Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Vascular Surgery > 2: Vascular Disease In Other Sites > Flashcards

2: Vascular Disease In Other Sites Flashcards

(54 cards)

Start Studying
1
Q

What is renal-artery stenosis

A

Narrowing of one or both renal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two possible causes of renal artery stenosis

A
  • Atherosclerosis

- Fibromuscular dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What % of RAS is due to atherosclerosis

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What % of RAS is due to fibromuscular dysplasia

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In which population is atherosclerotic RAS more common

A

Males over 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In which population is fibromuscular dysplasia RAS more common

A

Females under 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how may renal artery stenosis present clinically

A
  • Renal bruit
  • Treatment-resistant HTN
  • Features of renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the pathophysiology of renal artery stenosis

A

Narrowing of the renal arteries causes ischaemic. This results in activation of RAAS system. Aldosterone increases sodium + hence fluid retention. Increases peripheral vascular resistance leading to secondary HTN. Ischaemia also causes ischaemic renal injury and progressive atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What three investigations are important in work-up of RAS

A
  1. U+E
  2. Duplex USS
  3. CT/MR angiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How will U+Es present in RAS

A

Raised creatinine

Hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is treatment-resistant hypertension and hypokalaemia a good indicator of

A

Renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is there hypokalaemia in renal artery stenosis

A

Renal ischaemia causes activation of RAAS and hyper-aldosteronism. This causes exchange of sodium for potassium causing hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the indications for duplex USS

A
  • HTN onset before 30
  • Resistant to three anti-HTN medications
  • Renal dysfunction with ACEi
  • Unexplained renal atrophy - difference of more than 1.5cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

On CT angiography if there is stenosis of proximal renal artery segment what does it suggest

A

Atherosclerotic pathophysiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

On CT angiography if there is stenosis of distal renal artery segment what does it suggest

A

Fibromuscular dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What lifestyle factors are used in management of renal artery stenosis

A

Smoking cessation
Weight loss
Control diabetes and HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why should ACEi not be given to manage blood pressure in renal insufficiency

A

Due to toxic if renal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is ultimate management of renal artery stenosis

A

Percutaneous trans-luminal angioplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What percentage of the renal artery must be stenosed to require percutaneous trans-luminal angioplasty

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Explain why ACEi are contraindicated in patients with renal artery stenosis

A

Normal system:
PGE2 causes vasodilation of renal artery to control blood flow through glomerulus and Angiotensin II controls efferent arteriole

In RAS:
There is narrowing of the afferent impairing flow. Therefore more reliant on efferent to control flow through glomerulus. If ACEi are used this is lost.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define acute mesenteric ischaemia

A

occlusion of blood supply to the small bowel resulting in necrosis and possible perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In which age-group is mesenteric ischaemia more common

23
Q

What are 4 causes of mesenteric ischaemia

Study These Flashcards
A
  1. Thrombosis
  2. Embolism
  3. Mesenteric venous thrombosis
  4. Non-occlusive disease
24
Q

When is mesenteric vein thrombosis more common

Study These Flashcards
A

Younger patients w/ hyper-coagulable states

25
Explain non-occlusive disease as a cause of mesenteric thrombosis
Drop in cardiac output
26
What are three risk factors for acute mesenteric ischaemia
- Hypercoagulable states - AF - Vasculitis
27
What is the triad of symptoms for acute mesenteric ischaemia
1. Severe abdominal pain 2. No abdominal signs 3. Rapid shock
28
what is the stereotypical presenting complaint of acute mesenteric ischaemia
Abdominal pain disproportionate to clinical findings
29
where is the abdominal pain in acute mesenteric ischaemia
Central
30
if due to embolism describe onset of pain in acute mesenteric ischaemia
Abrupt onset and extremely painful
31
if due to thrombosis explain symptoms of acute mesenteric ischaemia
Less severe - as there is collateral supply
32
what artery is occluded in 90% of acute mesenteric ischaemia
Superior mesenteric artery
33
what does the superior mesenteric artery supply
Midgut
34
What investigations may be ordered in mesenteric ischaemia
FBC (Raised WBC) Abdominal X-Ray CT/MRI CT angiography
35
What investigations may be ordered in mesenteric ischaemia
FBC (Raised WBC) Abdominal X-Ray CT/MRI CT angiography (confirmatory)
36
How should acute mesenteric ischaemia be managed
Emergency laparotomy - remove necrotic segments
37
What are main complications of acute mesenteric ischaemia
Peritonitis | Sepsis
38
How common is chronic mesenteric ischaemia
Rare!
39
In which individuals does chronic mesenteric ischaemia occur
>60
40
What is the most common presentation of chronic mesenteric ischaemia and when does this occur
Asymptomatic - when there is occlusion of single artery. More than this causes symptoms
41
If symptomatic, how does chronic mesenteric ischaemia present
Intestinal angina - dull epigastric pain following meals
42
What is the problem with chronic mesenteric ischaemia
Pain may cause avoidance of eating which can lea to weight loss
43
What will be auscultated in chronic mesenteric ischaemia
abdominal bruit
44
Explain chronic mesenteric ischaemia
stenosis of two or more main gastric arteries causes a post-prandial mismatch between blood supply and metabolic demand
45
Why is one artery occluded asymptomatic
due to collateral supply from other vessels
46
What is first line investigation for chronic mesenteric ischaemia
CT abdomen
47
How is chronic mesenteric ischaemia managed
Nutritional support- regular small meals Long-term anticoagulant Revascularisation
48
What medication is used to control risk factors contributing to carotid stenosis
Clopidogrel Atorvostatin ACEi
49
What is first-line management for carotid stenosis
Carotid endarterectomy
50
What are the indications for carotid endarterectomy in carotid stenosis
1. Symptomatic, Cartoid.a stenosis >70% and life-expectancy >5y 2. Asymptomatic and stenosis >80%
51
if individuals are unfit for carotid endarterectomy what is second-line
Endovascular carotid.a stenting
52
what is the main risk of carotid artery stenosis
stroke
53
What are the indications for carotid endarterectomy in carotid stenosis
1. Symptomatic, Cartoid.a stenosis >70% and life-expectancy >5y 2. Asymptomatic and stenosis >80% 3. Symptomatic and stenosis 50-69%
54
Explain clinical presentation of carotid artery stenosis
asymptomatic. May cause gradual decline condition. Presents suddenly with stroke/TIA

Vascular Surgery (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions