vascular/IR trivia Flashcards
1
Q
What is the anatomy of a pulmonary sling?
A
aberrant left pulmonary artery arising from the right pulmonary artery
2
Q
What are the two UNIQUE attributes of a pulmonary sling?
A
- only anamoly to create indentations in posterior trachea and anterior esophagus
- only anamoly to cause stridor in a pt with a LEFT arch
3
Q
What does ‘replaced’ mean in regards to hepatic arterial anatomy?
A
arises from non-classic vessel
4
Q
What does ‘replaced’ mean in regards to hepatic arterial anatomy?
A
different origin
5
Q
What does ‘accessory’ mean in regards to hepatic arterial anatomy?
A
duplicated vessel with aberrant origin of spare
6
Q
A vessel in the ligamentum venosum most like represents what?
A
accessory or replaced left hepatic artery arising from left gastric
7
Q
What is the normal position of the right hepatic artery in relation to the right portal vein?
A
anterior
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
9
Q
What are the branches of the posterior division of the internal iliac?
A
Iliolumbar
lateral sacral
superior gluteal
10
Q
The persistent sciatic is a continuation of what artery?
A
internal iliac
11
Q
What are the two complications of a persistent sciatic artery?
A
aneurysm and early atherosclerosis
12
Q
Where does the persistent sciatic course in the thigh?
A
posterior to the femur
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
14
Q
What two specific vessels are connected by the Arc of Riolan?
A
middle colic of SMA to left colic of IMA
15
Q
What vessel forms a loop around the large bowel?
A
marginal artery of drummond
16
Q
What is the Winslow pathway?
A
internal thoracic to inferior epigastric
17
Q
What two vessels are connected by the Corona Mortis?
A
external iliac to obturator
18
Q
What osseus structure does the corona mortis classically pass over?
A
superior pubic ramus
19
Q
Where does the subclavian vein run in regards to the anterior scalene?
A
anterior
20
Q
Where does the subclavian artery run in regards to the anterior scalene?
A
posterior to anterior scalene
21
Q
At what landmark does the subclavian artery become the axillary artery?
A
1st rib
22
Q
What anatomic landmark divides the axillary artery into the brachial artery?
A
teres MAJOR
23
Q
What artery is usually bigger, the ulnar or radial artery?
A
ulnar
24
Q
Which artery usually gives off the interosseus branch, radial or ulnar?
A
ulnar
25
Which gives off the supercifial palmar arch, ulnar or radial?
ulnar
26
What anatomic landmark does the SFA become popliteal artery?
exiting aDDuctor canal
27
Most gastric varices are formed from what gastric vein?
left gastric vein
28
Is a splenorenal shunt associated with GI bleeding?
29
What cardiac vascular abnormality is associated with a left sided SVC?
unroofed coronary sinus
30
What CHD abnormality is most often associated with a left sided SVC?
ASD
31
What visceral organ is often abnormal when there is a duplicated IVC?
renals
32
Which limb is superior with a circum-aortic renal vein, anterior or posterior limb?
anterior = superior
posterior = inferior
33
What is absent with an Azygos Continuation of the IVC?
intrahepatic IVC
34
Where do hepatic veins drain during an azygos continuation?
RIGHT ATRIUM
35
Azygos Continuation should make you say what?
polysplenia
36
IVC/aorta reversal should make you say what?
Asplenia
37
What is the differential for atherosclerotic calcifications of the ascending aorta?
takayasu
syphillis
38
Which sinus is usually involved with a sinus of valsalva aneurysm? How is this fixed?
right
Bentall (graft of ascending aorta)
39
Are mycotic aneurysms more often saccular or fusiform?
saccular
40
What is the classic tried found in Loeys Dietz?
1. hypertelorism
2. bifid uvula or cleft palate
3. shitty and tortuous vessels
41
Percutaneous procedure for Ehlers-Danlos? Why not?
no
increased risk of dissection
42
Does median arcuate ligament syndrome get worse with inspiration or expiration?
expiration
43
Does mesenteric ischemia from an arterial standpoint have thickened or thinned colonic wall?
thin
44
Does mesenteric ischemia from a venous standpoint have thickened or thinned colonic wall?
thickened
45
Where is Griffith's point?
splenic flexure
46
Where is Sudeck's point?
recto-sigmoid juncture
47
Is colonic angiodysplasia an arterial or venous issue?
arterial
48
If colonic angiodysplasia is associated with aortic stenosis, what is this called?
Heyde Syndrome
49
With HHT, extensive hepatic shunting can cause what?
biliary necrosis and/or bile leak
50
Does FMD affect the renal artery ostium?
no
51
FMD can predispose to spontaneous what?
dissection
52
Does FMD get stented?
never
53
Popliteal entrapment most common involves what muscle? What can worsen in?
medial head of gastroc.
dorsiflexion or plantar flexion
54
paraplegic or quadriplegic are at increased risk of VTE?
para
55
What is the triad of Klippel Trenaunay?
1. port wine stain
2. bone/tissue hemi-hypertrophy
3. venous malformation
56
What is the vein of Servelle? What disease is it indicative of?
superficial vein in leg and thigh
Klippel trenuay
57
What is the age group of cystic adventitial disease? What artery is predominantly affected?
young men
popliteal
58
What is the age group of cystic adventitial disease? What artery is predominantly affected?
young men
popliteal
59
What artery is clasically affected by TCA arteritis other than branches of the external carotid?
brachial/axillary/subclavian
60
What disease is associated with giant/temporal cell arteritis?
polymyalgia rheumatica
61
What vasculitis is more common in men?
PAN
62
What happens to the vessel during PAN?
micro-aneurysm
63
What virus is associated with PAN?
Hep B
64
What drug is associated with microaneurysms in the kidney?
meth
65
Coronary artery aneurysms greater than what size are considered too big to spontaneously regress?
> 8mm
66
What two conditions does a patient with Churg Strauss always have?
asthma
eosinophilia
67
Does Churg Strauss cavitate?
No
68
Profound scrotal skin edema should make you think what disease?
HSP
69
A hand angiogram showing hypothenar hammer syndrome will most likely show what?
pseudo-aneurysm off of ulnar artery
70
A hand angiogram of Buegers disease should show what appearance for the ulnar artery?
normal
71
How does Microscopic Polyangiitis present on CT?
diffuse pulmonary hemorrhage
72
Rabbit ear shaped spectral waveform can be indicative of what disease?
early steal
73
Reversal of diastolic flow on carotid doppler is indicative of what disease proximally?
aortic regurgitation
74
What is the latin name for a double aortic systolic peak?
pulsus bisferiens
75
Pulsus Bisferiens on a carotid doppler can be indicative of what two diseases proximally?
aortic regurgitation
HCOM
76
Are the sizes of sheaths dictated by their inner or outer diameter?
inner
77
Generally, in French, how much bigger is the hole a sheath makes in the vessel compared to its inner diameter?
2F bigger
78
Does a shorter or longer 'floppy' tip have a greater likelihood of vessel dissection?
shorter
79
What are the two stiffest wires?
Lunderquist
Backup Meier
80
What does a J Tip # represent?
diameter of curve in 'mm'
81
How much flow (in mL/sec) per french size?
8 mL/sec per French
82
How much flow (in mL/sec) per french size?
8 mL/sec per French
83
Is axumin good for soft tissue or osseus mets?
soft tissue
84
Never use a closure device if there is risk of an?
infection
85
When can heparin be stopped and started after access?
usually two hours
86
How long does plavix need to be held?
5 days
87
How many units of heparin for a pseudoA?
500 - 1000
88
If the cavity size of a pseudoA is less than 2cm, how should that be managed?
conservatively
89
Neck size of a pseudoA needs to be smaller than what for thrombin treatment?
< 1cm
90
Where is thrombin injected in a pseudoA?
cavity apex
91
PseudoA need to be treated within what time frame?
two weeks (do much better)
92
PseudoA compressed above the inguinal ligament can lead to what?
RP bleed
93
What is the minimum proximal landing zone for an EVAR?
10 mm
94
What is the maximum proximal aortic diameter for an EVAR?
3.2 cm
95
Tortuosity of proximal aorta has to be less than what degree?
< 60
96
What does a juxta renal AAA mean?
proximal landing zone is less than 1cm
97
What is the pathophysiology behind a type 3 endoleak?
defect/fracture in the graft
98
What is the pathophysiology behind a type 4 endoleak?
porosity
99
Particles smaller than what size may necrose tissue?
300 microns
100
Do bronchial arteries tend to need re-access?
yes
101
What malignancy likes ethiodol?
hepatoma/HCC
102
Treat inflow or outflow first?
in flow
103
What is the timepoint for thrombolysis vs surgery?
14 days
104
TBI should be greater than what number?
0.6
105
If toe pressures are less than what # are toe ulcers unlikely to heal?
30 mm Hg
106
Are the collaterals occluded during phlegmasia alba or phlegmasic cerulea dolens?
dolens
107
What % of IVC filters thrombose within 5 years?
10%
108
Is an IVC filter placed infrarenal or suprarenal during pregnancy?
supra
109
Where is an IVC filter placed with a circumaortic renal vein?
below the lowest renal vein
110
Greater than what size is considered a mega IVC?
28 mm
111
Does an IVC filter increase or decrease the risk of DVT?
increase
112
Can a clotted IVC filter be removed?
no
113
What type of contraindication is bacteremia for an IVC filter placement?
relative
114
According to lionheart, how is a caval wall injury/dissection treated if caused by IVC filter removal?
anticoagulation
115
Where does intimal hyperplasia take place with a synthetic AV graft?
downstream from venous graft anastomosis
116
What two pressures can be used to diagnose portal hypertension?
1. portal pressure greater than 10 mm Hg
| 2. Portal to systemic gradient pressure of greater than 5 mm Hg
117
Right heart pressure greater than what contraindicates a TIPS?
10-12 mm Hg
118
After TIPS, you want your gradient to be what?
less than 12 mm Hg
119
What is normally posterior, right hepatic vein or right portal vein?
right hepatic vein
120
MELD scores greater than what are at an increased risk of early death after elective TIPS?
18
121
Is too high or too low a gradient a risk for developing hepatic encephalopathy after a TIPS?
too low
122
Does BRTO improve or worsen HE?
improve
123
Does BRTO increase or decrease hepatic blood flow?
increase
124
How many right hepatic ducts are there? Names?
Two
anterior and posterior
125
What is the most common hepatic ductal anatomy?
right posterior drains into left hepatic duct
126
Don't pull a chole tube before what time point? Why not?
two weeks
immature tract --> bile leak
127
There is a high risk of biliary abscess in TACE pt with what three conditions?
1. biliary stent
2. prior sphincterotomy
3. post whipple
128
What is the maximum radiation dose that can be delivered to the lungs via shunt fraction with Y90?
30 Gy
129
What is the energy of Y90?
0.93 MeV
130
What is the half life of Y90?
64 hours
131
Key structures need to be how far away from RFA burn zone?
> 1 cm
132
What is the maximum size a lesion can be to be 'cured' with RFA?
<4 cm
133
When I say pancreatic arcade bleeding (pseudo) aneurysm, you say?
celiac artery stenosis
134
An RBC scan can detect GI bleeds with flow down to what volume?
0.1 mL/min
135
A CTA can detect GI bleeds with flow down to what volume?
0.4 mL/min
136
Transgluteal approach through what ligament will avoid the sciatic nerve?
sacrospinatus
137
Diverticular abscess greater than what size should be drained?
2 cm
138
WHat angle to access Brodel's zone?
30 degrees off sagittal
139
Drain a lung abscess? Why?
never
bronchopleural fistula
140
What is an air leak?
air within pleural space
141
What arrhythmia can pulmonary angiography cause?
RBBB
142
Treat the afferent limb of pulmonary AVM if greater than what size?
3mm
143
How is a rasmussen aneurysm embolized?
coils
144
WHat do you see on angio with bronchial artery bleed?
tortous, enlarged bronchial arteries
145
Do T2 bright or T2 dark fibroid UFE do better?
T2 bright
146
What location of fibroid responds the best to UFE?
submucosal
147
Do cervical fibroids respond well to UFE?
no bitch
148
IS DVT/PE a risk of UFE?
yes
149
Intra-cavitary fibroids less than what size can get UFE?
<3cm
150
Left or right side down during an air embolus?
left
151
What is the maximum dose of local anesthesia?
4-5 mg/kg
152
What are the two earliest signs of lidocaine toxicity?
tinnitus and dizziness
