Arterial Disorders

Question 1

Peripheral arterial stenosis or occlusion is predominantly caused by

Answer 1

Atherosclerosis and or thromboembolic disease but may also occurred as a result of trauma

Question 2

What is the most commonly affected artery in claudication?

Answer 2

Superficial femoral artery

Question 3

What disease causes thigh or buttock clarification?

Answer 3

Aortoiliac disease

Question 4

In which syndrome buttock Claudication combined with sexual impotence which is secondary to arterial insufficiency?

Answer 4

Leriche’s Syndrome

Question 5

Where does the non healing ulcers are located in claudication ?

Answer 5

Dorsum of the feet on the shins and especially around the malleoli

Question 6

Patient with ischaemic rest pain with or without ulceration or gangrene tissue loss are termed to have

Answer 6

Chronic limb threatening ischaemia

Question 7

Which pulsation to an arterial occlusion is usually absent

Answer 7

Distal

Question 8

What indicates arterial venous fistula?

Answer 8

A Continuous machinery Murmur

Question 9

Femoropopliteal obstruction is

Answer 9

Unilateral claudication in the calf femoral pulse palpable with absent unilateral distal pulses

Question 10

What is very useful in assessment of steno occlusive arterial disease in emergency setting

Answer 10

A handheld Doppler ultrasound probe

Question 11

Vessels are clearly seen in which investigation?

Answer 11

CT angiography but it’s dye is neprotoxic

Question 12

What is the gold standard investigation of arterial occlusive disease?

Answer 12

Digital subtraction per cutaneous angiography

Question 13

Which drugs exacerbate claudication ?

Answer 13

Antihypertensive particularly beta blockers

Question 14

What prosthetic graft may be employed in operations of arterial stenosis or occlusion?

Answer 14

Prosthetic polytetrafluoroethylene

Question 15

How surgeons improve the patency of PTFE?

Answer 15

Constructing the low anastomosis using a small collar of vein miller cuff or Saint Mary boot between the PTFE and the recipient artery

Question 17

What is an example of painless loss of vision in one eye?

Answer 17

Ipsilateral amaurosis fugax or mono nuclear blindness

Question 18

What does occur in the first part of the subclavian artery is occluded?

Answer 18

Subclavian steal syndrome

Question 19

The microscopic death portion of tissue is referred as

Answer 19

Gangrene

Question 20

Diabetic gangrene is usually caused by a combination of three factors

Answer 20

Ischaemia secondary to macrovascular disease and microvascular dysfunction peripheral sensory motor neuropathy which leads to tropic skin changes and immuno separation caused by an excess of sugar in the tissues which predisposes to infection

Question 21

What are the five Ps of acute limb ischaemia?

Answer 21

pain, pallor,paraesthesia, pulselessness and paralysis

Question 22

Which artery is most commonly affected resulting in TIA or stroke ?

Answer 22

Middle cerebral artery

Question 23

Emboli may lodge into the following organs

Answer 23

Arm and leg, brain, retina, mesenteric vessels

Question 24

Why does acute limb ischaemia occurs?

Answer 24

As a result of emboli arterial occlusion or trauma

Question 25

Ischaemia beyond how many hours is usually irreversible and results in limb loss?

Answer 25

Six hours

Question 26

What is the immediate treatment of extended thrombus distal and proximally to the embolus?

Answer 26

Administration of 5000 unit of heparin IV can reduce this extension and maintain patency of the surrounding

Question 27

The treatments available for patient with Limb emboli are

Answer 27

Embolectomy and thrombolysis

Question 28

What is the classical clinical picture of compartment syndrome?

Answer 28

Severe pain out of proportion with clinical findings that worsens with time despite appropriate analgesia

Question 29

What fibres are most sensitive to hypoxia?

Answer 29

Non-myelinated type C sensory fibres

Question 30

What does the examination of the limb in compartment syndrome reveals?

Answer 30

Attains compartment with passive flexion and extension of muscle causing pain

Question 31

What is the treatment of compartment syndrome?

Answer 31

Urgent compartment fasciotomy to release the compression

Question 32

What is the usual site of fasciotomy ?

Answer 32

Calf, specially the anterior tibial compartment

Question 34

Where does the compartment syndrome occasionally affect?

Answer 34

Thigh , arm and feet

Question 35

What are the features seen in Embolic occlusion acute Mesenteric ischaemia ?

Answer 35

Sardine, severe abdominal pain, with bowel emptying vomiting and bloody diarrhoea and a source of emboli present usually cardiac

Question 36

Fallopian tube insufflation or illegal abortion may cause

Answer 36

Air embolism

Question 37

What are the indication for amputation?

Answer 37

🗡️Dead limb -gangrene ; 🗡️Deadly limb -wet gangrene ,spreading cellulitis ,arteriovenous fistula, malignancy ; 🗡️Dead loss limb - severe rest pain with unreconstructable critical leg ischaemia, paralysis , contracture , trauma

Question 38

What is Phantom pain?

Answer 38

Amputed patient frequently remark that they can feel the amputed limb that is phantom limb and sometimes remark that it is painful. It is known as phantom pain.

Question 39

What is true aneurysm?

Answer 39

Aneurysm containing the three layers of the arterial wall intima media and advantitia in the aneurysm sac

Question 40

What is false aneurysm?

Answer 40

A single layer of fibrous tissue as the wall of the sec

Question 41

What is the most common type of large vessel aneurysm?

Answer 41

Abdominal aortic aneurysm and is found into 2 percent of the population at autopsy 95% have associated atheromatous degeneration and 95% occur below the renal arteries

Question 42

Which aneurysm is a surgical emergency?

Answer 42

Ruptured abdominal aortic aneurysm

Question 43

A patient has severe abdominal and or back pain is hypotensive and has a pulsatile abdominal mass. What is your diagnosis?

Answer 43

Ruptured abdominal aortic aneurysm

Question 44

What is the investigation for rapture abdominal aortic aneurysm?

Answer 44

CT scan

Question 45

What should be considered as the first line option for all anatomically suitable ruptured aortic aneurysm?

Answer 45

Endo vascular aneurysm repair