriche syndrome

A

impotence
absence of femoral pulse
lower extremity claudication
muscl wastin fo the buttocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Where are foot findings with peripheral arterial diease

A

ulcers of DORSAL foot
HEEL
TOES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Where are foot findings with peripheral venous insuf

A

MEDIAL or lateral MALLEOLUS (gaiter zone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Charoct’s foot

A

diabetic ulcers - planter or lateral foot with DM neuropathy:
Injury to autonomi motor and sensory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Beurger’s sign

A

dependent rubor with PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Cilostazol

A

Pletal:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is med tx for PVD

A

betablockers
statin
ACE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Aortofemoral bypass grafting patency rate at 5 years

A

greater then 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How do patency rates for extraantomic bypass compare

A

lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Where do you see fibromuscular hyperplasia

A

renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Where do you revasc celiac

A

common hepatic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is principle collateral between celiac and superior mesenteric arteries

A

Gastroduodenal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Major watershed of bowel

A

Splenic flecture

Sigmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What bowel arteries can be sacrficed

A

IMA

NOT SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What pathophysio findings of stenosis indicated you should stent versus angioplasty

A

Atherosclerosis: STENT

Fibromuscular dysplasia: angioplsty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is fibromuscular dysplasia

A

middle to distal portion of the renal artery (spares the proximal renal artery)
Involves: intima medial or adventitia (all 3 layers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Renal artery stenosis

A

Fibromuscular dysplasia
Bilateral 50%!
3 times more in FEMALE
Diastolic hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Tx of renal artery steosis

A

Plasty if proximal (because this is usually just an extension of the aortic plaque.
Then stent because usually recurs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Meseneric ischemia

A

Embo to SUPERIOR mesenteric artery 50% of all cases of ACUTE mesenteric ischemia
Thrombus is 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Where do most SMA emboli lodge

A

distal 3-10 cm from the origin of the SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Tx of SMA occlusion

A

Embolectomy and ALWAYS a second look.
Anticoag
W/u embo source

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Diagnosis of renal artery stenosis

A

CTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

NASCET

A

North American SYMPTOMATIC Carotid Endarterectomy Trial:
70% occlusion - CVA or death risk in 2 years:
26% with antiplatelet alone
9% with CEA
50-69% stenosis:
risk reduced with CEA also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

ACAS

A

ASYMPTOMATIC Carotid Atheroslerosis Study:
60% occlusion:
11% stroke in 5 yrs with antiplatelet
5% with CEA

68
Q

CREST

A

Open increase risk of MI

Stent increased risk of stroke

69
Q

Other common causes of carotid artery occlusion besides hamburgers

A

Fibromuscular dysplasia
Takaysu arteritis
Dissection
Trauma

70
Q

Vertebral Basilar disease

A

Subclavian steal syndrome:
Occlusion proximal to the origin of vertebral artery causes dcreased perfusion of the subclavian artery (this makes the vertebral artery act as a collateral in arm circulation)
Sx: ipsilateral brachal artery pressure is reduced by 40 mmHg
Left sublavian is more likely because increased length.

71
Q

Treatment of subclavian steal syndrome

A

bypass from vertebral artery to distal subclavian occulusion site

72
Q

Which side is more likely to develop iliac DVT

A

LEFT by 4 times!

Aortic bifurcation compresses the left iliac vein

73
Q

Pagets Shroder

A

TPA and first rib resection

74
Q

Adson’s test

A

diappearance of the radial pulse with abduction and external rotation of the shoulder
Non-specific TOS sign

75
Q

Hyperhydrosis

A

middle and internal gangion

76
Q

Retroperitoneum zones and treatment

A 
Zone I:
midline - Aorta vena cava
Zone II:
Perinephric - 
Zone III:
Pelvic - iliac vessels - watch if blunt non expanding
Explore any penetrating trauma
Explore any zone I injury
77
Q

How do you get proximal control of Zone I and II retroperitoneal injuries

A

Proximal control of the aorta just below the diaphragm

78
Q

How do you get proximal control of pelvic retroperitoneal hematoma

A

This is Zone III:

Control at the level of infrarenal aorta

79
Q

Inflammatory aneurysm define

A

Careful not the same as mycotic (infected) aneurysm.

Ruputure risk not greater than noninflammatory aneurysm of same diameter

80
Q

Inflammatory aneurysm comorbidity

A

Often involves the 4th portion of the duodenum
Inferior vena cava
LEFT renal vein
Ureters - hydronephrosis spont resolve

81
Q

Tx of Inflammatory aneurysm

A

DO NOT dissect the duodenum off the aorta
May need to divide the renal vein if densely adherent (divide near IVC)
Use left retroperitoneal approach - elevated left kidney
Juxtarenal involvement may preclude endovascular approach.

82
Q

AAA anatomy required for EVAR

A

15 mm proximal neck
25-30 mm max diameter
Less than 60 degree angulation btw the proximal neck and the suprarenal aorta
Adequate access caliber 7-8 mm with out prohibitive friable calcification

83
Q

When does renal artery stenosis need to be fixed

A

Sudden worsening of preexisting hypertention
Resistant HTN despite 3 meds
Worsening Renal function after ACE
Unexplained atrophy of one kidney
HTN causing end organ damage (renal insuf, recurrent CHF)

84
Q

Complications of Heparin

A

HIT: dcr platelet (by 50% of baseline) - usually within the first 2 days
Skin necrosis
Osteopenia
OK to use with pregnancy

85
Q

Complications of Warfarin

A 
Skin necrosis (Protein C)
Cholestatic hepatic injury with prolonged use
86
Q

What is proximal control for truly emergent ruptured AAA

A

Clamping the aorta a the diaphragm (take down triangular lig - mob esoph)

87
Q

Risk of AAA rupture per year with size

A

4-4.5cm: 1-3%
5.5 -5.9 cm 9%
6 - 6.9 cm: 10%
>7 cm: 32%!

88
Q

Indications for IMA replant

A

Poor back bleeding from IMA (colaterals not well dvlpd)
Pressure greater than 40 mmHg adequate collaterals
Signs of rich collaterals with arch of Riolan (btw middle colic off the SMA and the LEFT colic artery off the IMA)
Poor colonic doppler
Intramural colonic pH acidosis

89
Q

Intraop gross signs of heparin resistance

A 
RED thrombus occluding graft
No change in clotting time
(More common in CPBP)
Cause: deficiency in antithrombin III
Tx: give FFP that has antithrombin III
90
Q

when to fix Asx iliac artery aneurysm

A

3.5 cm

91
Q

how to fix iliac artery aneurysm

A

Endo first choice (“but” higher risk of butt claudication to occlusion of internal iliac)
open prosthetic ok

92
Q

work up for aortic enteric fistula

A 
upper GI (possible ped c-scope)
second choice: CT
93
Q

Treatment of infected IV drug abuse femoral artery aneurysm

A

Ligate!

94
Q

Management of penetrating trauma to lower extremity with absent pulse

A

OR!

95
Q

What penetrating trauma might get an angio before OR

A

Zone I neck
Zone III neck
Transmediastinal GSW

96
Q

Most common symptom of popliteal aneurysm

A

Thrombus (chronic ischemia)
49% followed by distal emoblization
Later compresses pop vein

97
Q

What is considered rapid expansion of AAA on survelence

A

> 1 cm / yr

98
Q

Management of frostbite

A

Rapid rewarming 40-42C bath until sensation returns
(tissue injury is worsened by partial rewarming and reexposure to cold)
Remove clear blisters (leave hemorrhagic blisters)
Avoid debridement
Delay amputation for prolonged (3-4 months!) demarcation and internal healing
Limb elevation
Antibiotics and tetnus

99
Q

Mechanism of frostbite

A 
Ice crystals form in extracellular space
Loss of osmotic transport of water out of cell
Leads to cellular dehydration
Hypercoaguation state
Tissue injury
100
Q

most common aortic emergency

A

spontaneous dissection

101
Q

medical management of aortic dissection

A 
#1 nitroprusside
#2 beta blocker
102
Q

diagnosis of aortic dissection

A 
transesophageal echocardiogram
(But doesn't visualized distal aorta)
103
Q

pathophysiology and risk factors responsible for AAA

A

MMP ( not atherosclerosis) were
hypertension makes it worse
Smoking activates MMP
( diabetes is not associated with aneurysm)

104
Q

d-dimer used to diagnosis

A

aortic dissection
PE
Clot breakdown products

105
Q

reentry operation for dissection

A

composite graft the bowel trunk

106
Q

artery responsible for spinal cord ischemia

A

artery of Adamkiewicz

level the lumbar

107
Q

anterior spinal symptoms

A

loss of pain and temperature

theStill have proprioception

108
Q

What is percent occlusion that impede blood flow

A

70-75%!

109
Q

were or findings associated with renal artery stenosis

A

fibrointimal hyperplasia:
the string of beads sign
distal two thirds of renal artery

110
Q

treatment of renal artery stenosis due to atherosclerosis

A

stent

111
Q

treatment of renal artery stenosis to do fibrointimal hyperplasia

A

angioplasty

112
Q

what does the artery or Riolon collateralized between

A

SMA and IMA in circle

113
Q

which does be meandering artery of Drummond collateralized

A

SMA and IMA and the outer circle

114
Q

what is the collateral between the gastroduodenal artery and the SMA

A

pancreaticoduodenal artery

115
Q

which lower extremity is more likely to embolize

A

the left because of less acute angle of common iliac

116
Q

what is the Mattox maneuver

A

LEFT visceral medial rotation
Anterior transperitoneal approach
Trauma vascular access

117
Q

what is the Cattel-Barrash maneuver

A

RIGHT visceral medial rotation (Bill developed for head of pancreas)

118
Q

described the relationship between the renal artery and the renal vein

A

renal artery more CRANIAL

Renal vein VENTRAL

119
Q

where is the splenic artery when compared to splenic vein

A

splenic artery more cranial (like renal artery)

120
Q

first-line treatment for thrombosis of AV fistula

A

TPA!

If venous component affected angioplasty

121
Q

where his procedure of choice with hand ischemia after AV fistula

A 
DRIL procedure  distal revascularization interposition ligation
#1 ligated distal radial artery (Because blood is flowing from radial to ulnar artery and then to the vein)
#2 jump graft from proximal to distal we ligated artery the
122
Q

venous insufficiency signs

A

MEDIAL malleolus

123
Q

Most common risk factor for spontaneous venous thromboembolism

A

factor V Leiden
is a Autosomal dominant
mechanism: in activation by activated protein C
a 6 fold increase in thrombus in the left homozygous vein 80 fold

124
Q

name hypercoagulable disorders

A 
#1 factor V Leiden-most common
#2 anti-thrombin 3 deficiency
#3 prothrombin gene mutation
#4 protein C and S. deficiency
#5 elevated homocysteine
#6 antiphospholipid syndrome
#7 smoking, obesity, pregnancy, oral contraceptives, malignancy
125
Q

who has a highest risk of venous thromboembolism all comers

A

TRAUMA

Spinal cord injury

126
Q

which side is more common to get a iliac vein DVT

A

LEFT

Left iliac vein compressed by right iliac artery note is May Turner syndrome

127
Q

superficial venous thrombosis

A

rate of concomitant DVT 5-40%
Duplex ultrasound essential
If within 1 cm of saphenofemoral junction can propagate into the deep system-this case needs anticoagulation or ligation of the saphenous vein and junction

128
Q

suppurative thrombophlebitis

A

taken out IV
Antibiotic
Sometimes surgical removal of infected vein

129
Q

heparin-induced thrombocytopenia

A

caused by platelet activating antibody
Increases thrombin generation
Present 5-10 days after heparin
10 being present because of previous exposure-platelet count drops for 10 days in this case

130
Q

Management of heparin-induced thrombocytopenia

A 
alternative anticoagulants:
argaroban
lepirudin
Both thrombin inhibitors
 both monitored by partial thromboplastin
both irriversible
131
Q

how it is argatroban cleared

A

hepatic

132
Q

how is Lepirudin cleared

A

kidney

133
Q

treatment of Paget Schroeder syndrome

A 
axillary-subclavian vein thrombosis
Diagnosis duplex ultrasonography
Treatment:
Immediate heparin
Catheter and directed thrombolyis
 angioplasty  some recommend first rib resection
134
Q

EKG findings with PE

A 
sinus tachycardia
S1, q.3, T3
Prominent S wave in lead one
Q wave
Inverted T  in lead 3
This is consistent with right ventricular strain but not commonly present
135
Q

treatment of spontaneous left iliac femoral vein thrombosis

A

Rule out May turner syndrome
Thrombolytic therapy
If thrombectomy is successful but residual stenosis present recommend spent (not just angioplasty)
RARE to recommend operative embolectomy- phlegmasia alba dolens does not response to thrombolysis

136
Q

absolute indications for permanent IVC filter

A
  1. development of DVT or PE with contraindication to anticoagulation her acute GI bleed)
  2. A new venous thromboembolism that develops despite receiving anticoagulation
  3. Patient with venous thromboembolism developed hemorrhage while already receiving anticoagulation
137
Q

relative indications for RETRIEVABLE IVC filter

A 
#1 before planned from the lysis of new DVT
#2 recent DVT in plan to Maj. surgery
#3 prophylaxis and severe trauma of head, pelvis, spinal cord
138
Q

relative indications for permanent IVC filter

A 
#1 venous thromboembolism in poorly compliant patient
#2 recurrent episodes of venous thromboembolism
#3 large free-floating thrombus in IVC
139
Q

reddish blue nodule develops and left arm a 70-year-old woman after chronic swelling for 20 years post modified radical mastectomy

A 
lymph angiosarcoma
 “Stuart Treves syndrome”
 rare highly lethal malignancy
Caused by chronic lymphedema
A rigid firm blood vessels instead of lymphatics (better name is angiosarcoma )
140
Q

Exam findings of lymph angiosarcoma

A

Purple colored patches form plaques and nodules
Palpable subcutaneous mass
poorly healing eschar with recurrent bleeding and infection

141
Q

treatment of lymph angiosarcoma

A

Surgical
Wide local excision equal outcome to amputation
Does NOT respond well to chemotherapy or radiation
Poor prognosis high recurrence rate high metastatic rate

142
Q

Kaposi’s sarcoma

A

similar findings to lymphangioma sarcoma

Very rarely develops in lymphedematous extremity

143
Q

most common cause of primary lymphedema

A

lymphedema praecox

144
Q

3 types of primary ymphedema

A 
#1  congenital ( one type is Milroy disease)
#2  lymphedema praecox
#3 lymphedema tarda
145
Q

lymphedema praecox

A

most common-80-90%
developed during childhood or teenage
10 times more common in women
starts in the foot or lower leg usually

146
Q

lymphedema tarda

A

start after the age of 35

147
Q

secondary lymphedema

A

more common than primary lymphedema
most common worldwide: filariasis ( Wuchereria Bancrofti)
most common cause in the United States: post axillary node dissection

148
Q

clinical findings of lymphedema

A 
#1   nonpitting
#2 involves toes unlikely venous
#3 recurrent cellulitis
#4  peau d'orange
149
Q

test for lymphedema

A

only needed his diagnosis in question with no recent surgery

Best tests: Lymphoscintigraphy-

Once diagnosis has been made CT or MRI health rule out pathology

150
Q

factors that warfarin inhibits

A

PACs and liver inhibiting vitamin K dependent procoagulant factors:
2, 7, 9, 10
Protein C, protein S

151
Q

Warfarin skin necrosis

A

first days of therapy
Associated with deficiencies of:
Protein C, protein S, factor VII, malignancy

152
Q

Heparin mechanism of action

A

potentiate anti-thrombin inhibition of thrombin and activated factor X

drops the level of anti-thrombin 3

153
Q

factor V Leiden deficiency affect what vessels

A

vein and ARTERIES

154
Q

prothrombin 20210 defect

A

THE second most common inherited hypercoagulability

155
Q

antiphospholipid syndrome

A

Lupus anticoagulant- anti- cardiolipin antibody

156
Q

autoimmune association with hypercoagulability

A 
(anti-cardiolipin antibody)
 #1 systemic lupus erythematous
#2 social and syndrome
#3 rheumatoid arthritis
157
Q

elevated homocystine

A

most severe cloters of the hypercoagulability disorders

lowered with vitamin B = better ( and folate)

158
Q

What kind of trauma injury has highest risk of venous thromboembolism

A

spinal cord injury HIGHEST
Fracture of femur or tibia
Other factors include older age, blood transfusion, need for surgery

159
Q

Argatroban

A 
direct thrombin inhibitor
Used for  heparin-induced thrombocytopenia
Monitored by active partial thromboplastin time
Half-life the 40-50 minutes
The ureter were stable
Cleared by HEPATIC
Used for treatment of:
 one HIT
#2 coronary intervention
160
Q

Lepirudin

A 
monitored by activated partial thromboplastin time
#2 direct inhibitor of thrombin
#3 irreversible
#4 out 560 and 90 minutes
#5 cleared by KIDNEY
 #6 reversed by  thrombin
161
Q

management of thrombosis of greater saphenous vein

A

even though “greater” saphenous this is a SUPERFICIAL vein
Duplex venous system
Nonsteroidal anti-inflammatories
NOT Heparin
unless 1 cm within the saphenofemoral junction

162
Q

treatment of venous insufficiency disease failed compression therapy

A

stripping greater saphenous vein ( WITHOUT high ligation)

163
Q

Linton procedure

A

large open incision associated with significant wound healing complications

164
Q

subfascial approach for venous disease

A

endoscopic trochars with carbon dioxide insufflation
Perforators clipped and divided
MODEST have patent deep system

165
Q

the vein valve transplantation

A

interposing brachial vein to the popliteal vein

40-50% of patients have persistent recurrence of ulcers in the long-term if preoperative ulceration present

VASCULAR (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions