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vascular/IR trivia Flashcards

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1
Q

What is the anatomy of a pulmonary sling?

A

aberrant left pulmonary artery arising from the right pulmonary artery

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2
Q

What are the two UNIQUE attributes of a pulmonary sling?

A
  1. only anamoly to create indentations in posterior trachea and anterior esophagus
  2. only anamoly to cause stridor in a pt with a LEFT arch
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3
Q

What does ‘replaced’ mean in regards to hepatic arterial anatomy?

A

arises from non-classic vessel

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4
Q

What does ‘replaced’ mean in regards to hepatic arterial anatomy?

A

different origin

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5
Q

What does ‘accessory’ mean in regards to hepatic arterial anatomy?

A

duplicated vessel with aberrant origin of spare

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6
Q

A vessel in the ligamentum venosum most like represents what?

A

accessory or replaced left hepatic artery arising from left gastric

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7
Q

What is the normal position of the right hepatic artery in relation to the right portal vein?

A

anterior

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8
Q

What is the position of the right hepatic artery in relation to the right portal vein when it is replaced?

A

replaced = posterior to left portal vein

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9
Q

What are the branches of the posterior division of the internal iliac?

A

Iliolumbar

lateral sacral

superior gluteal

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10
Q

The persistent sciatic is a continuation of what artery?

A

internal iliac

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11
Q

What are the two complications of a persistent sciatic artery?

A

aneurysm and early atherosclerosis

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12
Q

Where does the persistent sciatic course in the thigh?

A

posterior to the femur

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13
Q

What is the vascular variant connecting the celiac trunk to the SMA that lies outside of the inferior pancreatico-duodenal artery?

A

Arc of Buhler

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14
Q

What two specific vessels are connected by the Arc of Riolan?

A

middle colic of SMA to left colic of IMA

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15
Q

What vessel forms a loop around the large bowel?

A

marginal artery of drummond

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16
Q

What is the Winslow pathway?

A

internal thoracic to inferior epigastric

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17
Q

What two vessels are connected by the Corona Mortis?

A

external iliac to obturator

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18
Q

What osseus structure does the corona mortis classically pass over?

A

superior pubic ramus

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19
Q

Where does the subclavian vein run in regards to the anterior scalene?

A

anterior

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20
Q

Where does the subclavian artery run in regards to the anterior scalene?

A

posterior to anterior scalene

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21
Q

At what landmark does the subclavian artery become the axillary artery?

A

1st rib

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22
Q

What anatomic landmark divides the axillary artery into the brachial artery?

A

teres MAJOR

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23
Q

What artery is usually bigger, the ulnar or radial artery?

A

ulnar

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24
Q

Which artery usually gives off the interosseus branch, radial or ulnar?

A

ulnar

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25
Q

Which gives off the supercifial palmar arch, ulnar or radial?

A

ulnar

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26
Q

What anatomic landmark does the SFA become popliteal artery?

A

exiting aDDuctor canal

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27
Q

Most gastric varices are formed from what gastric vein?

A

left gastric vein

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28
Q

Is a splenorenal shunt associated with GI bleeding?

A
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29
Q

What cardiac vascular abnormality is associated with a left sided SVC?

A

unroofed coronary sinus

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30
Q

What CHD abnormality is most often associated with a left sided SVC?

A

ASD

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31
Q

What visceral organ is often abnormal when there is a duplicated IVC?

A

renals

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32
Q

Which limb is superior with a circum-aortic renal vein, anterior or posterior limb?

A

anterior = superior

posterior = inferior

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33
Q

What is absent with an Azygos Continuation of the IVC?

A

intrahepatic IVC

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34
Q

Where do hepatic veins drain during an azygos continuation?

A

RIGHT ATRIUM

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35
Q

Azygos Continuation should make you say what?

A

polysplenia

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36
Q

IVC/aorta reversal should make you say what?

A

Asplenia

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37
Q

What is the differential for atherosclerotic calcifications of the ascending aorta?

A

takayasu

syphillis

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38
Q

Which sinus is usually involved with a sinus of valsalva aneurysm? How is this fixed?

A

right

Bentall (graft of ascending aorta)

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39
Q

Are mycotic aneurysms more often saccular or fusiform?

A

saccular

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40
Q

What is the classic tried found in Loeys Dietz?

A
  1. hypertelorism
  2. bifid uvula or cleft palate
  3. shitty and tortuous vessels
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41
Q

Percutaneous procedure for Ehlers-Danlos? Why not?

A

no

increased risk of dissection

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42
Q

Does median arcuate ligament syndrome get worse with inspiration or expiration?

A

expiration

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43
Q

Does mesenteric ischemia from an arterial standpoint have thickened or thinned colonic wall?

A

thin

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44
Q

Does mesenteric ischemia from a venous standpoint have thickened or thinned colonic wall?

A

thickened

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45
Q

Where is Griffith’s point?

A

splenic flexure

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46
Q

Where is Sudeck’s point?

A

recto-sigmoid juncture

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47
Q

Is colonic angiodysplasia an arterial or venous issue?

A

arterial

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48
Q

If colonic angiodysplasia is associated with aortic stenosis, what is this called?

A

Heyde Syndrome

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49
Q

With HHT, extensive hepatic shunting can cause what?

A

biliary necrosis and/or bile leak

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50
Q

Does FMD affect the renal artery ostium?

A

no

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51
Q

FMD can predispose to spontaneous what?

A

dissection

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52
Q

Does FMD get stented?

A

never

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53
Q

Popliteal entrapment most common involves what muscle? What can worsen in?

A

medial head of gastroc.

dorsiflexion or plantar flexion

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54
Q

paraplegic or quadriplegic are at increased risk of VTE?

A

para

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55
Q

What is the triad of Klippel Trenaunay?

A
  1. port wine stain
  2. bone/tissue hemi-hypertrophy
  3. venous malformation
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56
Q

What is the vein of Servelle? What disease is it indicative of?

A

superficial vein in leg and thigh

Klippel trenuay

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57
Q

What is the age group of cystic adventitial disease? What artery is predominantly affected?

A

young men

popliteal

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58
Q

What is the age group of cystic adventitial disease? What artery is predominantly affected?

A

young men

popliteal

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59
Q

What artery is clasically affected by TCA arteritis other than branches of the external carotid?

A

brachial/axillary/subclavian

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60
Q

What disease is associated with giant/temporal cell arteritis?

A

polymyalgia rheumatica

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61
Q

What vasculitis is more common in men?

A

PAN

62
Q

What happens to the vessel during PAN?

A

micro-aneurysm

63
Q

What virus is associated with PAN?

A

Hep B

64
Q

What drug is associated with microaneurysms in the kidney?

A

meth

65
Q

Coronary artery aneurysms greater than what size are considered too big to spontaneously regress?

A

> 8mm

66
Q

What two conditions does a patient with Churg Strauss always have?

A

asthma

eosinophilia

67
Q

Does Churg Strauss cavitate?

A

No

68
Q

Profound scrotal skin edema should make you think what disease?

A

HSP

69
Q

A hand angiogram showing hypothenar hammer syndrome will most likely show what?

A

pseudo-aneurysm off of ulnar artery

70
Q

A hand angiogram of Buegers disease should show what appearance for the ulnar artery?

A

normal

71
Q

How does Microscopic Polyangiitis present on CT?

A

diffuse pulmonary hemorrhage

72
Q

Rabbit ear shaped spectral waveform can be indicative of what disease?

A

early steal

73
Q

Reversal of diastolic flow on carotid doppler is indicative of what disease proximally?

A

aortic regurgitation

74
Q

What is the latin name for a double aortic systolic peak?

A

pulsus bisferiens

75
Q

Pulsus Bisferiens on a carotid doppler can be indicative of what two diseases proximally?

A

aortic regurgitation

HCOM

76
Q

Are the sizes of sheaths dictated by their inner or outer diameter?

A

inner

77
Q

Generally, in French, how much bigger is the hole a sheath makes in the vessel compared to its inner diameter?

A

2F bigger

78
Q

Does a shorter or longer ‘floppy’ tip have a greater likelihood of vessel dissection?

A

shorter

79
Q

What are the two stiffest wires?

A

Lunderquist

Backup Meier

80
Q

What does a J Tip # represent?

A

diameter of curve in ‘mm’

81
Q

How much flow (in mL/sec) per french size?

A

8 mL/sec per French

82
Q

How much flow (in mL/sec) per french size?

A

8 mL/sec per French

83
Q

Is axumin good for soft tissue or osseus mets?

A

soft tissue

84
Q

Never use a closure device if there is risk of an?

A

infection

85
Q

When can heparin be stopped and started after access?

A

usually two hours

86
Q

How long does plavix need to be held?

A

5 days

87
Q

How many units of heparin for a pseudoA?

A

500 - 1000

88
Q

If the cavity size of a pseudoA is less than 2cm, how should that be managed?

A

conservatively

89
Q

Neck size of a pseudoA needs to be smaller than what for thrombin treatment?

A

< 1cm

90
Q

Where is thrombin injected in a pseudoA?

A

cavity apex

91
Q

PseudoA need to be treated within what time frame?

A

two weeks (do much better)

92
Q

PseudoA compressed above the inguinal ligament can lead to what?

A

RP bleed

93
Q

What is the minimum proximal landing zone for an EVAR?

A

10 mm

94
Q

What is the maximum proximal aortic diameter for an EVAR?

A

3.2 cm

95
Q

Tortuosity of proximal aorta has to be less than what degree?

A

< 60

96
Q

What does a juxta renal AAA mean?

A

proximal landing zone is less than 1cm

97
Q

What is the pathophysiology behind a type 3 endoleak?

A

defect/fracture in the graft

98
Q

What is the pathophysiology behind a type 4 endoleak?

A

porosity

99
Q

Particles smaller than what size may necrose tissue?

A

300 microns

100
Q

Do bronchial arteries tend to need re-access?

A

yes

101
Q

What malignancy likes ethiodol?

A

hepatoma/HCC

102
Q

Treat inflow or outflow first?

A

in flow

103
Q

What is the timepoint for thrombolysis vs surgery?

A

14 days

104
Q

TBI should be greater than what number?

A

0.6

105
Q

If toe pressures are less than what # are toe ulcers unlikely to heal?

A

30 mm Hg

106
Q

Are the collaterals occluded during phlegmasia alba or phlegmasic cerulea dolens?

A

dolens

107
Q

What % of IVC filters thrombose within 5 years?

A

10%

108
Q

Is an IVC filter placed infrarenal or suprarenal during pregnancy?

A

supra

109
Q

Where is an IVC filter placed with a circumaortic renal vein?

A

below the lowest renal vein

110
Q

Greater than what size is considered a mega IVC?

A

28 mm

111
Q

Does an IVC filter increase or decrease the risk of DVT?

A

increase

112
Q

Can a clotted IVC filter be removed?

A

no

113
Q

What type of contraindication is bacteremia for an IVC filter placement?

A

relative

114
Q

According to lionheart, how is a caval wall injury/dissection treated if caused by IVC filter removal?

A

anticoagulation

115
Q

Where does intimal hyperplasia take place with a synthetic AV graft?

A

downstream from venous graft anastomosis

116
Q

What two pressures can be used to diagnose portal hypertension?

A
  1. portal pressure greater than 10 mm Hg

2. Portal to systemic gradient pressure of greater than 5 mm Hg

117
Q

Right heart pressure greater than what contraindicates a TIPS?

A

10-12 mm Hg

118
Q

After TIPS, you want your gradient to be what?

A

less than 12 mm Hg

119
Q

What is normally posterior, right hepatic vein or right portal vein?

A

right hepatic vein

120
Q

MELD scores greater than what are at an increased risk of early death after elective TIPS?

A

18

121
Q

Is too high or too low a gradient a risk for developing hepatic encephalopathy after a TIPS?

A

too low

122
Q

Does BRTO improve or worsen HE?

A

improve

123
Q

Does BRTO increase or decrease hepatic blood flow?

A

increase

124
Q

How many right hepatic ducts are there? Names?

A

Two

anterior and posterior

125
Q

What is the most common hepatic ductal anatomy?

A

right posterior drains into left hepatic duct

126
Q

Don’t pull a chole tube before what time point? Why not?

A

two weeks

immature tract –> bile leak

127
Q

There is a high risk of biliary abscess in TACE pt with what three conditions?

A
  1. biliary stent
  2. prior sphincterotomy
  3. post whipple
128
Q

What is the maximum radiation dose that can be delivered to the lungs via shunt fraction with Y90?

A

30 Gy

129
Q

What is the energy of Y90?

A

0.93 MeV

130
Q

What is the half life of Y90?

A

64 hours

131
Q

Key structures need to be how far away from RFA burn zone?

A

> 1 cm

132
Q

What is the maximum size a lesion can be to be ‘cured’ with RFA?

A

<4 cm

133
Q

When I say pancreatic arcade bleeding (pseudo) aneurysm, you say?

A

celiac artery stenosis

134
Q

An RBC scan can detect GI bleeds with flow down to what volume?

A

0.1 mL/min

135
Q

A CTA can detect GI bleeds with flow down to what volume?

A

0.4 mL/min

136
Q

Transgluteal approach through what ligament will avoid the sciatic nerve?

A

sacrospinatus

137
Q

Diverticular abscess greater than what size should be drained?

A

2 cm

138
Q

WHat angle to access Brodel’s zone?

A

30 degrees off sagittal

139
Q

Drain a lung abscess? Why?

A

never

bronchopleural fistula

140
Q

What is an air leak?

A

air within pleural space

141
Q

What arrhythmia can pulmonary angiography cause?

A

RBBB

142
Q

Treat the afferent limb of pulmonary AVM if greater than what size?

A

3mm

143
Q

How is a rasmussen aneurysm embolized?

A

coils

144
Q

WHat do you see on angio with bronchial artery bleed?

A

tortous, enlarged bronchial arteries

145
Q

Do T2 bright or T2 dark fibroid UFE do better?

A

T2 bright

146
Q

What location of fibroid responds the best to UFE?

A

submucosal

147
Q

Do cervical fibroids respond well to UFE?

A

no bitch

148
Q

IS DVT/PE a risk of UFE?

A

yes

149
Q

Intra-cavitary fibroids less than what size can get UFE?

A

<3cm

150
Q

Left or right side down during an air embolus?

A

left

151
Q

What is the maximum dose of local anesthesia?

A

4-5 mg/kg

152
Q

What are the two earliest signs of lidocaine toxicity?

A

tinnitus and dizziness

vascular trivia (1 decks)

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