Vascular surgery

Question 1

What is the most common cause of occlusive disease in the lower extremity?

Answer 1

Peripheral Vascular Disease

Question 2

What is the degenerative pathophysiologic process of peripheral vascular disease?

Answer 2

• Formation of plaque/stenosis
• Thrombosis/Ischemia
• Embolism
• Aneurysm formation of weak vessel wall

Question 3

What are the listed risk factors of peripheral vascular disease?

Answer 3

• Hypercholesterolemia
• elevated triglycerides
• Cigarette smoking
• Hypertension
• Diabetes mellitus
• Obesity
• Genetic predisposition
• Gender (Males>Female)
• Impaired long term glucse regulation
• Homocysteine
• C-reactive protien

Question 4

What are the symptom of peripheral vascular disease?

Answer 4

• Mottling
• IMPOTENCE
• Cold extremites
• Claudication
• Ulceration

Question 5

What is the mortality rate of patient diagnosed with peripheral vascular disease?

Answer 5

• 5 years/30%death

- 10 years/70%death

Question 6

What is the treatment of peripheral vascular disease?

Answer 6

• Pharmacologic therapy

- Surgical

Question 7

What is the greatest risk to vascular surgery?

Answer 7

-Myocardial infarction (MI)

Question 8

T/F: Beta blockers and statins have a cardiovascular protective feature when used during anesthesia?

Answer 8

TRUE

Question 9

What monitors or preoperative testing should be anticipated for a vascular surgery?

Answer 9

• A Line
• Swan (PAC)
• TEE
• EKG

Question 10

What are risk factors for an abdominal aortic aneurysm?

Answer 10

• Atheroscherosis
• Proteolysis of elastin and collagen within a vessel wall
• HTN
• Cigarette Smoking
• Genetic predisposition
• Obesity

Question 11

T/F: Obesity may mask the signs and symptoms of AAA.

Answer 11

-TRUE

Question 12

T/F: Minimal blood factor is associated with a endovascular AAA repair.

Answer 12

FALSE

Question 13

What is the systemic anticoagulation of heparin when performing a endovascular precedural?

Answer 13

50-100 units/kg

Question 14

What are some advantages of Endograph vascular procedure?

Answer 14

• hemodynamic stability
• decrease in embolic events
• decrease blood loss
• reduced surgical stress response
• Decrease in renal dysfunction
• decrease in post op pain

Question 15

What are the complication of an endograph vascular procedure?

Answer 15

• Endograph thrombosis
• endograft migration
• Endograft rupture
• Graft infection
• Iliac artery rupture
• Lower extremity ischemia
• Ischemic gut

Question 16

What are contraindication for a surgical repair of a AAA?

Answer 16

• Intractable angina
• Recent MI
• Sever pulmonary dysfunction
• Chronic renal insufficiency

Question 17

What law is in used in the aneurysmal dimensions?

Answer 17

-Law of Laplace

Question 18

List the monitors that would be used during a AAA repair?

Answer 18

• EKG
• Pulse oximetry
• Capnography
• Temperature
• Urinary catheter
• Nerve Stimulator
• A line
• PAC

Question 19

What are the SITE for cross clamping during a AAA?

Answer 19

• Suprarenal
• Justarenal
• Infrarenal

Question 20

T/F: The Suprarenal is the most commonly clamped site for a AAA.

Answer 20

FALSE (Infrarenal)

Question 21

T/F: Increase in afterload will cause an increase in myocardial wall tension.

Answer 21

TRUE

Question 22

What is a Neuroendocrine response?

Answer 22

Mediated by cytokines and tumor necrosis factor, as well as plasma catecholamines and cortisol

Question 23

What will occur if there is a interruption of blood flow to the artery of adamkiewicz and collateral blood flow?

Answer 23

Post Op Parapegia

Question 24

T/F: The incidence of neurologic complications DECREASE as the clamp is positioned higher on the aorta.

Answer 24

FALSE

Question 25

What artery supplies the left colone?

Answer 25

-Mesenteric artery