Week 8 Part 2 Flashcards

1
Q

For a liver transplant, where are the 4 vascular anastomoses?

A
suprahepatic vena cava
infrahepatic VC
hepatic artery 
portal vein
*also biliary duct anastomosis
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2
Q

What’s the sequelae of events for anastomosis occlusions/stenosis:

A

necrosis-fibrosis-stenosis

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3
Q

What is the most significant vascular complication with liver transplant?

A

Hep artery thrombosis- high mortality rate

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4
Q

In assessing vascular patency in a liver transplant, what vessels are assessed? What are they inspected for?

A

HA, PV, IVC, HV’s

narrowed diameter, thrombus, normal spectral waveform + direction

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5
Q

If we’re going to see a renal artery thrombosis, when will we see it?

A

in the first few days

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6
Q

What’s the difference b/w primary and secondary renal vein thrombosis?

A

primary originates in the RV, secondary originates into iliac V

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7
Q

What renal artery is prone to stenosis? And where?

A

Rt main renal artery at the ostium (takeoff from aorta)

due to it’s sharp angle superiorly and then inferiorly towards the rt kidney

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8
Q

How do we obtain the AO/RA ratio

A

angle correct is used
PSV in AO just prox to RA takeoff
measure PSV within stenosis
RA PSV/ AO PSV

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9
Q

A AO/RA ratio of _____ is not considered to be hemodynamically significant

A

<3.5

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10
Q

PSV in the RA is considered normal up to what speed?

A

180cm/s

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11
Q

Distal RA there’s usually no window seen. True or false

A

True.

This was bolded in the slides

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12
Q

Replaced right hepatic artery originates from

A

SMA

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13
Q

Formula for resistive index?

A

PSV-EDV/PSV

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14
Q

What renal arteries do you want to obtain a signal in

A

arcuate or segmental at UP, mid and LP cortex.

she also said interlobar, interlobular, or segmental

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15
Q

What RI measurement indicates resistance?

A

> 0.7

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16
Q

What happens to the blood flow in the PV with inspiration and expiration?

A

decrease w/ inspiration (due to the inc abdo pressure)

increase w/ expiration (due to the dec abdo pressure)

17
Q

What’s the normal size of the splenic vein?

A

<10mm

it increases in size w/ inspiration + portal hypertension

18
Q

How do we measure an artery?

A

outer wall to outer wall

19
Q

What’s the normal size of the SMV?

A

<10mm

will increase in size w/ inspiration, after a meal and portal hypertension

20
Q

Increased flow velocity in the hepA is associated w/

A

jaundice, cirrhosis, lymphoma and mets

21
Q

Normal flow velocity of the hepatic artery in a fasting patient?

A

PSV- 30-40cm/s

EDV- 10-15 cm/s

22
Q

The splenic artery gives rise to what?

A

gastroepiploic

branches to the panc and stomach

23
Q

What is a sign of IVC occlusion? What can cause it?

A

bilateral leg swelling

extrinsic compression -nodes
RCC
HCC

24
Q

Right sided heart failure appears as what in the hep veins + IVC?

A

over distension bc of backup of flow
no phasic flow
IVC measures the same in inspiration and expiration

25
Q

Budd Chiari syndrome is:

A

thrombus or hepatoma extension into HV’s