Abdominal Vascular Studies Flashcards

1
Q

The gonadal arteries arise from the aorta how?

A

Anterolaterally

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2
Q

Is the celiac axis part of the mesenteric arteries?

A

yes

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3
Q

Common iliacs typically measure:

A

<1.5cm

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4
Q

Saccular aneurysms occur more often in the:

A

thoracic aorta

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5
Q

Pseudoaneurysms involve all three layers

A

false

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6
Q

What measurement do they intervene with aneurysms?

A

> 5.5cm

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7
Q

What’s the preferred method of treatment for AAA?

A

EVAR – endovascular aneurysm repair. A stent is inserted via a groin vessel

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8
Q

What can be seen after an EVAR procedure?

A

endoleaks

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9
Q

What types of endoleaks are most common?

A

Type 1- flow is leaking proximally or distally at an attachment point due to a poor seal at one end
Type 2- retrograde flow is leaking into the aneurysmal sac via a branch vessel

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10
Q

If you see flow in what two vessels indicates an endoleak?

A

IMA and lumbar arteries

These should be occluded as a result of the graft

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11
Q

What disease makes one prone to thoracic aorta dissection?

A

Marfan’s

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12
Q

Which lumen is bigger, true or false?

A

False

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13
Q

Aorta measurements should be :

A

outer to outer

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14
Q

Aorta velocities?

A

40-100cm/s

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15
Q

Where does the SMA and IMA provide blood to?

A
SMA= small and large bowel
IMA= large bowel
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16
Q

Mesenteric arteries aka

A

Splanchic

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17
Q

Most common form of mesenteric iscemia is? What are the main causes?

A

Chronic mesenteric ischemia – 2/3 vessels need to be severely occluded before symptoms arise. Atherosclerosis is main cause

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18
Q

Which is more serious, acute or chronic mesenteric ischemia?

A

Acute – is caused by thrombus, embolus or external compression, and mimics the same as Gb disease, etc. Mortality rate of 50%

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19
Q

In the mesenteric vessels, where is the most likely area for an aneurysm ?

A

splenic artery, usually found incidentally

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20
Q

Where does the celiac primarily supply blood to?

A

liver and spleen

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21
Q

Arterial perfusion relies on:

A

cardiac output
blood pressure
blood volume

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22
Q

Normal ICA/CCA PSV ratio

A

<2

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23
Q

The _______ in ankle systolic pressure after exercise is an indicator of severity of PAD

A

Fall

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24
Q

After a patient has been on the treadmill for 3 minutes, they come off an get pressures taken. They have a high fall in pressure, what does this indicate?

A

Severe PAD

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25
Q

What’s the alternative to the treadmill test?

A

Reactive hyperemia test

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26
Q

Plethysmography aka

A

pulse volume recording

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27
Q

In reactive hyperemia, a decrease of _____ or more indicates PAD

A

50%

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28
Q

When an occlusion occurs in the ICA, flow in the ophthalmic artery becomes ______ in order to supply the brain

A

retrograde

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29
Q

With penile Dopplers, PSV is an indicator of? and EDV?

A

PSV- arterial dysfunction

EDV- venous dysfunction

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30
Q

If patients are going through chemo or radiation, what can they experience?

A

Takayasus arteritiis: inflammation of vessel walls

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31
Q

Carotid body tumor aka

A

paraganglioma, highly vascular tumor

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32
Q

What’s the treatment for plaque in arteries?

A

endarterectomy

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33
Q

PSV is the first thing to be affected in a stenosis. In critical stenosis it’s EDV

A

True

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34
Q

The higher the stenosis, the ______ the EDV

A

higher

35
Q

Normal flow velocities for SCA, CCA, ICA, ECA and vertebrals:

A
SCA: 140cm/s
CCA: 80-100cm/s
ICA: <125cm/s
ECA: <120cm/s
Vertes: 20-60cm/s
36
Q

What bumps up stenosis from moderate to severe?

A

EDV

37
Q

When we see an ICA waveform in the ECA, what does this mean?

A

Internalization – when the ICA is occluded, the ECA takes on the job

38
Q

When do we see water hammer sign:

A

With aortic regurgitation – signifies that something is going on distally
Rapid forward flow, and then a little bit of reversal

39
Q

Risk factors for atherosclerosis:

A
Smoking
Obesity
Hyperlipidemia
Hypertension
Diabetes
Family hx
Psychosocial factors
Unhealthy diet
Gender
Age
40
Q

HDL and LDL levels

A

HDL- >60mg/dl is good

LDL- >160mg/dl is too high

41
Q

What’s the most devastating area of a stroke? Cerbellar, RT side, Brain stem or LT side

A

Brainstem

42
Q

Within _____cm of the carotid bulb do most stenoses occur?

A

2cm

43
Q

What are the gold standards for strokes?

A

MRA and CT

44
Q

Stent’s can cause

A

an increase in velocity within. Gradual but not abrupt. Up to 150cm/s

45
Q

What ratio indicates restenosis in a stent?

A

2:1

46
Q

What is the criteria of stenosis for CAS and CEA?

A

> 50-99% stenosis for symptomatic
60-99% for asymptomatic
risk must be under 3%
But also the notes say they don’t put stents in asymptomatic pt’s rn?

47
Q

Yin - yang appearance

A

Pseudoaneurysm

48
Q

Where is aortic coaractation most common? Is it acquired or congenital?

A

Congenital – most often in aortic arch

49
Q

Risk factors for DVT:

A

Hereditary – blood disorders

Acquired- age, obesity, malignany, pregnancy, OC use, trauma, immobilization, recent surgery

50
Q

What is the Homan’s sign?

A

Pain on dorsiflexion of foot

51
Q

What are the 3 main symptoms of DVT:

A

Swollen, warm and painful legs

+ Homan’s sign

52
Q

What does D-dimer test measure? When is it not helpful?

A

D-dimer measures the fibrin that accumulate in the blood

Not helpful for pt’s over 80, pregnant, or hospitalized

53
Q

It is the simplest, noninvasive way to monitor the percentage of hemoglobin that is saturated with oxygen

A

Pulse oximeter <95% is abnormal

54
Q

Post thrombotic syndrome symptoms:

A

chronic leg swelling, ankle pigmentation and ulceration

55
Q

What causes skin pigmentation?

A

Breakdown of hemoglobin

56
Q

Difference in mobile vs immobile patients with clots:

A

mobile (mild) cases, the body’s normal thrombolytic mechanisms will clear it up
immobile patients, the clot will increase in size

57
Q

If patients are obese and you cannot see the vein, what can help you with a diagnosis?

A

Loss of phasicity and poor augmentation response

58
Q

What’s the most common cause of an upper extremitiy DVT?

A

placement of a central venous catheter or pacemaker lead

59
Q

What are some symptoms of UEVT?

A
asymptomatic
facial/arm edema
neck/shoulder pain
blurred vision (SVC)
head fullness (SVC)
vertigo/blurred vision (SVC)
60
Q

If you see an abnormal signal in one vessel, what should you do?

A

Compare with the other side

61
Q

Paget-Schroetter syndrome:

primary UEDVT= are PSS + TOS

A

Heavy exertion from activities such as wrestling, weight lifting, etc. causes microtrauma to vessel intima, which leads to coagulation issues. UEDVT in young healthy individuals

62
Q

Secondary DVT:

A

Caused by VAD and/or cancer. Incorrectly placed catheters are the cause. central catheters should be placed in lower third of SVC by RA

63
Q

Where are more central venous access devices placed? Which side is preferred?

A

SCV and IJV. Right IJV is preferred because of it’s straight course to the heart

64
Q

What increases the pulsatility of the doppler waveform in the EIV and CFV?

A

Tricuspid valve regurgitation and/or right heart failure

65
Q

Renals should measure:

A

<2cm

66
Q

Superficial thrombophlebitis most commonly occurs in:

A

varicose veins

67
Q

Clinical signs of superficial thrombophlebitis?

A

Severe pain and redness, inflammation, swelling, pyrexia and palpable cord

68
Q

Lower limb artery stenoses criteria:

A
<1.5:1 - normal
1.5-2:1- 25-50%
2-4:1- 50-75%
4:1- >75%
No flow: occluded
69
Q

What’s a good predictor of renal artery disease? Is US the gold standard?

A

RI. No, CTA or MRA

70
Q

Where does FMD most commonly affect the RA?

A

Mid to dst portion

71
Q

Is FMD bilateral?

A

Yes

72
Q

Do we use angle correct on RAR

A

Not on intrarenal vessels

73
Q

What can cause RV thrombosis?

A

underlying diseases, dehydration, hyper-coagulability

tumors, extrinsic compression

74
Q

What happens if FMD is left untreated?

A

Potential dissection

75
Q

Most common organs for infarct

A

Spleen and kidney

76
Q

After a transplant, what would likely occur first? Occlusion or stenosis?

A

Occlusion

77
Q

Where do we measure the aorta in the RAR?

A

Just before renals

78
Q

Resistant index aka

A

Pourcelot index

79
Q

What vessels do we use for the RAR

A

Segmental or arcute in UP, mid and LP

80
Q

RAR value? RI value?

A

RAR- >3.5

RI- >0.7

81
Q

The most common location for a incompetent perforating vein?

A

2/3 down the thigh, Hunterian perforator

82
Q

Is the valsalva a useful tool in the lower leg?

A

No

83
Q

Abnormal calf & thigh perforator measurement

A

3mm calf

4mm thigh