Brainscape's Knowledge GenomeTM

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


See full index

Surgery Revision > Vascular > Flashcards

Vascular Flashcards

1
Q

Sources of cardiac embolism

A
  • atrial and ventricular
  • paradoxical
  • endocarditis
  • cardiac tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Arterial sources of emboli

A
  • artheroembolism

- aortic mural thrombus

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

3 causes of thrombi

A
  • atherosclerosis
  • hypercoagulable states
  • bypass graft occlusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does irreversible limb necrosis start?

A

After 6-8 hours

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

How to classify acute limb ischaemia

A

Rutherford classification

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

Investigation of choice for acute limb ischaemia

A

CT angiography

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

Investigations for acute limb ischaemia

A
  • U/S
  • CTA
  • MRA
  • Echo
  • Transfemoral arteriography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Possible management modalities of acute limb ischaemia

A
  • anticoag alone
  • operative intervention
  • endovascular intervention
  • mechanical thrombectomy
  • thrombolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition of an aneurysm

A

A focal permanent dilatation of an artery greater than 1.5 times that artery’s normal diameter

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

Definition of Ectasia

A

A focal dilatation of an artery greater than the normal diameter of that artery, but less than 1.5 times the normal diameter

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

Definition of arteriomegaly

A

The entire arterial segment is diffusely dilated

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

Definition of aneurysmosis

A

Multiple aneurysms with intervening normal arterial segments

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

Complications of aneurysms

A
  • rupture
  • thrombotic occlusion
  • thrombo-embolism
  • pressure-related problems
  • spontaneous fistulisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of aneurysms

A
  • degenerative
  • infective
  • CTD
  • trauma
  • inflammatory
  • post-dissection
  • post-stenotic
  • congenital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ways to classify arterial aneurysms

A
  • anatomical location
  • aneurysm type (T/F)
  • morphology
  • size
  • etiology
  • clinical presentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of AAA

A
  • infra-renal
  • juxta-renal
  • para-renal
  • supra-renal
  • thoracoabdominal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for AAA

A
  • uncontrolled HPT
  • hyperchol.
  • smoking
  • chlamydia pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of AAA

A
  • abdo/back pain

- compression (vomiting, constipation, flank pain, venous disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

First line investigation for AAA

A

Duplex doppler

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

Who to screen for AAA

A
  • caucasian males >65 yo
  • peripheral aneurysms
  • throacic aortic aneurysms
  • family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Symptoms of a ruptured AAA

A
  • sudden onset acute backpain
  • shock
  • pulsatile abdo mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is Cullen’s sign found?

A

Umbilicus

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

Where is Grey-Turner sign found?

A

Flanks

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

What is Hardman risk index for?

A

To predict who to intervene for with AAA

- >3 = 100% mortality

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

Causes of Thoraco-abdominal aneurysms

A
  • degen
  • Takayasu’s
  • intimo-medial mucoid degen
  • HIV-related aneurysm
  • mycotic aneurysm
  • TB aortitis with aneurysm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Common peripheral aneurysms

A
  • popliteal

- femoral

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

Uncommon peripheral aneurysms

A
  • subclavian
  • extra-cranial carotid
  • mesenteric
  • renal artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Deformities associated with diabetic motor neuropathy

A
  • pes cavus

- hammer toes

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

Natural history of Charcot’s osteoarthropathy

A
  • ligamentous failure
  • subluxation and dislocation
  • swollen and red
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a normal ABI?

A

0.9-1.1

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

Foot deformities of diabetic foot

A
  • skin cracks, fissures, calluses
  • claw/hammer toes
  • Rocker bottom feet
  • Pes cavus
  • Hallux valgus/rigidis
  • Charcot’s foot
  • fixed flexion deformity of PIPJ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How to classify treatment of diabetic foot

A

Wagner classification (Grade 0-5)

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

How to classify follow-up for diabetic foot

A

Foot-at-risk classification (Category 0-3)

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

Acute indications for referral for diabetic foot

A
  • callus formation
  • ulceration
  • ischaemic changes
  • acute local sepsis
  • non-healing trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Chronic indications for referral for diabetic foot

A
  • recurrence
  • worsening deformity
  • worsening neuropathy
  • worsening sugar control
  • ischaemic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Risk factors for venous thromboembolism

A
  • age
  • obesity
  • varicose veins
  • family history
  • thrombophilia
  • majory surgery/immobility
  • acute illness/sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Complications of venous thromboembolism

A
  • PE
  • pulmonary HPT
  • post-thrombotic syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Signs of a DVT

A
  • phlegmasia alba dolens
  • phlegmasia cerulea dolens
  • Homan’s sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is homan’s sign?

A

Calf pain at dorsiflexion of the foot

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

How to know if it is likely a DVT

A

Well’s score >2
D-dimer (neg excludes)
Duplex US

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

Features of DVT on Duplex US

A
  • venous compressability
  • intraluminal echoes
  • venous flow
  • filling defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Methods of prophylaxis for DVT

A

General

  • hydration
  • early mobilization

Mechanical

  • elastic compression stockings
  • intermittent pneumatic stockings

Pharmacological

  • Unfractionated heparin
  • LMWH
  • oral Vit K antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Clinical categorisation of PAD

A
  • aorto-iliac
  • femero-popliteal
  • tibio-peroneal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Types of claudication

A
  • intermittent
  • spinal
  • venous
  • atypical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Stratification of PAD

A
  • Fontaine

- Rutherford

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

Pharmacotherapy for PAD

A

Cilostazol (phosphodiesterase type 3 inhibitor)

Nafidrofuryl- hydroxytaptamine type 2 inhibitor

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

Classification for chronic venous disease

A

CEAP

  • clinical signs
  • etiology
  • anatomy
  • pathophysiology
48
Q

Risk factors for chronic venous disease

A
  • increasing age
  • pregnancy
  • family history
  • obesity
  • prolonged standing
  • caucasian race
  • poor dietary fibre
49
Q

Clinical classification of chronic venous disease

A 
0 = no signs
1 = telangiectasia, reticular veins, malleolar flare
2 = varicose veins
3 = oedema without skin changes
4 = skin changes (pig, eczema, lipodermato)
5 = skin changes with healed ulceration
6 = skin changes with active ulceration
50
Q

Causes of venous hypertension

A 
Reflux (90%)
- superficial
- deep
Obstruction (10%)
- iliofemoral
- superficial femoral
51
Q

Cause of venous insufficiency

A
  • varicose veins
  • DVT
  • external pressure
  • inborn valve def
  • prolonged muscle inactivity
  • muscle dysfunction/paralysis
  • skeletal poblems
52
Q

Symptoms of venous insufficiency

A
  • aching
  • throbbing
  • leg fatigue/ heaviness
  • swelling
  • worse at night
53
Q

Complications of venous insuff

A
  • thrombophlebitis and rupture

- oedema - ulceration

54
Q

Where does the GSV run?

A
  • medial calf and thigh
55
Q

Where does the SSV run?

A
  • posterolateral calf
56
Q

Where does the pelvic vein run?

A
  • upper medial thigh and labia
57
Q

Investigation of chronic venous disease

A
  • Duplex doppler

- CT venography for complicated cases

58
Q

Treatment of chronic venous disease

A
  • compression
  • sclerotherapy
  • surgery
59
Q

Definition of a venous ulcer

A

A full thickness defect of the skin, present for >30 days that fails to heal spontaneously and is sustained by chronic venous disease

60
Q

How to treat venous ulcer

A

Compression!

61
Q

Clinical presentation of ischaemic ulcers

A
  • over bony prominences
  • very painful at rest, relieved by gravity
  • punched out
  • surrounding skin changes
  • delayed cap refill
62
Q

Presentation of neuropathic ulcers

A
  • deep punched out over pressure points
  • usually painless
  • Charcot’s foot
63
Q

Describe Martorell ulcer

A

Very painful ulcer of lower leg associated with poorly controlled hypertension

64
Q

Investigation of venous ulcers

A
  • duplex doppler
  • ambulatory venous pressure
  • plethysmography
65
Q

Why do people with upper limb ischaemia present later?

A
  • good collaterals in the neck and less muscle mass
66
Q

Etiology of upper limb ischaemia

A
  • embolic (90%)
  • thrombosis
  • trauma
  • iatrogenic (invasive procedures)
  • Takayasu’s
  • aortic dissection
  • hypercoagulable states
67
Q

Management of upper limb ischaemia

A
  • anticoag (unfrac, heparin)
  • analgesia
  • refer to vascular
  • embolectomy
  • thrombolysis (if acute on chronic)
68
Q

How to manage embolisation after an intra-arterial injection

A
  • irrigate with heparin-saline solution
  • inject vasodilator (nitroglycerine)
  • heparin
  • low mol weight dextran + dexamethasone
69
Q

Explain subclavian steal syndrome

A

retrograde blood flow in the vertebral artery due to proximal stenosis/occlusion of the subclavian artery
- leads to vertebrobasilar insufficiency

70
Q

Etiology of chronic upper limb ischaemia (large vessel)

A
  • atherosclerosis
  • aneurysms
  • arteritis
  • arterial thoracic outlet compression syndrome
71
Q

Clinical findings in chronic upper limb ischaemia

A
  • unilat Raynauds
  • BP difference between arms
  • palpable cervical rib
  • palpable subclavian artery
  • bruit of subclavian artery
72
Q

Management of chronic upper limb ischaemia

A
  • risk factor modification
  • anti-platelet therapy
  • percutaneous transluminal angioplasty + stent
  • bypass surgery
73
Q

Causes of upper limb ischaemia (small vessel)

A
  • vasospasm (Raynauds)
  • CTD
  • Beurger’s disease
  • occupational injury
  • vasculitis
  • misc
74
Q

Principles of treating digital ulcers

A
  • conservative debridement
  • retain as much tissue as possible
  • avoid damaging blood supply
  • appropriate wound cover
  • treat vasospasic conditions
  • appropriate Ab
  • protection against further injury
75
Q

Management of Raynauds

A
  • general (warmth, gloves)
  • drugs (nifedipine 5mg tds)
  • sympathectomy
76
Q

Causes of secondary hypertension

A
  • endocrine disorders
  • renal parenchymal disorders
  • renovascular disorders
77
Q

Causes of renovascular hypertension

A
  • RAS
  • coarctation of the aorta
  • middle aortic syndrome
78
Q

Features suggesting secondary hypertension

A
  • early onset (<30)
  • late onset
  • severe HPT
  • malignant HPT
  • HPT needing multi-drug Rx
  • medically refractory
  • epigastric bruits
  • grade 3/4 HPT retinopathy
  • flash pulm oedema
  • refractory angina
  • stigmata of endocrine d/o
79
Q

Endocrine screen for hypertension

A
  • 9am serum cortisol
  • 24 hour urinary cortisol
  • serum aldo
  • plasma renin assays
  • 24hr urinary metaneph/catchol
  • plasma catechol
  • thryoid tests
  • parathyroid tests
  • serum Ca and Phos
80
Q

Imaging for secondary hypertesion

A
  • CT (abdo, brain, chest)
  • US of thyroid
  • radio-isotope scans
  • Duplex of kidneys
  • MAG 3 renogram
  • Captopril renogram
  • Vascular (CTA, MRA, DSA)
81
Q

Pathophysiology of renovascular hypertension

A
  • activation of the RAAS system
82
Q

Ang II actions

A
  • acts on ATII receptors - vasoconstriction

- aldosterone release - fluid retention

83
Q

Anatomical classification of RAS

A
  • ostial
  • parostial
  • truncal
  • accessory
  • segmental
  • mixed
  • renal artery occlusion
84
Q

Pathological classification of RAS

A 
Atherosclerotic
Non-atherosclerotic
- FMD
- Takayasu's
- renal artery dissection
- RA aneurysms
- trauma
- radiation-induced
85
Q

Treatment of RAS

A
  • medical (ACE-I)
  • percutaneous transluminal renal angioplasty + stenting
  • surgical revasc
  • nephrectomy (if unilat)
86
Q

Requirements for a nephrectomy for RAS

A
  • 1 kidney <8cm

- single kidney GFR <10

87
Q

What is FMD?

A

A degenerative condition of branchless vessels

- occurs in young women

88
Q

Types of FMD

A
  • medial
  • adventitial
  • intimal
89
Q

Dx of FMD on DSA

A
  • normal aorta
  • string of beads
  • mid and distal 1/3 of the renal artery
90
Q

Gold standard treatment of FMD

A
  • transluminal balloon angioplasty
91
Q

What is Takayas’s disease

A

Non-specific large vessel vasculitis

92
Q

Findings of Takayasu’s disease on CTA

A
  • thick walled aorta
  • aortic occlusion
  • RAS
93
Q

Gold stardard treatment of Takayasu’s

A

Surgical revasc

94
Q

Where does coarctation of the aorta usually occur

A

At the ligamentum arteriosum

95
Q

Diagnosis of coartcation

A
  • ECG (LVH)
  • Chest XRAY (post. inf. rib notching)
  • CTA/MRA/DSA
  • TOE
96
Q

Classification of coarctation

A
  • post-ductal
  • pre-ductal
  • interrupted
97
Q

Surgical management of coarctation

A
  • patch angioplasty
  • interpositional bypass graft
  • resection and re-anastomosis
98
Q

Interventional management of coarctation

A
  • balloon angioplasty
  • aortic stent
  • aortic stent grafting
99
Q

What is mid-aortic syndrome

A

Acquired vascular condition - narrowing of the aorta

100
Q

Disorders associated with mid-aortic syndrome

A
  • Takayasu’s
  • atherosclerosis
  • cong. hypoplasia
  • Von Recklinghausen’s disease
  • FMD
  • tuberculous aortitits
101
Q

Clinical features of mid-aortic syndrome

A
  • upper limb HPT
  • radio-femoral delay
  • inter-scap/ abdo bruits
  • lower extremity claudication
102
Q

Etiology of acute mesenteric ischaemia

A
  • arterial embolism
  • arterial thromboembolism
  • venous thrombosis
  • non-occlusive mesenteric ischaemia
  • rare (aortic dissec, vasculitis)
103
Q

Natural history of intestine in mesenteric ischaemia

A
  • changes in villi
  • mucosa sloughs off
  • transmural necrosis
  • perforation
  • sepsis
  • death
104
Q

Presentation of acute Mesenteric ischaemia

A
  • severe abdo pain (sudden, colicky)
  • N+V
  • Hx of arrythmias/MI
  • atherosclerotic disease
105
Q

Abdo XRAY findings in acute mesenteric ischaemia

A
  • dilated small bowel
  • wall oedema
  • gas in wall
106
Q

Management of acute mesenteric ischaemia

A

Resus and anticoag

Surgical

  • exploratory lap
  • resection
  • revasc

Endovasc

  • aspiration thrombectomy
  • thrombolysis
  • angioplasty + stenting
107
Q

Associations with mesenteric vein thrombosis

A
  • thrombophilia
  • portal HPT
  • intra-abdo malignancies
  • pancreatitis
  • preg
108
Q

Causes of non-occlusive mesenteric ischaemia

A
  • severe systemic illness

- usually in ICU on inotropes

109
Q

Presentation of chronic mesenteric ischaemia

A

Mesenteric angina (post-prandial, peri-umbilical, recurrent)

  • LOW + food fear
  • N + V
110
Q

Management of chronic mesentery ischaemia

A

Endovasc
- balloon angioplasty and stenting

Surgery

  • re-implantation techniwue
  • endarterectomy
  • bypass
111
Q

Amaurosis Fugax

A

Temporary retinal artery ischaemia

112
Q

How to predict likelihood of secondary ischaemic event

A

ABCD2 stroke risk score

  • age
  • BP
  • clinical features
  • duration
  • diabetes
113
Q

Surgery for carotid artery stenosis

A

Carotid endarterectomy (local/GA)

114
Q

Complications of endovasc. carotid angioplasty and stenign

A
  • ipsilat ischaemic stroke
  • labile BP
  • ACS
  • death
  • local Hg
  • nerve injuries
115
Q

What does the verebrobasilar system supply?

A
  • occipital cortex
  • cerebellum
  • thalamus
  • brain stem
116
Q

Presentation of vertebrobasilar insufficiency

A
  • vertigo
  • visual disturbance
  • drop attacks
  • numbness/tingling
117
Q

Surgical management of vertebrobasilar insufficiency

A
  • endarterectomy

- bypass grafting/ direct arterial transposition

Surgery Revision (8 decks)

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