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Tax > Week 1 > Flashcards

Week 1 Flashcards

1
Q

A critical stenosis is the narrowing of the arterial lumen resulting in a hemodynamically signification reduction in what 3 things?

A

Volume, pressure and flow

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2
Q

In the aorta, how much of the area (%) has to be encroached before there is a reduction in pressure and flow distally?

A

90%

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3
Q

In smaller vessels, how much of the area (%) has to be encroached before there is a reduction in pressure and flow?

A

70-90%

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4
Q

With a complete occlusion of the ICA, what sound is heard?

A

Thumping

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5
Q

During a stenosis, what sound is heard?

After the stenosis, what sort of sound is heard?

A

Whistle or high pitched

Garbled

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6
Q

What is the measurement for CIMT? (carotid intima media thickness)

A

N= <0.9mm

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7
Q

Slide 11 & 12 on wk1 carotid grading is pretty much all bolded but not good flashcard content

A

So look at that stuff

ok

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8
Q

Where do we sample when comparing the velocity in a stenosis?

A

Usually proximal, but can be wherever the velocity is the most normal (if there’s a stenosis in the proximal setting

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9
Q

The higher the ratio, the greater the stenosis. True or False

A

True

directly proportional

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10
Q

How much of a vessel needs to be stenosed for it to be considered critical?
(diameter reduction)

A

50-80%

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11
Q

Diameter reduction is comparable to _____ measurements in a stenosis.

A

PSV

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12
Q

What is the formula for percentage stenosis for diameter reduction?

A

1-(residual/original)x100

longitudinal view of a vessel is needed to obtain this measurement

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13
Q

Residual diameter is the segment distal to the stenosis. True or False

A

False— it is the area within the stenosis

Original is the normal measurement

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14
Q

Remember: hemodynamically significant lesions are those with _______ diameter reduction.

A

> 50%

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15
Q

What view is required to obtain an area reduction image? What formula is used?

A

Transverse
Same formula as diameter reduction
1- (residual/original) x 100

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16
Q

Remember: hemodynamically significant lesions are those with _______ area reduction.

A

> 75%

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17
Q

For a hemodynamically significant stenosis:
_______% diameter reduction
_______% area reduction

A

> 50% DR

>75% AR

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18
Q

_____ stenosis: deceleration spectral broadening with a peak systolic velocity (PSV) <125 cm/s

A

<15%

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19
Q

______ stenosis: pansystolic spectral broadening with a PSV <125 cm/s

A

16-49%

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20
Q

_______ stenosis: EDV >140 cm/s

A

80-99%

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21
Q

_____ stenosis: pansystolic spectral broadening with a PSV of >125 cm/s and end diastolic velocity (EDV) <110 cm/s
or ICA/CCA PSV ratio >2 but <4

A

50-69%

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22
Q

________ stenosis: pansystolic spectral broadening with PSV >270 cm/s or
EDV >110 cm/s or ICA/CCA PSV ratio >4

A

70-79%

23
Q

____________: no flow; terminal thump

A

Complete occlusion

24
Q

What is the ratio formula for calculating a hemodynamically significant stenosis?

A

Prox ICA PSV/ distal CCA PSV

25
Q

What does the ratio of ICA/CCA have to exceed to be considered a hemodynamically significant stenosis?

A

2

26
Q

Subtotal occlusion of ICA demonstrates what? (hint: it is a sign)

A

String sign

Also trickle flow

27
Q

The PSV is the first component of the spectral waveform to reduce due to a stenosis. True or false

A

True

28
Q

Bruit appears as what on Color Doppler? (hint: it is a sign)

A

Confetti

29
Q

What did the one nut say while chasing the other nut

A

Imma cashew

30
Q

Subclavian steal syndrome shows a decrease in pressure on what side? What is the waveform?

A

The side of the innominate/subclavian stenosis will have lower pressure (usually by 20-40mm/Hg)

Will have a damped/monophasci flow pattern

31
Q

A TIA resolves within how many hours?

A

24

32
Q

TIA affects which side of the body?

A

The opposite side, with the exception of amaurosis fugax (which affects the same side eye)

33
Q

What does R.I.N.D. stand for?

A

Reversible Ischemic Neurological Deficit

34
Q

What is R.I.N.D?

A

Neurological symptoms that completely resolve after >24hours

35
Q

What is a CVA (cerebral vascular accident)?

A

Neurological symptoms that do not resolve and leave the patient with permanent deficit

36
Q

Qu’est-ce que c’est amaurosis fugax?

A

Blindness affecting one eye. Usually described as a “shade being pulled over the eye”

37
Q

Amaurosis fugax affects only a portion of the visual field. True or false

A

False– can be all, partial or simply blurred vision

38
Q

Infarction of the _______ is the most common cause of stroke.

A

MCA (middle cerebral artery)

39
Q

When the frontal lobe is injured, what does the patient experience?

A 
Loss of movement (paralysis)
Unable to focus
Difficulty with language, can't get words out
Mood swings
Difficulty problem solving
40
Q

When the parietal lobe is injured, what does the patient experience?

A

Difficulties with hand-eye coordination
Problems reading, writing and naming
Lack of awareness

41
Q

When the occipital lobe is injured, what does the patient experience?

A

Defects in vision or blind spots
Blurred vision
Visual illusions/hallucinations
Difficulty reading & writing

42
Q

When the temporal lobe is injured, what does the patient experience?

A

Difficulty understanding language and speaking (aphasia)

43
Q

When the cerebellum is injured, what does the patient experience?

A 
Difficulty coordinating fine movements
Difficulty walking
Tremors
Dizziness (vertigo)
Slurred speech
44
Q

When the brainstem is injured, what does the patient experience?

A

Breathing, HR, & consciousness
Difficulty swallowing
Problems w/ balance & movement
Dizziness & nausea (vertigo)

45
Q

When the MCA is affected, what are the signs and symptoms?

A 
Dysphasia/Aphasia
Contralateral hemiparesis/hemiplegia
Confusion
Behavioural changes
Agitated delirium
46
Q

When the ICA is affected, what are the signs and symptoms?

A 
Contralateral weakness 
Numbness or paralysis
Ipsilateral amaurosis fugax
Aphasia
Bruit
Occasional alteration in level of consciousness
47
Q

When the ACA is affected, what are the signs and symptoms?

A

Contralateral hemiparesis (esp. in lower extremity)
Incontinence
Loss of coordination
Impaired motor & sensory functions

48
Q

When the PCA is affected, what are the signs and symptoms?

A

Dyslexia

Coma w/o paralysis

49
Q

When the vertebrobasilar arteries are affected, what are the signs and symptoms?

A 
Facial numbness
Diplopia (double vision)
Vertigo
Dysphagia
Amnesia
Ataxia
50
Q

When the anterior circulation is affected, what are the signs and symptoms?

A 
*Unilateral* motor and sensory deficits 
Paresthesia- tingling or numbness *on one side*
Dysphasia and or aphasia 
Monocular disturbances
Behavioural abnormalities
51
Q

When the posterior circulation is affected, what are the signs and symptoms?

A 
*Bilateral* motor and sensory deficits
Vertigo
Ataxia (muscle incoordination)
Bilateral visual field defects
Bilateral paraesthesia
Drop attack (falling to the ground without other symptoms)
52
Q

What is an endarectomy?

A

This surgery removes the plaque and is done with a stenosis >70%

53
Q

What are the non-surgical methods for treating carotid atherosclerosis?

A

Balloon angioplasty and atherectomy

There’s a risk of acute embolization secondary to these procedures

Aspirin/anticoagulants/platelet inhibitors

54
Q

Carotid exams are always a bilateral exam. True or false

A

True

Tax (16 decks)

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