Brainscape's Knowledge GenomeTM

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


See full index

AMC MCQ - Key points > Vascular Brief > Flashcards

Vascular Brief Flashcards

1
Q

Describe the first symptom of acute limb ischemia

A

Pain

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

What is the first sign of acute limb ischemia?

A

Pallor

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

What is the last symptom of acute limb ischemia?

A

Paresis

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

Where is the most common site of acute limb ischemia?

A

Bifurcation of aorta

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

What is the first investigation in the management of acute limb ischemia?

A

Duplex scan

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

What is the first medication to be given in the treatment of acute limb ischemia?

A

IV heparin immediately

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

What is the definitive treatment for acute limb ischemia?

A

Embolectomy

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

What is the treatment for severe swelling of the limb after embolectomy?

A

Emergent fasciotomy

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

What is the diagnosis when EKG shows hyperacute T-wave after embolectomy?

A

Hyperkalemia

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

What is the immediate treatment for hyperkalemia with significant EKG changes?

A

Immediate Ca gluconate

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

What is the diagnosis of a patient with bleeding after arterial catheterization?

A

Arterial injury

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

What is the first step in the treatment of arterial injury?

A

Apply pressure to stop bleeding

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

What is the definitive treatment of arterial injury?

A

Surgery

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

What is the diagnosis of a patient with intermittent claudication?

A

Chronic limb ischemia

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

What is the first step in the management of a patient with chronic limb ischemia?

A

Ankle Brachial Index (ABI)

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

What is the most serious symptom of a patient with chronic limb ischemia?

A

Rest pain

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

What is the most important treatment of chronic limb ischemia?

A

Gradual exercise program

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

What is the treatment of acute limb ischemia?

A

Angioplasty and stent

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

What is the most common complication after bypass graft?

A

Restenosis

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

What is the most common risk factor for peripheral artery disease (PAD)?

A

Diabetes mellitus

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

What is the mechanism of PAD caused by diabetes mellitus?

A

Microangiopathy

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

What does limb ischemia with intact pulsation indicate?

A

Small vessel thrombosis

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

What is the most important clinical presentation of abdominal aneurysm?

A

Pulsatile abdominal mass

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

What are the serious signs in aortic aneurysm?

A

VVV IMP

Patients with a known AAA presenting with abdominal or back pain, syncope or tenderness over the aneurysm, require urgent assessment by a vascular surgeon for potential surgery.

Aortic aneurysms – screening, surveillance and referr

25
Q

Describe the initial investigation for abdominal aortic aneurysm or what to do if the patient is unstable.

A

Initial investigation is ultrasound. If unstable, proceed with ultrasound.

26
Q

What is the investigation of choice for abdominal aortic aneurysm?

A

CT scan.

27
Q

What is the most common cause of foot ulceration in diabetes patients?

A

Neuropathy.

28
Q

Where are the most common sites for pressure ulcers in diabetic patients?

A

Pressure areas, with the most common sites being the head of the 1st metatarsal and the heel.

29
Q

How can you best protect a smoker patient with diabetes, hypertension, and hyperlipidemia from the risk of amputation?

A

Through leg caring.

30
Q

What is the first and most important step in the sequence of treatment for diabetic ulcers?

A

Debridement.

31
Q

What is the second step in the treatment sequence for diabetic ulcers?

A

Antibiotics.

32
Q

How should you manage a clear ulcer with clear discharge in diabetic patients?

A

Just dressing.

33
Q

What is the best investigation to exclude Marjolin ulcer or malignancy?

A

Biopsy.

34
Q

What is the most important investigation to exclude osteomyelitis?

A

MRI.

35
Q

Describe the condition that would lead to a young healthy male smoker needing a leg amputation.

A

Buerger’s disease.

36
Q

What is the treatment of choice for a patient with recurrent transient ischemic attacks (TIA) caused by carotid stenosis?

A

Carotid endarterectomy surgery (not stent).

The treatment of choice for a patient with recurrent transient ischemic attacks (TIA) caused by carotid stenosis according to RACGP guidelines includes:

  1. Carotid Endarterectomy (CEA):
    • Indication: Recommended for patients with significant carotid artery stenosis (usually greater than 70%) who are suitable surgical candidates.
    • Evidence: CEA has been shown to significantly reduce the risk of stroke in patients with symptomatic carotid stenosis.
  2. Carotid Artery Stenting (CAS):
    • Indication: An alternative to CEA for patients who are at high surgical risk or have anatomical factors that make surgery difficult.
    • Considerations: CAS may be preferred in certain cases, but it carries a slightly higher risk of stroke and procedural complications compared to CEA.
  3. Medical Management:
    • Antiplatelet Therapy: Aspirin or clopidogrel to reduce the risk of further thromboembolic events.
    • Statin Therapy: To manage cholesterol levels and stabilize atherosclerotic plaques.
    • Blood Pressure Control: Optimal management of hypertension.
    • Lifestyle Modifications: Smoking cessation, diet changes, regular exercise, and weight management.
  4. Monitoring and Follow-Up:
    • Regular follow-up with duplex ultrasonography to monitor the degree of stenosis and ensure the effectiveness of the treatment.
  • RACGP Guidelines: Detailed guidelines can be found on the RACGP website in the clinical resources section.
  • American Heart Association (AHA) Guidelines: Provide comprehensive recommendations for the management of patients with carotid artery stenosis.
  • European Society for Vascular Surgery (ESVS) Guidelines: Offer detailed recommendations on the treatment and management of carotid stenosis.

For more detailed information, you can refer to the RACGP guidelines on carotid artery disease and the management of TIA. RACGP Clinical Guidelines.

37
Q

What are the indications for surgery in patients with carotid stenosis?

A

Symptomatic patients with >50% stenosis and asymptomatic patients with ≥70% stenosis.

The RACGP guidelines indicate that surgery for carotid stenosis is primarily considered based on whether the disease is symptomatic or asymptomatic.

  1. Symptomatic Carotid Stenosis: Surgery is generally recommended for patients who have had a recent transient ischemic attack (TIA) or minor stroke and have significant carotid stenosis.
    • Carotid Endarterectomy (CEA) is advised for patients with 50-99% stenosis, ideally performed within two weeks of the initial neurological event.
    • Surgery aims to reduce the risk of recurrent strokes.
  1. Asymptomatic Carotid Stenosis: The management of asymptomatic carotid stenosis is more contentious. Best medical therapy (BMT), including antiplatelet therapy, statin therapy, and cardiovascular risk modification, is the primary approach.
    • Surgery may be considered for patients with stenosis greater than 80%, especially if they are younger with few comorbidities, as they will benefit most from stroke risk reduction over their lifetime.
    • For patients with less than 80% stenosis, annual surveillance with carotid duplex ultrasonography (CDUS) is recommended.
    • Surgery is less likely to be beneficial in older patients with significant comorbidities due to the lower cumulative stroke risk reduction and higher potential complication rates.
  • Carotid Artery Stenting (CAS): This may be used in patients who are at high risk for surgery due to other health issues or anatomical considerations. However, CAS generally has a higher rate of perioperative stroke compared to CEA and is reserved for specific situations where CEA is contraindicated.
  • Post-surgical follow-up typically includes CDUS at 4-6 weeks and at 6 months to monitor for restenosis.

These guidelines ensure that the decision for surgery is tailored to the individual patient’s condition, balancing the risks and benefits of the intervention. For more detailed information, you can refer to the RACGP guidelines on carotid artery stenosis management oai_citation:1,RACGP - Carotid artery stenosis oai_citation:2,academic.oup.com.

38
Q

How should you manage a patient with a red, hot, tender, swollen superficial vein that feels cord-like on examination?

A

Superficial thrombophlebitis.

39
Q

What is the treatment for superficial thrombophlebitis?

A

Compression by elastic stocking.

40
Q

What is the first step in the management of a patient with risk factors for deep vein thrombosis (DVT) who presents with swelling, pain, and tenderness?

A

Duplex scan.

41
Q

What is the most reliable sign of DVT?

A

Swelling.

42
Q

What is the first step in the treatment of DVT?

A

Immediate administration of LMWH.

43
Q

What is the long-term treatment after LMWH for DVT?

A

Warfarin for 3-6 months with a target INR of 2-3.

44
Q

What should be done if a patient on warfarin has an INR >9 and no bleeding is present?

A

Give FFP (fresh frozen plasma).

45
Q

What is the management for a patient on warfarin with major bleeding?

A

Give FFP.

46
Q

What is the management for a patient on warfarin requiring emergent surgery?

A

Give FFP.

47
Q

What is the management for a patient on warfarin requiring elective surgery?

A

Stop warfarin 5 days before surgery.

48
Q

What is the management for a patient on aspirin requiring emergent surgery?

A

Give platelets.

49
Q

What is the management for a patient on aspirin requiring elective surgery?

A

Stop aspirin 5 days before surgery.

50
Q

Describe the presentation of cellulitis.

A

LL swelling, pain, tenderness + high-grade fever.

51
Q

What does a high INR in a patient on warfarin indicate?

A

Hematoma.

52
Q

Where is the most common site for an ischemic ulcer?

A

Tip of fingers.

53
Q

Where is the most common site for a neuropathic ulcer?

A

Head of 1st metatarsal.

54
Q

Where is the most common site for a venous ulcer?

A

Against medial malleolus.

55
Q

Are antibiotics typically used for venous ulcers?

A

No.

56
Q

What is the main treatment for venous ulcers?

A

Compression stocking and elevation of leg.

57
Q

What is most important to prevent complications in the foot of a diabetic patient?

A

Proper foot care and glycemic control.

58
Q

What are the classifications of foot ulcers based on severity?

A

Mild, Moderate, Severe.

59
Q

What drugs need to be stopped before operations for a certain period of time?

A

Warfarin (5-7 days), Aspirin, clopidogrel, NSAIDs (5-7 days), Amitriptyline (5-7 days), Metformin (1 day).

AMC MCQ - Key points (49 decks)

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