Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Study Leave semester 2 year 1 > Week 8 Part 2 > Flashcards

Week 8 Part 2 Flashcards

1
Q

What’s peripheral arterial disease?

A

Narrowing of the arteries supplying the limbs and periphery , reducing blood supply to said areas.
Results in symptoms of claudication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What’s intermittent claudication?

A

A symptom of ischaemia in the limb
Occurring during exercise and relived by rest. Crampy, achy pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s claudication

A

Pain in buttocks, thigh, calf when you walk
Known as symptom of peripheral arterial disease
Due to narrowed or blocked arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s critical limb ischaemia

A

End stage of peripheral arterial disease
Inadequate supply of blood to a limb to allow it to function normally at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Features of critical limb ischaemia

A

Pain at rest
Non healing ulcers
Gangrene

Could lose limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why might acute limb ischaemia occur?

A

Perhaps due to rapid onset of ischaemia in a limb
Typically due to thrombus or a clot blocking the arterial supply of a distal limb eg limb version of heart attach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is acute limb ischaemia like limb version of heart attack

A

Often due to thrombus blocking supplies of blood to a limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gangrene vs necrosis

A

Gangrene is necrosis because of inadequate blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What’s atherosclerosis

A

Fatty deposits in blood vessels walal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s deposited in atherosclerosis

A

Lipids, then fibrous atheromatous plaques are developed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do the plaques cause in atherosclerosis??????????? (3)

A

Stiffening of walls therefore hypertension and therefore strain on heart
Stenosis eg in angina
Plaque rupture = thrombosis and therefore ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why would stiffening of walls in atherosclerosis lead to strain on heart

A

Stiffening of walls therefore hypertension and therefore strain on heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Taking a history: what risk factors to think of for atherosclerosis???

A

Smoking
Alcohol
Poor diet
Low exercise
Obesity
Poor sleep
Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Atherosclerosis: diabetes, hypertension, chronic kidney, inflammatory like rheumatoid arthritis … what’s the connection

A

These are all medical co morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Could angina be an end result of atherosclerosis?

A

Yah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Peripheral arterial disease could be an end result if what

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Chronic mesenteric ischaemia could be an end result of what

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TIA can be caused by atherosclerosis

A

Yah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Features of critical limb ischaemia can be remembered with the 6 p’s mnemonic

A

Pain
Pallor
Pulseless
Paralysis
Paraesthesia
Perishing cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What’s paraesthesia

A

Pins and needles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is the pain worse in critical limb ischaemia

A

Worse at night cuz gravity doesn’t pull blood into the foir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What’s the pain like in critical limb ischaemia

A

Burning pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What might a scar on the inner calf show?

A

For saphenous vein harvesting (previous CABG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What’s a hand held Doppler for

A

To accurately asses the pulse when they are difficult to palpate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Poor wound healing could be a sign of arterial disease

A

Ya
As well as ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Muscle wastage could be a sign of arterial disease on inspection

A

Yah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cyanosis is a sign of arterial disease

A

Ywha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Prolonged capillary time could be a sign of arterial disease

A

Yah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What’s buergers test for

A

Assessing for peripheral arterial disease in the leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Explain the two parts of buerger’s test

A

1st part) lie patient down. Lift legs 45’.hold for 2 mins. Look for pallor. = can’t overcome gravity. State buergers angle - that legs go pale

2nd part) hang legs. Legs should go normal. If peripheral arterial disease = blue as ischaemic tissue deoxygenated the blood
Dark red due to vasodilation in response to waste products of anaerobic respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Colour check of buergers test meaning??

A

hang legs. Legs should go normal. If peripheral arterial disease = blue as ischaemic tissue deoxygenated the blood
Dark red due to vasodilation in response to waste products of anaerobic respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What do leg ulcers indicate especially in peripheral arterial disease

A

Indicate the skin and tissues are struggling to heal due to impaired blood flow…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Arterial ulcers due to:
Venous ulcers due to:

A

Arterial ulcers: due to ischaemia secondary to an inadequate blood supply

Venous ulcers are due to: impaired drainage and pooling of blood in the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which are smaller, arterial or venous ulcers

A

Arterial usually. Also usually deeper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which are less painful, arterial or venous ulcers?

A

Venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Why use angiography (CT or MRI)

A

To use contrast to highlight arterial circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What do statins do

A

Lower cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Why atorvastatin for intermittent claudication?

A

Reduces cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why clopidogrel for intermittent claudication?

A

It’s an anti-platelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What’s aspirin

A

Non steroidal anti inflammatory drug used to reduce pain fever
Also antithrombotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why bypass surgery for intermittent claudication?

A

Using a graft to bypass the blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What’s an endarterectomy and why intermittent claudication?

A

Cutting vessel open and removing the atheromatous plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Surgical option for intermittent claudication???

A

Endovascular angioplasty and stenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Patients with critical limb ischaemia need what to manage the pain

A

Analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

If a patient has a hole in their heart eg atrial septal defect, what can a blood clot do

A

Pass into systemic circulation, and maybe travel to brain and cause a stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

We know several factors can lead to DVT, so what do we do

A

Give prophylactic treatment
Eg surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

I’d malignancy a risk factor for dvt

A

Yah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

If a patient presents with possible features of DVT or PE, what risk factors could we ask about?

A

Periods of immobility, surgery, and long haul flights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What’s a common prophylaxis for venous thromboembolism?

A

Low molecular weight heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Main contraindication to anti embolus compression stockings is what

A

Significant peripheral arterial disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

DVTs are usually bilateral

A

False
Unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Bilateral symptoms of DVT are what

A

Usually more likely to be
Chronic venous insufficiency or heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

DVT presentation?

A

Calf or leg swelling
Dilated superficial veins
Tenderness to the calf
Oedema
Colour changes to da legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

DVT could make you suspicious of what?

A

Pulmonary embokism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What’s a wells score?

A

Predicts risk of patient presenting with symptoms of DVT or PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

D dimer is a sensitive test useful for excluding what

A

Venous thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Pneumonia could raise a d dimer

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Malignancy could raise a d dimer

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Heart failure could raise a d dimer

A

Yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Surgery could raise a d dimer

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Pregnancy could raise a d dimer

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What’s the initial management for suspected or confirmed DVT or PE?

A

Anticoagulatiooooon
Start immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What’s the recommended first management for PE or DVT with the name???

A

Anticoagulant
Ends in ‘ban’ eg apixaban or rivaroxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Example for long term anti coagulation for VTE???? (2)

A

Warfarin
DOAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What’s DOAC??

A

Direct oral anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Example of DOAC

A

Ending with ban
Eg apixaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is warfarin?

A

A vitamin K antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What’s the furst line anticoagulant in pregnancy?

A

Low weight hepatin

69
Q

True or false
Continue anticoagulant for 3-6 months if reversible cause
Continue anticoagulant for 3 months in active cancer

A

Other way round
3-6 months if active cancer

70
Q

What are inferior vena cava filters

A

Basically filters
For those with recurrent PEs who cannot have anticiagulation

71
Q

If someone has a VTE without cause, look for what

A

Evidence of cancer

72
Q

What are varicose veins

A

Distended superficial veins

73
Q

What happens when valves in veins become incompetent

A

Varicose veins
Blood drawn down by gravity and pools in veins and feet

74
Q

What are perforating veins

A

Blood flow from superficial to deep

75
Q

What if perforating veins valves broken

A

Blood from from deep back to superficial veins, overloads them = dilatation = varicose veins

76
Q

What’s chronic venous insufficiency

A

Pressure is venous dilatation (varicose) = leakage of blood into nearby tissues
Haemoglobin leaked= broken down into haemosiderin = brown discolouration of lower legs

77
Q

Venous eczema caused by what

A

Skin becomes dry and inflamed when pooling of blood results in inflammation.

78
Q

What’s lipodrrmatoaclerosis

A

Skin and soft tissue becomes fibrotic and tight, so legs narrow and hard, due to pooling of blood cause broken valves in veins

79
Q

How might deep vein thrombosis lead to chronic veinous insufficiency

A

If damage to valves

80
Q

Could varicose veins burn

A

Yes
Also have itch
And oedema

81
Q

What does a duplex ultrasound test

A

Speed and volume of blood flow

Can be used to assess extent of varicose veins

82
Q

Surgical options for treating varicose veins?

A

Endo thermal ablation- insert catheter into the vein to apply radiotherapy ablation
Sclerotherpy -inject vein with irritant foam that causes closure of the vein
Stripping- veins pulled out of legs

83
Q

What’s Endo thermal ablation

A

Endo thermal ablation- insert catheter into the vein to apply radiotherapy ablation

84
Q

What’s sclerotherapy

A

Injecting the vein with an irritant foam that causes closure of the vein

85
Q

What are diabetic foot ulcers

A

Diabetic neuropathy
Patients who have lost the sensation in their feet are less likely to realise they’ve injured their feet
And raised blood sugar and immune system changes = ulceration and poor healing

86
Q

NSAIDS can worsen ulcers

A

Yah
For pain, use analgesia instrad

87
Q

Classification of carotid artery’s stenosis?

A

Mild = less than 50% reduction in diameter
Moderate = 50-69% reduction in diameter
Severe = 70% or more reduction in diameter

88
Q

Is carotid artery stenosis usually asymptomatic?

A

Yes
Usually diagnosed after TIA or stroke

89
Q

What’s a carotid bruit

A

Whooshing sound heard with a stethoscope over affected carotid artery caused by turbulent flow, around the stenotic area during systole

90
Q

Diagnosis of carotid artery stenosis?

A

Carotid ultrasound
CT or MEI angiogram to asses stenosis in more detail

91
Q

Management of carotid artery stenosis?

A

Modifiable ones
Incl. antiplatelet eg aspirin and clopidrogrel

Management of co morbidities eg hypertension and diabetes a

Lipid lowering meds eg atorvastatin

92
Q

2 examples of Antiplatelet meds

A

Aspirin
Clopidogrel

93
Q

Example of lipid lowering medications eg

A

Atorvastatin

94
Q

What’s an endarterectomy

A

Incision in the neck, opening up the carotid artery, and scraping out the plaque

95
Q

Alternative to endartextomy, which is first o period for carotid artery stenosis

A

Angioplasty and stenting

96
Q

What’s a catheter angiography

A

Basically using contrast administration with venous access of the patient, and taking live x-rays

97
Q

Do you use contrast in catheter angiography?

A

Yea

98
Q

What’s a lung scintigraphy

A

Ventilation/ perfusion imaging

99
Q

What are we asking with imaging for vascular diseases?

A

Is there a blockage?
Is there a leakage?

100
Q

Limitation of CT and leakage

A

Won’t identify small volume leaks
Also intermittent bleeding

101
Q

Is asthma and atopy a consideration before using constrast?

A

Yes

102
Q

Is poor renal function a consideration before using contrast?

A

Ya

103
Q

Examples of contrast reactions?

A

Nausea
Itching
Flushing
Seizures and arrhythmias

104
Q

Management for contrast reactions?

A

Usually supportive

105
Q

Would pulmonary oedema ever be a contrast reaction

A

Ya

106
Q

Would hypertension ever be a contrast reaction

A

Ya

107
Q

Common clinical use of Doppler imaging?

A

DVT
Shows flow I think?

108
Q

Ultrasound contrast is commonly used for characterising liver lesions

A

Yes

109
Q

Ultrasound contrast is actually made from micro bubbles

A

Yes

110
Q

Ultrasound contrast is an alternative to CT/MRI if unable to tolerate/allergic

A
111
Q

Contrast does what

A

AIDS visualisation of vascular structures

112
Q

IV iodinated contrast can be associated with what

A

Negative side wffects

113
Q

US uses reflections of what

A

Sound waves

114
Q

CT uses attenuation of what

A

Radiation, to generate images

115
Q

Chronic venous insufficiency may be caused by DVT

A

Yes

116
Q

The site of a venous ulcer is classically just above the malleoli

A

True
(Bone on foot)

117
Q

A potential complication of a stroke is a deep vein thrombosis

A

Yes
Because immobility is a risk factor

118
Q

A patient was admitted two hours ago after waking up this morning with symptoms of stroke. Brought to hospital urgently. Thrombolysis should be given immediately.

A

False

We don’t know when the symptoms definitely started since they woke UP with the symptoms

And check for contraindications
Eg CT scan to exclude haemorrhagic stroke

119
Q

Carotid endarterectomy should be considered if there is more than 70% stenosis of the internal carotid artery which is symptomatic

A

True

120
Q

Carotid artery disease is a common cause of ischaemic stroke and TIA

A

Yes

121
Q

Severe stenosis is likely to be symptomatic

A

Yes

122
Q

Symptoms of an aneurysm includes: pain, pulsation mass, local compression, or shock

A

True

123
Q

How many of the diabetic foot ulcers require amputation

A

Only 20%

124
Q

How many diabetic foot ulcers become infected

A

50%

125
Q

Right sided weakness, and right homonymous hemianopia = which side of brain affected by stroke

A

Left

126
Q

The presence of aphasia points towards what part of the brain being affected

A

Dominant hemisphere (normally the left) being affected

127
Q

Total anterior circulation stroke would often be motor and stuff

A

Yes
So like weakness
And maybe visual field defect

128
Q

Varicose veins of the lower leg occur in either the long saphenous or the short saphenous veins

A

Both
Because they’re superficia

129
Q

Smoking is a risk factor in the development of an abdominal aortic aneurysm

A

Yes
Like all cardiovascular diesse

130
Q

Lipodermatoaclerosis is a feature of chronic venous insufficiency

A

Yes
Long term venous stasis can lead to sclerosis of tissues of the leg

131
Q

Where can intermittent claudication a be felt

A

Buttocks
Thigh
Calf

132
Q

Aortic aneurysm screening offered to men over 65

A

Yes

Only men
Not women

133
Q

Aortic abdominal aneurysm is how much more likely in men than women

A

6 times more likelt

134
Q

Long saphenous drains into what vein

A

Femoral vein (deep system)

135
Q

Where does the shirt saphenous vein drain into

A

The popliteal vein (deep system)

136
Q

What’s delayed phase CT useful for

A

Identifying forms of ureteric obstruction, as the contrast is renally excreted in the urine

137
Q

Calcified structures will show up in a non-contrast CT scan easily.. such as what

A

Urinary calculi
And bine

138
Q

Why pain in narrowing of arteries

A

1) mismatch between oxygen demand and supply
2) anaerobic metabolism
3) build up of lactic acid = pain

139
Q

Are ruptured aortic aneurysms always fatal

A

Yea
Without appropriate resuscitation and surgery

140
Q

Catheter angiography involved a sterile procedure, injecting contrast and taking a rapid series of inages

A

Y

141
Q

What is the pain in intermittent claudications like

A

Cramping or a dull ache

142
Q

CT angiography detects what size of bleeds

A

Only small haemorrhages

143
Q

Could smaller haemorrhages be misses in a CT angiography

A

Yes

144
Q

Untreated syphilis can lead to what complications

A

Aortic aneurysm
Aortic regurgitation
Neurological complications

145
Q

Commonest embolic cause of a stroke is from

A

carotid artery disease
And atrial fibrillation

146
Q

DVT embolisms to where

A

Lungs

147
Q

Most strokes are painless. But why might haemorrhagic strokes be painful?

A

Because blood is highly irritant to the meninges

148
Q

An aortic dissection could cause aortic regurgitation

A

True
Dilatation of the ascending aorta May cause aortic regurgitation.

149
Q

Sign guidelines advise a target BP of below what

A

140/85

Vascular risk factors should be screened for and managed

150
Q

Should high blood pressure be treated in peripheral arterial disease

A

Yes

151
Q

Dysarthria is what

A

Slurred speech

152
Q

25% of diabetics develop a foot ulcer in their lifetime

A

True

153
Q

CT scans have different phases which show up different phases in the body

A

Yah

154
Q

How quickly for arterial CT scans

A

15 seconds

155
Q

6-10 seconds for delayed phase of CT scan

A

No
Minutes

156
Q

A risk factor for varicose veins do include DVTs

A

True

157
Q

How might DVT cause varicose veins

A

Disrupts the valve system, causing back pressure in the superficial system, which results in varicose veins

158
Q

95% of abdominal aortic aneurysms are INFRA-renal

A

True

159
Q

Medical management of peripheral artery disease is similar to coronary artery disease

A

True dat

160
Q

A Doppler test for varicose veins: hold Doppler prove over which junction

A

Saphenofemoral

161
Q

A Doppler test for varicose veins: hold Doppler probe over saphenofemoral junction, squeeze what muscles

A

Calf muscles

162
Q

What sound in a Doppler test for varicose veins would show incompetent saphenofemoral junction

A

A double whoosh

163
Q

Location for posterior tibial pulse

A

Halfway between medial malleolus and Achilles tendon

164
Q

Lateral to the extensor hallux tendon is what pulse

A

Dorsalis pedis pulse

165
Q

What’s paraplegia vs hemiplegia

A

Paralysis of both lower limbs = para
Hemi = one side

166
Q

Pneumonia is a complication of stroke

A

Yah
Maybe poor swallow reflex, so aspiration, so pneumonia

167
Q

What is the investigation of choice for assessing varicose veins

A

Doppler US scanning

168
Q

Why Doppler is investigation of choice for assessing varicose veins

A

Can assess flow through the veins and can therefore identify valvular incompetence seen in varicose veins

169
Q

Endovascular repair requires long term follow up

A

Yah

Study Leave semester 2 year 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions