Vascular surgery Flashcards

1
Q

Which cardiac symptom do we investigate in the case of arterial limb embolisation?
A) cardiac decompensation
B) angina pectoris
C) arrhythmia absoluta
D) rheumatic fever
E) cardiomyopathia

A

C) arrhythmia absoluta

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2
Q

The patophysiological cause of arterial thrombosis:
A) dilution of the blood
B) slow blood flow due to stenosis of the vessel
C) standing job
D) hormonal effects
E) diabetes mellitus

A

B) slow blood flow due to stenosis of the vessel

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3
Q

The cause of transient ischemic attack (TIA) can be:
A) hypotonia
B) diabetes mellitus, hypoglycemia
C) anuria
D) poisoning
E) stenosis of the internal carotid artery

A

E) stenosis of the internal carotid artery

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4
Q

Risk factors of arteriosclerosis, except:
A) smoking
B) genetic predisposition
C) diabetes mellitus
D) cirrhosis of the liver
E) hyperlipidemia

A

D) cirrhosis of the liver

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5
Q

Surgery of a patient with symptomatic abdominal aortic aneurysm, with a diameter of 6 cm:
A) it is only contraindicated if a severe concomittant risk factor is present
B) it is a high risk for surgery, so it is not indicated
C) conservative treatment is more effective
D) only with excellent ejection fraction, and intact coronary arteries
E) only indicated in patients younger than 70

A

A) it is only contraindicated if a severe concomittant risk factor is present

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6
Q

Typical dysbasia, intermittent claudication develops due to:
A) arthrosis of the hip or knee
B) pes planus
C) compression of the sciatic nerve
D) arterial occlusion, and reduced oxygen supply
E) deep vein thrombosis

A

D) arterial occlusion, and reduced oxygen supply

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7
Q

Which definition corresponds to the concept of progressive stroke?
A) Fluctuating neurological symptoms, which worsen after every episode, but definitive stroke has not yet been developed.
B) A focal brain leison becomes more extensive
C) Hemiparesis turns into hemiplegia
D) Besides hemiplegia, or hemiparesis aphasia evolves
E) The current post-stroke neurological status worsenes

A

A) Fluctuating neurological symptoms, which worsen after every episode, but definitive stroke has not yet been developed.

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8
Q

Symptom of a right internal carotid artery stenosis or occlusion in a right-handed patient:
A) right hemiparesis
B) right hemiplegia
C) left hemiparesis
D) aphasia
E) vision loss of the left eye

A

C) left hemiparesis

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9
Q

Characteristics of subclavian steal syndrome:
A) The first part of subclavian artery is occluded, so the flow is reversal in the ipsilateral vertebral artery, resulting vertigo.
B) Exercise-induced contralateral neurological symptoms due to increased blood flow in the upper-limb, which results transient ischaemia in the affected hemispherium.
C) It results different blood pressure of the upper limbs, because the third part of subclavian artery is occluded, so the blood pressure must be lower on the affected side.
D) If the difference in blood pressure is big between the two sides, vertigo is more significant, and the upper limb complaints are moderate.
E) It results ipsilateral hemispherial symptoms.

A

A) The first part of subclavian artery is occluded, so the flow is reversal in the ipsilateral vertebral artery, resulting vertigo.

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10
Q

What is the next step when noticing a subclavian steal syndrome?
A) Urgent hospitalisation and investigation, because circulatory disorders of the brain lead to severe brain damage.
B) In symptomatic cases carotid ultrasound, CT angiography should be performed, and endovascular treatment is recommended, if it is not feasable, surgery may be necessary. In asymptomatic cases only periodic check-ups are needed.
C) Operative reconstruction is recommended of the first part of subclavian artery from left thoracotomy.
D) It can be treated by control of the blood pressure.
E) No therapy, no observation is needed.

A

B) In symptomatic cases carotid ultrasound, CT angiography should be performed, and endovascular treatment is recommended, if it is not feasable, surgery may be necessary. In asymptomatic cases only periodic check-ups are needed.

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11
Q

Embolisation should not be performed in:
A) aortic aneurysm
B) traumatic bleeding of a side brach
C) vascular malformation
D) gastrointestinal bleeding
E) kidney cancer

A

A) aortic aneurysm

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12
Q

Which of the following is appropriate for the diagnosis of deep vein thrombosis?
1) phlebography
2) CT angiography
3) ultrasound
4) D-dimer test

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct

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13
Q

A patient after aortobifemoral bypass presents with succulent fistula of the right groin. Management is the following:
1) waiting, these type of fistulas usually heal spontaneously
2) wound management, ambulantory care
3) looking for suture granuloma in the wound
4) admission to vascular surgical department, fistulography, CT angiography, surgery

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

D) only the 4th answer is correct

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14
Q

A 65-year-old male patient presents with the history of aortobifemoral bypass 6 years ago. He noticed melaena and diarrhea lately and had no other complaints than general weakness until admission to the hospital. Which diagnosis is likely for this patient?
1) aorto-duodenal fistula
2) stress ulcer
3) aortojejunal fistula
4) colitis ulcerosa

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

B) the 1st and 3rd answers are correct

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15
Q

Possibilities in the treatment of deep vein thrombosis:
1) angio VAC/Jet therapy
2) selective thrombolysis
3) per os medical treatment, which do not need monitoring
4) phlebography

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

A) the 1st, 2nd and 3rd answers are correct

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16
Q

Which statements are true for EVAR (stent graft implantation)?
1) after 3 years of follow-up, the results with EVAR are worse than with open surgery
2) perioperative complication rate is higher with EVAR than with open surgery
3) type II. endoleak after EVAR not always needs active treatment
4) type I. endoleak after EVAR does not have to be treated

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

B) the 1st and 3rd answers are correct

17
Q

A patient with poor general condition (ASA III) presents with critical ischemia of the right lower limb. DSA demonstrates right ilio-femoral occlusion, significant stenosis of the left common iliac artery with the outflow of deep femoral artery on both sides. What is the right therapeutic choice?
1) right femoral amputation
2) Aorto-bifemoral bypass.
3) We try to improve the patient’s condition by conservative treatment
4) stenting of the left iliac artery, crossover bypass surgery from left to right

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

D) only the 4th answer is correct

18
Q

What are the right steps in the case of an acute Stanford type B aortic dissection causing chest pain?
1) exclusion of acute myocardial infarction
2) performing CT angiography to verify the dissection
3) admission to intensive care unit, hypotensive therapy by using beta-blockers
4) if the symptoms are persisting, or new symptoms (visceral) evolve, TEVAR is recommended

A) the 1st, 2nd and 3rd answers are correct
B) the 1st and 3rd answers are correct
C) the 2nd and 4th answers are correct
D) only the 4th answer is correct
E) all of the answers are correct

A

E) all of the answers are correct