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VASCULAR SYSTEM > ARTERIAL DISORDERS > Flashcards

ARTERIAL DISORDERS Flashcards

1
Q

⚡⚡ MOST COMMON type of ANEURYSM (morphology)

A

Fusiform ANEURYSM

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2
Q

🌸 TYPES of ANEURYSM

🧠⚡MAD SCAB ⚡

A
  1. Mycotic
  2. Atherosclerotic
  3. Dissecting
  4. Syphilictic
  5. Capillary Micro-aneurysm
  6. AV-Fistula
  7. Berry ANEURYSM
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3
Q

Shapes of ANEURYSM

A
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4
Q

⚡⚡ MOST COMMON VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON EXTRA-CRANIAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON PERIPHERAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON VISCERAL VESSEL INVOLVED IN ANEURYSM

⚡⚡ MOST COMMON VESSEL INVOLVED IN MYCOTIC ANEURYSM

A

⚡⚡ MOST COMMON VESSEL INVOLVED IN ANEURYSM
🎯 CIRCLE OF WILLIS

⚡⚡ MOST COMMON EXTRA-CRANIAL VESSEL INVOLVED IN ANEURYSM
🎯 INFRA-RENAL ABDOMINAL AORTA

⚡⚡ MOST COMMON PERIPHERAL VESSEL INVOLVED IN ANEURYSM
🎯 POPLITEAL ARTERY

⚡⚡ MOST COMMON VISCERAL VESSEL INVOLVED IN ANEURYSM
🎯 SPLENIC ARTERY

⚡⚡ MOST COMMON VESSEL INVOLVED IN MYCOTIC ANEURYSM
🎯 AORTA

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5
Q

⚡⚡ MOST COMMON CAUSE OF MYCOTIC ANEURYSM

A

Staphylococcus aureus

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6
Q

⚡⚡ MOST COMMON SITE OF PSEUDO-ANEURYSM

⭐ CAUSE

A

Femoral ARTERY

⭐ CAUSE: Cannulation (OR) Trauma

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7
Q

⚡⚡ MOST IMPORTANT RISK FACTOR for ANEURYSM FORMATION

A

ATHEROSCLEROSIS

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8
Q

Screening of ABDOMINAL AORTA is done in ______ after age _____

A

UK
> 65 years

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9
Q

Why screening of ABDOMINAL AORTIC ANEURYSM is done?

A

⭐ Common above age > 65yrs
⭐ whether Critical diameter is reached or not

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10
Q

Critical diameters of ANEURYSMS:

⭐ Critical diameter of POPLITEAL ARTERY ANEURYSM

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♀️

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♂️

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM

⭐ Critical diameter of DESCENDING THORACIC AORTIC ANEURYSM

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM in MARFAN’S SYNDROME & BICUSPID AORTIC VALVE

A

⭐ Critical diameter of POPLITEAL ARTERY ANEURYSM
🎯 2-3cm

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♀️
🎯 5cm

⭐ Critical diameter of ABDOMINAL AORTIC ANEURYSM ♂️
🎯 5.5cm

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM
🎯 5.5cm ➕ Rate of increase in size > 0.5 cm/yr

⭐ Critical diameter of DESCENDING THORACIC AORTIC ANEURYSM
🎯 6 cm ➕ Rate of increase in size > 1 cm/yr

⭐ Critical diameter of ASCENDING THORACIC AORTIC ANEURYSM in MARFAN’S SYNDROME & BICUSPID AORTIC VALVE
🎯 4.5-5cm

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11
Q

CLINICAL features of ABDOMINAL AORTIC ANEURYSM

A
  1. ASYMPTOMATIC
  2. ABDOMINAL Pain
  3. PULSATILE Mass
  4. EMBOLUS Formation ➡️ Blue toe SYNDROME
  5. Rupture ➡️ High Mortality
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12
Q

Blue Toe Syndrome

A

Showeringbof Embolus From ABDOMINAL AORTIC ANEURYSM to Foot
⬇️
Gangrene in toes

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13
Q

🩺 IOC of AAA

🩺 SCREENING IOC of AAA

A

🩺 IOC of AAA
🎯 CT ANGIOGRAPHY

🩺 SCREENING IOC of AAA
🎯 USG

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14
Q

INDICATIONS for SURGICAL INTERVENTION IN AAA

A

⭐ SYMPTOMATIC
⭐ Asymptomatic ➕ Size > 5.5 cm

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15
Q

SURGICAL INTERVENTION IN AAA

A
  1. EVAR (EndoVascular Aneurysmal Repair)
  2. OPEN SURGERY
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16
Q

🚫 CONTRAINDICATION of EVAR

A
  1. Difficult ILIAC AXIS
  2. ⬆️ ANGULATION
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17
Q

Identify

A

EVAR Stent

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18
Q

Why Lifelong monitoring after EVAR is needed?

A

Chances of ENDOLEAK
(Leak from EVAR)

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19
Q

Identify

A

EVAR in place

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20
Q

Types of ENDO-LEAKS

A
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21
Q

⭐ Type 1 ENDOLEAK MOST COMMONLY SEEN IN

⭐ Type 2 ENDOLEAK MOST COMMONLY SEEN IN

A

⭐ Type 1 ENDOLEAK MOST COMMONLY SEEN IN
🎯 THROCIC AORTIC ANEURYSM

⭐ Type 2 ENDOLEAK MOST COMMONLY SEEN IN
🎯 ABDOMINAL AORTIC ANEURYSM

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22
Q

Which GRAFT is used in OPEN SURGERY for AAA?

A

Dacron Graft

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23
Q

MATTOX PROCEDURE
🧠⚡LLRM ⚡

A

LEFT MEDIAL VISCERAL ROTATION

Left Descending Colon is ROTATED Medially
⬇️
Expose AORTA

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24
Q

CATTLE-BRASCH MANEUVER
🧠⚡CRRI ⚡

A

RIGHT ASCENDING COLON is ROTATED INTERNALLY (MEDIALLY)
⬇️
EXPOSES THE IVC

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25
Q

KOCHERIZATION

A

Mobilization of DUODENUM

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26
Q

⚡⚡ MOST COMMON CAUSE of DEATH AFTER ABDOMINAL AORTIC ANEURYSM SURGERY

A

Cardiovascular causes

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27
Q

COMPLICATIONS of AAA SURGERY

A
  1. Renal failure
  2. Aorto-Duodenal Fistula: Upper GI hemorrhage & Melena
  3. Colonic Ischemia: Lt side of colon
    IMA is involved.
  4. PARAPARESIS
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28
Q

Cause of PARAPARESIS after AAA Surgery

A

Involvement of ARTERY OF ADAMKIEWICZ
⬇️
Supplies Anterior Spinal Artery

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29
Q

Upper GI HEMORRHAGE: Hemetemesis (OR) Melena
➕
H/O AAA Surgery

A

Aorto-Duodenal Fistula

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30
Q

🧑🏻‍⚕️ Clinical Features of RUPTURED AORTIC ANEURYSM

A
  1. Shock
  2. Pulsatile swelling
  3. Flank Pain
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31
Q

⚡⚡ MOST COMMON site of BLEEDING accumulation in ruptured AAS

A

Left Retroperitoneum

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32
Q

🩺 IOC for RUPTURED AAA

A

CT ANGIOGRAPHY

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33
Q

💊💉 MANAGEMENT of RUPTURED AAA

A

Dacron Graft Repair

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34
Q
A

RUPTURED AAA

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35
Q

CRAWFORD Classification is used for

A

THORACO-ABDOMINAL AORTIC ANEURYSM

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36
Q

⚡⚡ MOST EXTENSIVE TYPE OF THORACO-ABDOMINAL AORTIC ANEURYSM

A

Type 2
(From Left SUBCLAVIAN ➡️ Aortic Bifercation (iliac artery)

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37
Q

Causes of THORACIC AORTIC ANEURYSM

A
  1. 2deg to ATHEROSCLEROSIS
  2. MARFAN Syndrome
  3. Ehler Danlos Syndrome
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38
Q

🧑🏻‍⚕️ Clinical Features of THORACIC AORTIC ANEURYSM

A
  1. ASYMPTOMATIC
  2. HOARSENESS ➡️ ORTNER’S Syndrome
  3. DYSPHAGIA
  4. DYSPNEA
  5. RUPTURE
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39
Q

Cause of HOARSENESS IN THORACIC AORTIC ANEURYSM

A

Pressure of DESCENDING THORACIC ANEURYSM on LEFT RECURRENT LARYNGEAL NERVE
⬇️
ORTNER SYNDROME

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40
Q

🧑🏻‍⚕️ Clinical Features of RUPTURED THORACIC AORTIC ANEURYSM

A
  1. DYSPNEA
  2. LEFT SIDED PLEURAL EFFUSION
41
Q

💊💉 MANAGEMENT of THORACIC AORTIC ANEURYSM

A
  1. Symptomatic
  2. ASYMPTOMATIC patients with
    ✨ ASCENDING diameter: 5.5cm
    ✨ DESCENDING diameter: 6cm
    ✨ MARFAN SYNDROME: 4.5-5cm

⬇️

  1. EVAR
  2. OPEN GRAFT REPAIR
42
Q

⚡⚡ MOST COMMON RISK FACTOR FOR AORTIC DISSECTION

A

Hypertension

43
Q

⚡⚡ MOST COMMON SITE FOR AORTIC DISSECTION

A

Lateral wall of ASCENDING THORACIC AORTA

44
Q

🧑🏻‍⚕️ Clinical Features of AORTIC DISSECTION

🧠⚡ 5th DECADE MALE⚡

A
  1. Chest Pain RADIATING to BACK in INTERSCAPULAR Region
  2. Aortic & Coronary Insufficiency
45
Q

Chest Pain of AORTIC DISSECTION

A

⭐ Chest Pain
⭐ RADIATING to BACK in INTERSCAPULAR Region

46
Q

🩺 IOC for AORTIC DISSECTION

⭐ IN STABLE PATIENT
⭐ IN UNSTABLE PATIENT

A

⭐ IN STABLE PATIENT
🎯 CT ANGIOGRAPHY

⭐ IN UNSTABLE PATIENT
🎯 TRANS-ESOPHAGEAL ECHO

47
Q

Identify

🧠⚡ identify line in the aorta⚡

A

CT ANGIOGRAPHY of AORTIC DISSECTION

48
Q

Chest X-RAY of AORTIC ANEURYSM

A
  1. Widening of CHEST
  2. Left sided PLEURAL EFFUSION
49
Q

Widening of MEDIASTINUM

A
  1. THORACIC ANEURYSM
  2. ABDOMINAL ANEURYSM
  3. AORTIC DISSECTION
50
Q

DeBakey classification used for

A

Aortic DISSECTION

51
Q

Stanford Classification used for

A

Aortic Aneurysm

52
Q

💊💉 MANAGEMENT of AORTIC DISSECTION

A
  1. Permissive Hypotension: ESMOLOL
  2. Grade 1 & 2 DeBakey: Graft Repair
  3. Grade 3 DeBakey:
    ✨ Progressive symptoms: Surgery
    ✨ Chronic: Conservative Management
53
Q

POPLITEAL ANEURYSM
🧑🏻‍⚕️ CLINICAL FEATURES

A
  1. Pulsating Swelling of Knee
  2. Loss of Contour in the KNEE Behind
  3. Pain & Distal Emboli
54
Q

Identify

A

Popliteal Aneurysm

55
Q

🩺 IOC for POPLITEAL ANEURYSM

A

CT ANGIOGRAPHY

56
Q

INDICATION for INTERVENTION in POPLITEAL ANEURYSM

A
  1. ASYMPTOMATIC with DIAMETER > 2 cm
  2. All SYMPTOMATIC PATIENTS
57
Q

Cause of FEMORAL ARTERY ANEURYSM

A

Puncture of the vessels

58
Q

Critical Diameter for FEMORAL ANEURYSM

A

3cm

59
Q

Identify

A

Femoral aneurysm

60
Q

💊💉 MANAGEMENT of FEMORAL ANEURYSM

A

< 3cm: Thrombin Injection (USG Guided)
≥ 3cm: Surgical Repair

61
Q

DOC for Raynaud’s Phenomenon

A

Calcium Channel Blockers

62
Q

Difference BETWEEN Raynaud’s Phenomenon & Acrocyanosis

A
63
Q

1° RAYNAUD’S vs 2° RAYNAUD’S

A
64
Q

Cause of SUBCLAVIAN STEAL SYNDROME

A

Stenosis in 1st PART of SUBCLAVIAN ARTERY
⬇️
On EXERCISING, Retrograde flow from VERTEBRAL Artery to side of Lesion ➡️ To SIDE of LESION
⬇️
Less Blood Flow to Brain
⬇️
Syncope & DIZZINESS

65
Q

🩺 IOC of SUBCLAVIAN STEAL SYNDROME

A

CT ANGIOGRAPHY

66
Q

💊💉 MANAGEMENT of SUBCLAVIAN STEAL SYNDROME

A

Angioplasty of stenosed segment

67
Q

⚡⚡ MOST COMMON SITE OF CAROTID ARTERY STENOSIS

A

Bifurcation

68
Q

⚡⚡ MOST COMMON CAUSE OF CAROTID ARTERY STENOSIS

A

Atherosclerosis

69
Q

🧑🏻‍⚕️ Clinical Features of CAROTID ARTERY STENOSIS

A
  1. Asymptomatic
  2. Amaurosis Fugax
  3. Dysphasia
  4. TRANSIENT ISCHEMIC ATTACK
70
Q

🩺 IOC for CAROTID ARTERY STENOSIS

A

Duplex scan

71
Q

INDICATION for Surgery in CAROTID ARTERY STENOSIS

A

≥ 70% Stenosis ➕ any of the following

  1. Amaurosis fugax
  2. C/L Facial Paralysis
  3. Arms/Legs Paralysis
  4. Hemianopia
  5. Dysphasia
72
Q

💊💉 MANAGEMENT of CAROTID ARTERY STENOSIS

A

⭐ CAROTID END-ARTERECTOMY
⭐ Angioplasty or GRAFTING

73
Q

Thoracic OUTLET SYNDROME

A

Blockage of outlet of thoracic outlet

⭐ Subclavian ARTERY ➡️ Cold fingers, Pallor, Raynaud’s Phenomenon
⭐ Subclavian VEIN ➡️ Swelling
⭐ BRACHIAL PLEXUS

74
Q

CAUSE OF THORACIC OUTLET SYNDROME

A
  1. Cervical Rib
  2. Arthritis
  3. Tumours
75
Q

🧑🏻‍⚕️ Clinical Features of THORACIC OUTLET SYNDROME

A

Arterial: Distal Gangrene & Claudication
Venous: SUBCLAVIAN or Axillary Vein Thrombosis
Neural symptoms: Symptoms of ULNAR aspect of hand

76
Q

🩺 IOC for THORACIC OUTLET OBSTRUCTION

A

CT ANGIOGRAPHY

77
Q

PROVOCATIVE TESTS FOR THORACIC OUTLET SYNDROME

🧠⚡ WAR-HAL⚡

A
  1. Wright / Hyper-abduction Test
  2. ADSON Test
  3. ROOS Test
  4. HALSTEAD’s maneuver
78
Q

➕ ADSON’S TEST

A

⬇️ or ⛔ I/L RADIAL PULSE

79
Q

Identify

A

ADSON’S TEST

80
Q

Identify

A

WRIGHT TEST

81
Q

Identify

A

ROOS TEST
(OR)
EAST test (Elevated Arm Stress Test)

82
Q

Identify

A

Elvey or ULTT (Upper Limb Tension Test)

83
Q

💊💉 MANAGEMENT of THORACIC OUTLET SYNDROME

A
  1. If Cervical Rib ➕ ➡️ RESECTED
  2. Physiotherapy
  3. Arterial Blockade: Angioplasty & Stenting
  4. Venous Thrombosis: Anticoagulants
84
Q

Identify

A

CRISCOID ANEURYSM

85
Q

CRISCOID ANEURYSM

A

AV Malformation involving the SUPERFICIAL TEMPORAL VESSELS

86
Q

Vascular Pulsatile Swelling
➕
Compressible

A

CRISCOID ANEURYSM

87
Q

💊💉 MANAGEMENT of CRISCOID ANEURYSM

A

Surgical management (OR) EMBOLIZATION

88
Q

AV Fistula
Causes

A
  1. Traumatic
  2. Iatrogenic
  3. Congenital
89
Q

⚡⚡ MOST COMMON AV FISTULA

A

Iatrogenic AV Fistula
⬇️
Dialysis

90
Q

Renal DIALYSIS AV FISTULA

A

Cimmino-fistula

Radio-cephalic fistula
BETWEEN
Radial Artery & Cephalic Vein

91
Q

Congenital AV FISTULA seen in

⭐️BSP⭐️

A
  1. Parke Weber Syndrome
  2. Beckwith Wiedmann Syndrome
  3. Sturge Weber Syndrome
92
Q

If CONGENITAL FISTULA ➕ in LIMB, leads to

A

HYPERTROPHY OF LIMB

93
Q

🧑🏻‍⚕️ Clinical Features of CONGENITAL AV FISTULA

A
  1. Pulsatile Swelling
  2. Palpable Thrill
  3. Bruit ➕
94
Q

AV FISTULA in long term leads to development of

A

High OUTPUT CARDIAC FAILURE

95
Q

NICOLADONI (OR) BRANHAM SIGN
Seen in

A

⭐ AV FISTULA
⭐ BP HIGH ➕ LOW HEART RATE

⭐ Press the feeding vessel of Av fistula
⬇️
Size of fistula ⬇️
Pulse rate ⬇️
Thrill/Bruit ⬇️
Systolic BP ⬆️⬆️

96
Q

🩺 IOC of AV FISTULA

A

MR ANGIOGRAPHY > Digital subtraction ANGIOGRAPHY

97
Q

💊💉 MANAGEMENT of AV FISTULA

A
  1. Embolization
  2. Surgical Ligation
98
Q

Chest X-RAY findings of AORTIC DISSECTION
🧠⚡D WEEBS ⚡

A

D: Dilated aortic arch
W: Widened mediastinum
E: Effusion (pleural)
E: Effusion (pericardial)
B: Blurring of aortic contour
S: Separation of intimal calcification

VASCULAR SYSTEM (5 decks)

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