General Surgery: Vascular

Front 1

Risk factors for atherosclerosis

Back 1

1) Smoking
2) HTN
3) Hypercholesterolemia
4) DM
5) Hereditary

Front 2

Claudication

Back 2

Profound fatigue, aching, or crampy pain in the extremity caused by exertion
**Reproducible at constant distance
**Relieved by rest

Front 3

5 P's of Peripheral Ischemia

Back 3

1) Pain
2) Pallor
3) Pulselessness
4) Paresthesia
5) Paralysis

Front 4

Claudication

Back 4

Fatigue, aching, or crampy pain in the extremity caused by exertion
*Reproducible at constant distance
*Relieved by rest

Front 5

Ischemic rest pain

Back 5

Pain, burning, or tingling at rest, usually across the distal foot and arch

Front 6

Gangrene

Back 6

Tissue necrosis
*Blood flow inadequate to maintain tissue viability

Front 7

Ankle-brachial Index (ABI)

Back 7

Ankle systolic pressure divided by brachial pressure while pt is supine
*Normal = 1.1
*Claudication = 0.6
*Rest pain = 0.25

Front 8

Incompressible arteries in ABI

Back 8

Result from calcification, seen in diabetes and renal failure

Front 9

Duplex scanning

Back 9

Measures arterial obstruction via blood flow characteristics and velocity

Front 10

Gold standard for vascular imaging

Back 10

Angiography

Front 11

% of acute arterial emboli that originate in the heart

Back 11

80-90%

Front 12

2/3 of thrombi of the heart arise secondary to...

Back 12

Atrial fibrillation

Front 13

Paradoxical emboli

Back 13

Venous emboli that pass into arterial system through defects connecting right and left heart chambers

Front 14

Signs of impending irreversible limb ischemia

Back 14

1) Loss of sensation
2) Mottling of the skin
3) Involuntary muscle contraction
4) Loss of pressure & temp

Front 15

Management of acute arterial insufficiency

Back 15

Immediate heparinization

Front 16

When is fasciotomy considered?

Back 16

When ischemia lasts for more than 4 hours
*Relieves compartmental pressure and avoids compression of arterial and venous vessels

Front 17

Complications of reperfusion of ischemic tissue

Back 17

1) Lactic acidosis
2) HYPERkalemia
3) Myoglobinuria or ATN
4) Muscle edema or compartment syndrome

Front 18

Atheroembolism

Back 18

Sudden rupture of athersclerotic plaque

Front 19

"Blue toe syndrome"

Back 19

Lower extermity atheroembolism
Sharply demarcated areas of focal ischemia of lower leg or foot

Front 20

Symptoms of Blue toe syndrome

Back 20

1) Intense pain
2) Purplish discoloration of skin
3) Thigh and calf myalgias

Front 21

Do patients with Blue toe syndrome have palpable distal pulses?

Back 21

Yes

Front 22

Management of Blue toe syndrome

Back 22

1) Arteriography & echocardiography
2) Surgical therapy - endarterectomy
3) Heparin

Front 23

MCC of stroke

Back 23

Carotid artery atherosclerosis

Front 24

MC site of disease in cerebral circulation

Back 24

Carotid bifurcation

Front 25

Transient Ischemic Attack (TIA)

Back 25

Sudden onset of focal neurologic deficit that resolves completely within 24 hours

Front 26

Do TIAs cause ipsilateral or contralateral deficits?

Back 26

Contralateral

Front 27

Amaurosis fugax

Back 27

Transient loss of vision in the ipsilateral eye, secondary to obstruction of branch of ophthalmic artery

Front 28

Vertebrobasilar insufficiency results in

Back 28

1) Binocular vision loss
2) Drop attacks
3) Dysarthria
4) Vertigo
5) Dysphagia
6) Incoordination

Front 29

Middle cerebral artery stroke leads to...

Back 29

1) Contralateral hemiparesis or hemiplegia
2) Paralysis of contralateral lower part of face
3) Contralateral homonymous hemianopsia
4) Aphasia

Front 30

Anterior cerebral artery stroke leads to...

Back 30

1) Contralateral monoplegia
2) Sparing of face
3) Abnormalities of higher cerebral function

Front 31

Used as medical therapy for prevention and treatment of CVAs when aspirin is contraindicated

Back 31

Ticlopidine

Front 32

MC site of disease in cerebral circulation

Back 32

Carotid bifurcation

Front 33

Transient Ischemic Attack (TIA)

Back 33

Sudden onset of focal neurologic deficit that resolves completely within 24 hours

Front 34

Do TIAs cause ipsilateral or contralateral deficits?

Back 34

Contralateral

Front 35

Amaurosis fugax

Back 35

Transient loss of vision in the ipsilateral eye, secondary to obstruction of branch of ophthalmic artery

Front 36

Vertebrobasilar insufficiency results in

Back 36

1) Binocular vision loss
2) Drop attacks
3) Dysarthria
4) Vertigo
5) Dysphagia
6) Incoordination

Front 37

Middle cerebral artery stroke leads to...

Back 37

1) Contralateral hemiparesis or hemiplegia
2) Paralysis of contralateral lower part of face
3) Contralateral homonymous hemianopsia
4) Aphasia

Front 38

Anterior cerebral artery stroke leads to...

Back 38

1) Contralateral monoplegia
2) Sparing of face
3) Abnormalities of higher cerebral function

Front 39

Used as medical therapy for prevention and treatment of CVAs when aspirin is contraindicated

Back 39

Ticlopidine