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Phase 2 - Peri-Op > Vascular Conditions > Flashcards

Vascular Conditions Flashcards

1
Q

What is an enlargement <1.5 times its size called?

A

Ectasia

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2
Q

What is a pseudo-aneurysm?

A

Where there is a collection of blood in the TA which is continuous with the lumen

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3
Q

What is an Ectasia?

A

An enlargement <1.5 times its size

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4
Q

What is arteriomegaly?

A

Generalised enlargement of arteries

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5
Q

When do you treat an aneurysm?

A

When it gets larger or ruptures

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6
Q

What are the presenting features of a ruptured AAA?

A

Abdo Pain
Radiates to back
Hypovolaemic Shock
Syncope/LoC

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7
Q

What is the most common peripheral aneurysm?

A

Popliteal - 70%

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8
Q

What are the risk factors for a femoral aneurysm?

A

IVDU

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9
Q

What are the complications of a peripheral aneurysm?

A

Thromboembolism

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10
Q

What is Aortic DIssection?

A

Where there is spitting of the tunica media from the TI.

Causes an alternative path for blood to flow

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11
Q

What are the risk factors for AAA and dissection?

A 
Male
White
Atherosclerotic Risks
FHx
CT disorders
Hypertension
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12
Q

What is a risk factor for dissection (but not AAA)?

A

Bicuspid Aortic Valve

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13
Q

What are the symptoms of propagating Aortic Dissection?

Forwards

A

Renal - AKI and anuria
Anterior Spinal - paraplegia, uneven BP and pulses
Carotids - hemiplegia

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14
Q

What are the symptoms of propagating Aortic Dissection?

Backwards

A

MI

Valve disease

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15
Q

Presentation of an aortic dissection?

A

Tearing chest pain
Worse leaning back
Syncope/LoC
Shock

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16
Q

Types of Aortic DIssection?

A

Type 1 - ascending aorta

Type 2 - other (30%)

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17
Q

Types of Aortic Dissection?

A

Type 1 - ascending aorta

Type 2 - other (30%)

18
Q

What are the complications of an AAA repair?

A

Renal failure - due to clamping (ischaemia)
- due to contrast
It can move, leak

19
Q

What are the complications of an AAA repair?

A

Renal failure - due to clamping (ischaemia)
- due to contrast
It can move, leak
Dislodging a clot

20
Q

What is the classic presentation of a Aortic Aneurysm rupture?

A

Pain
Hypotension
Pulsatile Mass

21
Q

What are the risk factors for Acute Mesenteric Ischaemia?

A

AF
Valve Disease
Hypercoagulable States
Other causes: Hypovolaemic Shock

22
Q

Where is the occlusion normally in AMI?

A

Just distal to the origin of the SMA

23
Q

How does AMI present?

A

Acute, worsening, central colicky pain
Hypotension
Shock
Abdominal Bruit

24
Q

How do you treat AMI?

A

ABCDE
O2
Heparin and Thrombolytics
Sepsis 6

25
Q

How do you investigate AMI?

A 
Bloods - ABG
Amylase
G&amp;S
Clotting
Amylase

ECG (AF)
CT - oedema and arteriography
CXR (perforation and gasless abdomen)

26
Q

What are the symptoms of Chronic Mesenteric Ischaemia?

A

Colicky, central abdo pain
After meals
Weight loss/Anorexia due to avoidance
Can pass blood in stools

27
Q

Where does the problem occur in Chronic Mesenteric Ischaemia

A

Atleast 2 mesenteric vessels

Normally atherosclerotic

28
Q

How do you treat Chronic Mesenteric Ischaemia?

A

Reduce Atherosclerotic Risk Factors

Stent if worried about AMI

29
Q

Investigating Chronic Mesenteric Ischaemia?

A

CT angiogram
Bloods - atherosclerotic risk
Abdo bruit

30
Q

Where is the problem in Colonic Ischaemia?

A

Normally at the watershed area

IMA

31
Q

Symptoms of Colonic Ischaemia?

A

LIQ pain, colicky

Bloody diarrhoea

32
Q

X Ray appearance of Colonic Ischaemia?

A

Diffuse thickening (oedema)

33
Q

What can Colonic Ischaemia lead to?
How does it present?
How do you treat?

A

Gangrenous Colitis
Hypovolaemic shock and peritonitis
Rapid fluid resuscitation
Resection and stoma formation

34
Q

What is Acute Limb Ischaemia?

A

Reduction of blood supply to a limb under 2 weeks

35
Q

Why does it occur?

A

Usually thromboembolic

Can be due to shock, vasospasm etc

36
Q

Symptoms of acute limb ischaemia?

A 
Pale
Painful
Parasthesia*
Perishingly Cold
Paralysis*
Pulseless

*Late symptoms

37
Q

Appearance of acute limb ischaemia

A

Marble white
Mottled, reticular, blanching
Same but non-blanching (too late to save limb)

38
Q

Investigating Acute Limb Ischaemia?

A

Bloods - ABG, Clotting, G&S
Duplex
ECG

39
Q

What is compartment syndrome?
Who?
Investigations?
Symptoms?

A

Where there is increased pressure in a closed compartment, it restricts the blood flow to a limb and can cause ischaemia and necrosis.
Needs urgent decompressive fasciiectomy
More common in males, young, post trauma, in casts, immobile
ABGs, Myoglobin, CK, H+, K+

PAINNNNN, worse on passive movement of distal tendon

40
Q

How do you treat ALI?
Embolism
Thrombotic
Irreversible

A

Embolectomy
Thrombolysis, PCI, Bypass Grafting
Amputation

Phase 2 - Peri-Op (5 decks)

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