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51 Cards in this Set
- Front
- Back
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1. What are the risk factors for peripheral vascular disease?
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a. Smoking
b. **Family hx** c. Diabetes d. HTN e. Dyslipidemia f. Obesity |
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2. What are the MCCs of peripheral vascular disease?
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a. Atherosclerosis
b. Inflammation |
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1. What are some common surgical problems related to PVD?
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a. Carotid artery occlusive disease
b. AAA c. Peripheral artery occlusive disease |
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4. What are two flow abnormalities that can lead to CAOD?
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a. Turbulent flow
b. Atherosclerotic plaque |
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5. What is the first muscle you cut through to get to the carotid? What is your subsequent landmark?
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a. Platysma
b. Anterior border of SCM |
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6. What are the common presentations of CAOD?
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a. Neurologic deficits
b. TIA-- less than 24 hours c. Reversible ischemic neurologic deficit-- 24-72 hours d. CVA- permanent e. Amaurosis fugax |
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7. What should you always listen for if CAOD is suspected?
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a. Carotid bruits
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8. What are the components of a workup for CAOD?
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a. Carotid Doppler-- signs of stenosis
b. Carotid angiography-- quantification of stenosis |
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1. What is the contraindication for a carotid angiography?
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a. Cannot use contrast in chronic renal disease
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10. What type of flow pattern will a diabetic’s arteries exhibit?
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a. Diphasic
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11. What is heard in monophasic flow?
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a. Woosh
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12. How do you tx CAOD?
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a. Statins, Plavix
b. Lifestyle modification c. Control HTN and diabetes |
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13. What are the surgical indications for CAOD?
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a. Completed stroke
b. Evolving stroke-- emergent |
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14. How long should you ideally wait to treat CAOD in a stroke patient?
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a. 4-6 weeks
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15. What surgery is indicated for a high risk CAOD patient?
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a. Ballooning/stenting
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16. What surgical tx is indicated for CAOD?
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a. Endarterectomy
b. **Preferred tx** |
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17. What should you avoid when scraping out an atherosclerotic plaque?
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a. Intimal damage
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18. What type of repair is rare on the carotid?
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a. Primary closure
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19. What are some common iatrogenic nerve injuries in CAOD?
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a. IX-XII
b. Marginal mandibular nerve |
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20. What should you do to check for neurologic damage in a CAOD operative patient?
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a. Do a neurologic exam before and after surgery
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21. What is the location of the majority of AAA’s? How do you access them?
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a. Infrarenal
b. Through the groin |
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22. What is an AAA?
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a. Focal dilatation of the aorta >1.5x normal diameter
b. Normal diameter= 2 cm c. > 3 cm= aneurysm |
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23. What gender runs the higher risk of rupturing an AAA?
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a. Female
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24. What is the clinical presentation of an AAA?
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a. Excruciating pain in back, abdomen, or groin
b. Hypovolemic shock c. Grey-Turner sign |
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25. When should patients be screened for AAA?
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a. Men age 65-75 with hx of smoking
b. Men age 65-75 with a first degree family member requiring AAA repair |
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26. What are the risk factors for AAA?
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a. Same as for atherosclerosis
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1. How often should a patient be screened once an AAA has been discovered?
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a. Screen 6 mos. after discovery
b. If no expansion→ c. <4 cm= every 2 years d. 4-4.5 cm=annually e. >4.5 cm- every 6 months |
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28. What are the indications for an AAA repair?
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a. Expanding >.5 cm/6 months or >1 cm/year
b. Symptomatic c. > 5.5 cm d. Saccular aneurysms |
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29. What are the surgical options for an AAA repair?
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a. EVAR
b. Open repair |
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30. What are the pros/cons to an EVAR?
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a. Lower perioperative M/M
b. Does not eliminate risk of future rupture c. Preferred in patients with higher operative risks with adequate anatomy |
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31. What are the pros/cons to an open repair?
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a. Higher perioperative M/M
b. More definitive repair c. Preferred in younger patients with low/average operative risk |
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32. What are the limitations of an EVAR?
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a. Need adequately sized femoral artery (10 mm)
b. Aortic neck length (10-15mm) c. Aortic neck angulation (<60 degrees) |
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33. What are the possible complications of an EVAR?
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a. Stent migration/kinking
b. Inadequate seal c. Incomplete expansion/fixation d. Component separation e. Infection f. Endoleak |
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34. What are the symptoms of PAOD?
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a. Claudication
b. Leriche syndrome c. Impotence d. Ulcers e. Diminished distal pulses f. Skin color changes |
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35. What is Leriche syndrome? What does it indicate?
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a. Gluteal claudication, absent femoral pulses
b. Indicates aortoiliac disease |
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36. What does rest pain indicate in PAOD?
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a. Severe disease
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37. What is the use of ABI in the dx of PAOD?
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a. >1.2=calcification
b. 1-1.2=normal c. .9-1= acceptable d. <.9=occlusive disease |
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38. What ABI is indicative of rest pain?
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a. <.5
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39. What ABI is indicative of ulcers?
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a. <.4
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40. What ABI is indicative of gangrene?
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a. <.3
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41. What dx imaging should you use in PAOD if ABI is normal?
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a. Duplex US
b. Assesses stenosis/occlusion |
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42. What imaging should be used if PAOD is found through duplex ultrasound?
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a. CTA or MRA
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43. What are the options in bypass to tx PAOD?
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a. Axillary-bifemoral
b. Fem-fem c. Fem-pop |
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44. What are the symptoms of compartment syndrome?
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a. Pain
b. Pallor c. Pulselessness d. Poikilothermia e. Paresthesia f. Paralysis |
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45. What is a subclavian steal?
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a. Arm fatigue and verebrobasilar insufficiency from obstruction of subclavian artery proximal to vertebral branch point
b. Ipsilateral arm movement→ increased vascular deman c. Retrograde vertebral artery flow steals from the vertebrobasilar arteries |
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46. What are the symptoms of a subclavian steal?
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a. Upper extremity BP discrepancy
b. Syncope, vertigo, dysarthria, ataxia |
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47. What is the tx for a subclavian steal?
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a. Carotid-subclavian bypass
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48. What are the risk factors for DVT?
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a. Virchow’s triad→
b. Hyperoagulable state c. Intimal injury d. Venous stasis |
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49. What is the medical tx for DVT?
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a. Anticoagulation
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50. What is the secondary tx for DVT?
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a. IVC filter placement
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51. What are the indications for an IVC filter?
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a. Contraindicated to antiocoagulation
b. PE while on anticoagulations c. Pregnancy d. Para/quadriplegia |
