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109 Cards in this Set
- Front
- Back
What are the 3 layers of a blood vessel
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intima
media adventitia |
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Where is the vasa vasorum located
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within the adventitia
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What is responsible for repair of cells
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endothelium (lining inside of intima)
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Where is the smooth muscle located
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media
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Name the 8 basic angiographic findings
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stenosis
aneurysm dissection extravasation psuedoaneurysm AV fistula in situ thrombosis embolism |
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What does a normal renal artery look like
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smooth walls
will taper from proximal to distal |
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What is the MC vascular finding
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stenosis
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What should aspects of a blood vessel should be evaluated when looking at a stricture
5 |
length
severity concentric vs eccentric calcification collaterals |
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What is the 2nd MC finding on an angiogram
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aneurysm
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What should aspects of a blood vessel should be evaluated when looking at a aneurysm
3 |
size
eccentricity concominant dz |
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What is the MC 2ndary cause of htn
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RAS
Accounts for 1-4% of all patients with hypertension |
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Where are the MC locations for FMD in upper and lower extremities
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Most common upper extremity artery: Brachial; also seen in subclavian, and axillary arteries
Most common lower extremity artery: External iliac; also seen in femoral, popliteal, and tibial arteries |
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What is the cause of FMD
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Noninflammatory, nonatherosclerotic arterial disease of unknown etiology
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Where are the 2 MC locations of FMD overall
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Renal is most common 60-70%
Internal carotid 20-30% |
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What is the classic imaging appearance of FMD
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"String of beads" appearance on diagnostic imagin
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Why is angiography the gold standard for treatment of FMD
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"Gold standard" offers simultaneous therapeutic interventions: Percutaneous revascularization with balloon angioplasty and/or stenting
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What is the classic angiographic appearance of FMD
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Classic "string of beads"
Diameter of beading larger than diameter of normal artery |
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What are the hallmark features of dissection
3 |
intimal flap
compression of true lumen delayed filling of false lumen |
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Can it be difficult to differentiate a dissection from an aneurysm if intimal flap is not seen
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yes
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What is a pseudoaneurysm
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confined collection of contrast that is restrained by adventitia or periadventitial tissue
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Are AVF often assoicated with pseudoaneurysms
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yes
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What is a common cause of an AVF
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penetrating trauma or aneurysmal rupture
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What are 3 causes of in situ thrombosis
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aute response to vessel injury
trauma hypercoaguable states |
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Where are embolisms most commonly seen
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bifurcation
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What does an embolism look like on angiography
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a filling defect
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Does an embolism have assoicated colleterals
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no, it is acute
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What 2 vessels are prone to embolism
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RA and SMA
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What are the 4 general sizes of blood vessels
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large (aorta and great vessels)
medium (renal, carotid, sma) small (tertiary segmental branches) arterioles |
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Are arterioles and capillaries visible on angiography
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no
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Are the arterioles affected in wegners
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yes
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What size vessels are affected in takayasu arteritis
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large
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What size vessels are affected in FMD
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medium
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What size vessels are affected in polyarteritis nodosa
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small
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Why is takayasu referrred to as pulsless disease
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bc it affects the great vessels and thoracic aorta and may result in occlusion of these arteries and loss of pulse
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Does polyarteritis nodosa cause aneurysms of small vessels
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yes
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What part of the body is affected by burgers disease
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lower extremities
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What vascular disease occurs in children
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kawasakis
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What age group tends to get Buergers and leriche
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early middle age
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What is the ddx of common arterial vascular disorders
5 |
atherosclerosis
FMD embolic dz intimal hyperplasia traumatic vascular injury |
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What is the ddx of not so common arterial vascular disorders
5 |
inflammatory vasculitis
physiologic disturbance AVM neoplasia congenital/metabolic |
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What is a fibrofatty plaque
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this is a lesion with a fatty core and is covered by a fibrous plaque
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What is a atheroma
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this is a complex fibrofatty plaque with calcification, ulceration, hemorrhage
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What are the complications of fibrofatty plaques/atheromas
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stenosis, aneurysm, embolization
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Where do aneurysm MC occur as a result of atherosclerosis
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infrarenal
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What is a major clue of stensosis on angiographic imaging
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collaterals
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What is blue toe syndrome
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this is embolization from atherosclerotic disease that causes distal occlusions
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What tissue is replaced in fibrodysplasia
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although fibroous medial dysplasia is most common this can occur in the intima, media or adventitia
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What is the MC location of fibrousdysplasia
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medial
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What is the MC location of fibroous dysplasia
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right renal artery
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What location within the renal artery is most common
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distal aspect (
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Does fibrous medial dysplasia occur more commonly in men or woment
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women
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what side for FMD is morre common
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right
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What other arteries are affected by FMD
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carotid and external iliac
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Where do 85% or thromboembolism originate
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heart
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What predisposes a patient to thromboembolism from the heart
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recent MI or a-fib
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Where do 10% of thromboembolism come from
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aneurysms (aorto-iliac region or femoral-popiteal)
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What are atheroemboli
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this is distal arterial aneurysm (cause blue toe syndrome)
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Do emboli commonly occur in the SMA
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yes
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What is a cause of intimal hyperplasia
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vascular injury (platelets aggregate and stimulate smooth muscle cells)
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Does initmal hyperplasia sometimes result from the trauma of intravascular surgery
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yes
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Does intimal hyperplasia occur on the inside of a stent
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yes it can
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What are 4 possible results of vascular trauma
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occulsion
dissection pseudoaneurysm AV fistula |
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What is the pathophysiology of inflammatory vasculitis
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infitration of the media by histocytes
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What are the angiographic manifestations of inflammatory vasculitis
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stenosis
thrombosis vessel rupture pseudoaneurysm aneurysm |
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What are the etiologies of inflammatory vasculitis
3 |
infection
radiation idiopathic |
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Are mycotic aneurysm usually eccentri or concentric
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they are usualy eccentric
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Is kawaskis usually post viral
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yes
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What vessels does kawasakis typically affect
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the coronary arteries
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Where does polyarteritis nodosa typically affect
2 |
kidneys
pancreas |
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What are the findings of polyarteritis nodosa
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microaneursyms
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Where does temporal arteritis typically affect
2 |
temporal artery
arch vessels |
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What is the result of temoral arteritis
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stenosis or occlusion
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Where does takayasus disease affect
3 |
aorta, arch, pulmonary artery
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What is the result of takayasyu
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stensosis or occlusion
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What is the result of buergers disease
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segmental occlusion
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Where does buergers disease typically occur
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peripheral vasculature
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What are the locations of the idiopathic arteritis
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|
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Can polyarteritis lead to rupture
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yes
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Does polyarteritis cause microaneurysm
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yes
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In addition to the temporal artery and the aortic arch where else does temporal arteritis occur
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the upper extremity vessels (this can cause an upper extremity occlusion)
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Can takayasu disease cause a mid aortic stenosis
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yes
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What is the hallmark feature of buergers disease
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cork screw collaterals
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What are physiologic causes of vascular abnormalities
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extrinsic compression
drug induced vasospasm |
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What are 3 types of extrinsic compression
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popiteal entrapment
thoracic outlet syndrome median arcuate ligament compression |
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Which way is the popiteal artery deviated in popiteal entrapment syndrome
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medially
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When does the occlusion occur the axillary artery in thoracic outlet syndrome
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during abduction
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What secondary injury may occur to the subclavian/axillary artery as a result of thoracic outlet syndrome
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aneurysms
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What does median arcute ligament compression syndrome look like
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|
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What does the median arcuate ligament compress
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the celiac artery
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What is the cause of AVM
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congenital aberration of embryonic development at 4-10 wks
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Where is the MC location of an AVM
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pulmonary
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What are the findings of pulmonary AVMs
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lower lobe
enlarged PA branch tangle of vessels early draining veins |
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What is the MC syndrome associated with AVM
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osler webber rendu
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What is the big difference between an AV fistula and AVM
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there is a tangle of vessels (nidus) with an AVM
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What is the MC cause of AV fistula
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trauma
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What neoplasms that are associated with vessels
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hemangioma
hemangiosarcoma pericytoma |
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Are hemangiosarcoma and pericytoma malignant
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yes
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Where are the MC locations of hemangiomas
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skin, liver, spleen, pancreas
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What are the findings of a hemangioma
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large feeding vessel, densley staining mass
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What are some predisposing substances to vascular neoplasm
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arsenic
thorotrast PVC |
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What does balloon dilation look like
|
|
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What happens to the intima during balloon dilation
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it tears
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Is an angioplasty balloon compliant or non-compliant
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non-compliant
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What does non-compliant mean
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it will not increase beyond a certain size despite increased pressure
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What happens as result of angioplasty
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loss of vessel recoil
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Do you ever do angioplasty in an asymptomatic patient
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no
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What are some clinical SS that warrant angioplasty
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claudication
rest pain non-healing ulcer htn and renal failure (renal artery) |
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What are examples of underlying pathology that may require angioplasty
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atherosclerosis
FMD post operative stenosis |
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What is almost always the reason we do angioplasty
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atherosclerosis
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