Vascular Disease

Front 1

Layers of arteries and veins

Back 1

Tunica externa
Tunica media
Tunica intima

Front 2

MCC limb loss

Back 2

PAD

Front 3

PAD HX questions to ask

Back 3

claudication, rest pain, early fatigue, heaviness of the legs, ulcers

Front 4

Dependent rubor is what sign

Back 4

Buerger’s sign

Front 5

Hair in PAD

Back 5

Shiny, hairless skin (Due to Dec blood flow)

Front 6

What is Livedo reticularis seen in PAD

Back 6

mottled skin

Front 7

What is ABI?

Back 7

Uses a Doppler ultrasound to measure the systolic blood pressure at the brachial artery and at the posterior tibialis artery in the supine patient

Front 8

Normal ABI? severe disease?

Back 8

N: 0.9-1, D: <.5

Front 9

Fontaine stage 1

Back 9

usually asymptomatic, intermittant claudiation minimal pain
Ankle-Brachial Index < 0.9
Decreased distal pulses

Front 10

fontaine stage II

Back 10

Intermittent claudication, severe pain

Front 11

Fontaine stage III

Back 11

Daily rest pain, ulcers, gangrene and absent pulses

Front 12

Fontain stage IV

Back 12

Non-healing ulcers
Ankle-Brachial Index < 0.5

Front 13

3 things you see in Leriche syndrome when terminal aorta is blocked

Back 13

Claudication of buttocks or thigh
Loss of femoral pulse
Impotence

Front 14

stage II Fontaine: aorto-iliac disease manifests as? femoral popliteal?

Back 14

aorto-iliac disease manifests as pain in the thigh and buttock
femoral-popliteal disease manifests as pain in the calf.

Front 15

MC type of bypass graft for stage III

Back 15

Femoral-Popliteal bypass (Most common- using gortex or saphenous vein graft)

Front 16

MCC acute ischemia

Back 16

emboli

Front 17

MC locations and site of embolie

Back 17

from cardiac(afib, vascular dz), femoral artery bifercation

Front 18

5 P's of acute ischemia?

Back 18

pulselessness, paralysis, parasthesia, pain, pallor

Front 19

AAA? RF?

Back 19

>3cm, HTN, smoking

Front 20

MC AAA location

Back 20

infrarenal

Front 21

People with AAA have increased what? what does it do?

Back 21

matrix metalloproteinase (MMP) activity which favor degradation of Collagen and Elastin

Front 22

AAA operative indications

Back 22

Aneurysms >=5.5 cm
Increase in size >0.5cm over 6 months (rapid expansion)
Aneurysm becomes symptomatic (any size)
Rupture

Front 23

ruptured AAA triad

Back 23

hypotension, pulsatile abdominal mass and back pain

Front 24

Preferred AAA repair

Back 24

Endovascular Aneurysm Repair (EVAR)

Front 25

(most common peri-operative complication) AAA repair

Back 25

MI

Front 26

What is Artery of Adamkiewicz

Back 26

largest anterior segmental medullary artery.

Front 27

What is Marginal Artery of Drummond

Back 27

(connects) the inferior mesenteric artery (IMA) with the superior mesenteric artery (SMA).

Front 28

How does aortoenteric fistula present

Back 28

“herald bleed”

Front 29

Herald Bleed

Back 29

This initial bleed presents with melena or hematochezia
This is followed by a catastrophic bleed and exsanguination
High index of suspicion the key!!!!

Front 30

Stanford type A

Back 30

lesions involve the ascending aorta and aortic arch and may or may not involve the descending aorta

Need surgery!!

Front 31

Stanford Type B

Back 31

lesions involve the thoracic aorta distal to the left subclavian artery descending aorta

medical management

Front 32

Virchow's Triad

Back 32

Venous Stasis
Endothelial Injury
Hypercoagulable State

Front 33

MCC hypercoaguabliltiy

Back 33

factor V leiden

Front 34

Low risk DVT

Back 34

Minor surgery (<30 min) + no risk factors other than age
Major surgery (> 30 min) , age <40 yrs + no other risk factors
Minor trauma or medical illness

Front 35

Mod Risk DVT

Back 35

Major general, urological, gynecological, cardiothoracic, vascular or neurological surgery + age >40 yrs or other risk factor
Major medical illness or malignancy
Major trauma or burn
Minor surgery, trauma or illness in patients with previous DVT, PE or thrombophilia

Front 36

High Risk DVT

Back 36

Fracture or major orthopedic surgery of pelvis, hip or lower limb
Major pelvic or abdominal surgery for cancer
Major surgery, trauma or illness in patient with previous DVT, PE or thrombophilia

Front 37

Unilateral DVT SX

Back 37

calf pain, tenderness, redness
fever
persistent tachycardia

Front 38

Homans sign DVT

Back 38

pain on passive dorsiflexion of the ankle is a non-specific sign!!!

Front 39

“venous gangrene” (phlegmasia cerulea dolen

Back 39

Ileofemoral vein occlusion can result in a condition called “venous gangrene” (phlegmasia cerulea dolens = swollen, blue and painful)

Front 40

Phlegmasia alba dolens

Back 40

Painful white inflammation arterial spasm. The affected extremity is often pale with poor or even absent distal pulses.

Front 41

What is D-dimer and when is it useful?

Back 41

A fibrin degradation product that occurs in the presence of recent thrombus
Only useful in non surgical patients with no recent trauma

Front 42

What does US allow you to do in DVT

Back 42

Allows you to reasonably exclude a major fem-pop or calf deep vein thrombosis in symptomatic patients

Front 43

GS DVT

Back 43

venography

Front 44

TX DVT?

Back 44

Anticoagulation with unfractionated or low molecular weight heparin followed by oral anticoagulation
Optimal duration of treatment unknown but no proof that treatment beyond 3-6 months is required (1st episode)

Front 45

95% PE have what SX

Back 45

tachypnea

Front 46

PE ABG

Back 46

classic finding of hypoxia AND respiratory alkalosis

Front 47

EKG PE

Back 47

S” wave lead 1, “Q” wave in lead 3, “Inverted T-wave” lead 3.

Front 48

Venous stasis

Back 48

Due to prolonged/untreated venous hypertension in dependant extremities

Front 49

Venous Statsis

Back 49

Due to prolonged/untreated venous hypertension in dependant extremities