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Vascular Surgery by Emi > Miscalenous > Flashcards

Miscalenous Flashcards

1
Q

Swan CO

A

4-8 L/min

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2
Q

Swan CI

A

2.5-4L/min/m2

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3
Q

Swan PA pressure

A

20-30/5-15 mmHg

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4
Q

Swan wedge (PAWP)

A

8-12mmHg

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5
Q

Swan SVR

A

900-1300

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6
Q

TPN formula

A

1g/kg/day protein
25 kcal /kg/day (out of that 25% glucose, 3-4% aminoacids, 10% free fatty acids)
50% non protein calories as glucose and 50% fatty acids

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7
Q

sensitivity

A

true positive / true positive + false negative

ability to SENCE the disease

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8
Q

specificity

A

true negative / true negative + false positive

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9
Q

positive predictive value

A

true positive / true positive + false positive

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10
Q

negative predictive value

A

true negative / true negative + false negative

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11
Q

Horner’s syndrome

A

miosis (constricted pupil)
ptosis
anhydrosis (if pre-ganglionic)
enophtalmus

due to injury of sympathetic chain

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12
Q

post - sympathetcomy neuralgia

A

50% of patients

anteromedial thigh pain

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13
Q

Marfan’s mutation

A

FBN1 mutation

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14
Q

TGF-beta - 1 role

A

causes fibrotic reaction in skin in chronick venous insufficiency (inverted bottle neck)

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15
Q

Hollenhorst plaque

A

cholesterol cristal embolization to retinal circulation, incidental, not associated with increased risk of stroke

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16
Q

Hard signs of vascular injury

A

1) absent distal pulses
2. signs of distal ischemia
3. bruit / thrill
4. active, pulsatile bleeding
5. large, expanding hematoma
6. pulsatile hematoma

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17
Q

soft signs of vascular injury

A
  1. non expending hematoma
  2. peripheral nerve deficit
  3. h/o bleeding at the time of injury
  4. hypotension
  5. bony injury / penetrating wound
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18
Q

nephrogenic systemic fibrosis

A

after giving gadolinium in patients with renal insufficiency for MRA
diagnosed by skin bx
no treatment

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19
Q

what factors are expressed in macrophages of aortic aneurysms

A

MMP 2 and MMP 9

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20
Q

where is MMP 2 mostly expressed

A

in small aneurysms

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21
Q

where is MMP 9 mostly expressed

A

in large and ruptured aneurysms

22
Q

what inhibits MMP

A

doxycycline

23
Q

what excretes renin

A

juxtoglomerular aparatus

24
Q

what’s renin function

A

conversion of angiotensinogen to angiotensin I

25
Q

where is angiotensinogen produced

A

liver

26
Q

where is angiotensin converting enzyme produced

A

lung

27
Q

metabolic syndrome

A

3 or more of the following:

  1. HTN >130 / >85
  2. triglicerides >150mg/dl
  3. HDL <50 mg/dl for women and <40mg/dl for male
  4. fasting blood glucose >110 mg/dl
  5. abdominal obesity
28
Q

whats the difference between hemangioma and AV malformation

A

hemangioma is proliferative and they will involute in puberty. Malformation is on bases of dysmorphogenesis

29
Q

What happens to arteries with age

A

Larger arteries stiffen with reduced compliance
Systolic pressure increases
Loss of recoil and ability to maintain the diastolic pressure within compartment
Diastolic pressure decreases
Plus pressure increases

30
Q

What is the anti inflammatory action of nitric oxide

A

Inhibits is xpression of pro inflammatory mediators (monocytes chemoattractant protein 1, interleukins, macrophage colony stimulating facto r)
Inhibits activity of NF-kB v

31
Q

What is a primary vasoconstrictor

A

Endothelial. Also potent motive not

32
Q

What is tunica intima

A

Endothelium
Innermost layer
Monolayer of endothelium cells
Matrix of elastic fibers and collagen

33
Q

Tunic media

A

Thick middle layer
Varying amounts of collagen, elastic fibers and smooth muscles
Amount of elastic decreases progressively from large to small vessels
Provides structure
Maintaining vessel tone
Responding to signals from intimate endothelial cells

34
Q

Tunica adventitia

A

Outermost layer
Appears fragile and thin but strong collagen and elastic structure
One of the key components in overall strength of artery
Collagen, autonomic nerves, vasa vasorum

35
Q

Trunks arterial malformations

A 
Persistent sciatic artery
Kommerells diverticulum
Persistent right subclavian artery
Aortic ring
Mid aortic syndrome
36
Q

What is sciatic artery

A

Embryonic continuation of internal iliac artery
75% complete - hypoplastic or absent sfa
25% incomplete stops in the thigh

37
Q

Extratunkal arterial malformation definition

A

Embryologically developed inborn errors of vascular morphogenesis leading to true structural anomalies

38
Q

Types of vascular anomalies and division

A
  1. Tumors - hemangiomas and others

2. Malformations - high flow and low flow. Low flow - venous, lymphatic and combined

39
Q

Definition of hemangioma

A

True neoplasticism disorder and pathohistologically demonstrating increase endothelial cell turn over rate

40
Q

Definition of AVM

A

Arise by dysmorphogenesis without increased endothelial proliferation

41
Q

Infantile hemangioma

A

Most common vascular anomalies
Proliphwrarive phase in first year of life
Spontaneous involution
Usually doesn’t need treatment
Therapy is usually medical with corticosteroids and propranolol

42
Q

AVM on duplex

A

Demonstrates aretrialized venous waveform and spectral broadening

43
Q

Imaging modality of choice for hemodynamic diagnosis and treatment planning of AVM

A

DceMRI

44
Q

Bernoulli’s principle

A

When fluid flows it’s total energy remains constant provided there are no frictional losses

When area increases velocity decrease

45
Q

Fluid energy possess

A

Viscous losses result from friction between adjacent layers of blood or between blood and the vessel wall
Inertial losses relate to changes in the velocity or direction of blood flow

46
Q

Poiseuilles law

A

Pressure equals volume flow times resistance (8xlengthx viscosity over pi x radius to fourth)

47
Q

What does Poiseuille’s law describe

A

Describes the energy losses in an idealized fluid system

Estimates minimum pressure gradient expected for arterial flow

48
Q

Describe resistance in collaterals

A

It’s always higher than in normal vessels.

It’s fixed - does not change with exercise —> claudication

49
Q

Which way do you retract text is during spine exposure minimally invasive

A

Laterally

50
Q

When does retrograde ejaculation occur

A

Injury to sympathetic nerve plexus

Vascular Surgery by Emi (15 decks)

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