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14 Cards in this Set
- Front
- Back
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At what level of carotid stenosis does the benefit of carotid endartectomy outweigh medical treatment alone (i.e. ASA)?
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1. CEA for Stenosis of 60%-99% in asymptomatic patients. 2. CEA for patients with recently symptomatic carotid stenosis(amaurosis fugax, TIA, stroke) of 70 to 99 percent who have a life expectancy of at least five years. 3. CEA for 50-69% in symptomatic patients (controversial in women)
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What postop recommendation for patients after CEA?
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Treatment with ASA after CEA
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Patient has an episode of amaurosis fugax, what testing should be done?
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Duplex scanning of the carotids
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6 P's of acute arterial occlusion.
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pain, pulselessness, paralysis, pallor, paresthesia, poikilothermia
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What is often a consequence of ischemic-reperfusion injury in revascularization?
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Compartment Syndrome
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Signs of chronic ischemia on PE of the local extremity.
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hair loss, dependent rubor, loss of sensation, thin, shiny skin
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When is surgery often considered in PVD?
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After weighing operative risk consider: 1. rest pain/discomfort level. 2. livelhood requires the ability. 3.ulceration. 4. often due to the progressive nature of Aortoiliac disease
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What is "trash foot"?
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consequence of unclamping during bypass, leading to atheroembolization of distal small vessels
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Common complication of AAA repair
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Fluid shifts leading to cardiac arrhythmia or pulmonary edema.
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Common complication of repair after AAA rupture.
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ischemic colitis (bloody diarrhea)
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Patient postop AAA rupture repair has bloody diarrhea. Diagnosis? Testing? Treatment?
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Diagnosis: ischemic colitis; testing: immediate sigmoidoscopy. Treatment: bowel rest, IVF and blood, GI decompression, ABX, frequent exams (endo), if full thickness need resection and colostomy.
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Patient 2 years after Aortic repair presents with UGI bleed. Diagnosis? Treatment?
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Diagnosis: Aortoenteric fistula; Treatment: graftremoval, GI tract repair, extra anatomic bypass
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Most reliable clinical sign of DVT. If a DVT is found on duplex, what is the treatment? What should be wary of?
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unilateral, leg swelling. Treatment: systemic anticoagulation (3-6 months) with bed rest for 1st 48 hours. the PTT should be 1.5 to 2x normal. Beware HIT!
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Warfarin should be given until the INR is what?
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therapeutic levels are between 2-3.
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