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Sp: Coexisting I > 10. Vascular Disease > Flashcards

10. Vascular Disease Flashcards

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1
Q

innermost layer of artery

A

endothelium

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2
Q

atherosclerosis

A

response to vessel wall injury

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3
Q

atherosclerosis results in

A

endothelia dysfunction

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4
Q

indication of vascular disease

A

claudication

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5
Q

aneurysm

A

abnormal weakening of vessel wall

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6
Q

dissection

A

tear in intima allows blood into extra luminal channel

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7
Q

does an aneurysm or dissection have false lumen?

A

dissection

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8
Q

risk factors for thoracic aortic disease

A

HTN
geriatric
atherosclerosis
genetic predisposition
smoking

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9
Q

genetic predisposition for thoracic aortic disease

A

connective tissue disorders
bicuspid aortic valve

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10
Q

primary causes of thoracic aortic disease

A

genetic
- connective tissue
- bicuspid aortic valve

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11
Q

stanford A

A

ascending involved

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12
Q

Stanford B

A

ascending not involved

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13
Q

abdominal aortic disease primary causes

A

lifestyle causing atherosclerosis

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14
Q

goal ACT for vascular cases

A

200-300s

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15
Q

heparin initial dose for vascular cases

A

100U/kg

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16
Q

indications for surgery in thoracic aortic aneurysm

A

symptomatic
>5cm diameter
growth >10mm/year

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17
Q

ascending and aortic arch dissection requires

A

urgent surgery

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18
Q

descending thoracic aortic dissection indications for surgery

A

diameter >5.5cm
rarely urgent

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19
Q

Type A repairs

A

bypass
deep hypothermia
circ arrest

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20
Q

thoracic aorta surgery risk

A

spinal cord ischemia risk increased for paraplegia with cross clamp > 30 mins

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21
Q

what side should you put the radial art line into for thoracic repair?

A

Right - shows perfusion to brain

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22
Q

thoracic aneurysm BP

A

above clamp: MAP 100 mmHg
below clamp: MAP > 50 mmHg

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23
Q

clevidipine

A

CCB

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24
Q

clevidipine dose

A

2mg/hr

(MAX: 32mg/hr)

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25
3 ways to preserve neuro function during thoracic aneureysm repsir
1. SSEP/EEG monitoring 2. spinal cooling w/iced epidural 3. CSF drain
26
induction drugs for thoracic aneurysm
minimize HTN - versed - propo - narcotic (sufentanil)
27
most common congenital heart anomaly
bicuspid aortic valve
28
ID ruptured AAA
hypotension back pain pulsatile abdominal mass
29
DDx for ruptured AAA
renal colic diverticulitis gi hemorrhage
30
treatment for ruptured AAA
open endovascular
31
what aneurysm can be treated with endovascular repair
descending thoracic aneurysm
32
risks of endovascula repair of thoracic aneurysm
**1. migrate/occlude carotid** - incr stroke risk 2. distal ischeia 3. strong HD forces 4. difficult arterial access
33
risk of open AAA repair
incr M+M high risk of complications
34
risk of endovascular AAA repair
decr M+M no cross clamp (decr stroke risk) no hypoperfusion risk endoleaks **stent migration** ischemia
35
most common cause of reintervention during endovascular repair of AAA
stent migration
36
carotid endartectomies managment
ID pressure range w/surgeon vagal response likely venous blood 20% baselione
37
when can you extubate a carotid endarctectomy
once awake enough to follow commands
38
injuries during carotid endarctectomy
laryngeal nerve injury carotid body injury
39
HTN treatment during carotid endartectomy
clevidipine nipride NTG hydralazine labetalol
40
virchow's triad
venous stasis hypercoagulability disruption of vascular endothelium
41
most important complication of DVT
Pulmonary embolism
42
DVT prevention
SCDs lovenox regional (early ambulation)
43
DVT treatment
anticoag
44
recurrent PE treatment
IVC filter
45
DVT prevention in pts who are CI to anticoags
IVC filter
46
primary causes of peripheral vascular disease
**smoking** old age family history diabetes HTN obestity
47
collateral importance
without collateral flow you get stroke ensures cerebral perfusion
48
coronary subclavian steal
proximal stenosis of Left Subclavian produces reversal of blood flow through LIMA **diverts blood from heart to arm**
49
subclavian steal
proximal stenosis reverses flow through ipsilateral vertebral artery **diverts blood from brain to arm***
50
during subclavian steal, what do you expect the BP to be in the affected arm
lower
51
raynauds
poor peripheral perfusion
52
raynaud's managment
keep warm avoid art line avoid adding epi in regional local anesthetic
53
temporal arteritis risks
HIGH fire risk
54
AAA rupture into
L retroperitoneum
55
brains blood supply amoutn
20% of CO
56
brain is supplied by
internal carotid arteries vertebral arteries
57
what connects in the circle of willis
internal carotids basilar artery
58
vertebral arteries join at
basilar artery
59
A
external carotid
60
B
internal carotid
61
C
hypoglossal nerve
62
D
vagus nerve
63
E
common carotid
64
if an internal carotid is clamped, perfusion relies on
collateral flow though circle of willis
65
in order for collateral flow through circle of willis to occur
pressure must be high enough for retrograde flow to the contralateral anterior and middle cerebral arteries
66
open aortic repair risk
blood loss cardiac dysfunction pulm dysfunction renal dysfunction

Sp: Coexisting I (11 decks)

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