Vascular

Question 1

Basic pathophysiology of atherosclerotic arterial disease? (3)

Answer 1

Endothelial injury
Sub-epithelial deposition of lipids and inflammatory cells
Smooth muscle migration and proliferation

Question 2

Main risk factors for atherosclerotic arterial disease? (5)

Answer 2

Smoking
Hypercholesterolaemia
Hypertriglyceridaemia
Diabetes
Hypertension

Question 3

What are the main factors which influence the clinical manifestations of arterial disease? (4)

Answer 3

Disease site
Whether the site is an end-artery or is well-collateralized
The speed of disease progression
Co-morbidity/general health of the patient

Question 4

What are the main “mechanisms of injury” in arterial disease?

Answer 4

Haemodynamic (reduced flow e.g. intermittent claudication)
Thrombosis (e.g. MI, stroke)
Athero-embolism (e.g. internal carotid artery plaque leading to stroke/TIA/amaurosis fugax)
Thrombo-embolism (e.g. atrial fibrillation)

Question 5

Which jugular vein is commonly the best measure of central venous pressure?

Answer 5

Right internal jugular vein

Question 6

Systemic inflammatory symptoms + arthralgia + pulseless limbs?

Answer 6

Takayasu’s arteritis

Question 7

Fever + strawberry tongue + rash in a young child?

Answer 7

Kawasaki disease

Question 8

Why should the abdomen always be examined in varicose veins?

Answer 8

Abdominal masses may cause obstruction of venous return leading to varicose veins

Question 9

Name given to an amputation of the foot at the ankle?

Answer 9

Syme’s amputation

Question 10

Best line for delivery of long term antibiotics/chemotherapeutic agents?

Answer 10

PICC line

Question 11

Best line for rapid delivery of larger volumes of fluid?

Answer 11

Central venous line into the internal jugular or subclavian veins

Question 12

Best line for invasive monitoring of blood pressure/rapid arterial blood sampling?

Answer 12

Peripheral arterial catheter