Darrow - Blood Vessel and Lymphatic Disorders

Question 1

What is the treatment for aorto-iliac occlusion?

Answer 1

Axillo-femoral or aorto-femoral bypass

Question 2

What can you infer if a pt has buttocks claudication?

Answer 2

There is severe occlusion of the arterial supply to the lower limb(s)

Question 3

What does distance a pt is able to walk have to do with determining occlusion of arterial supply?

Answer 3

The further a pt is able to walk, the lower down the occlusion is

If a pt can only walk short distances, the occlusion is higher up

Question 4

Under what condition can a pt have a normal ankle-brachial index but still have poor circulation?

Answer 4

If arteries are calcified, then they will not compress easily, resulting in a near-normal ankle-brachial index with diminished blood supply

This can be seen more commonly in diabetic pts

Question 5

What is Osler’s sign?

Answer 5

Pseudohypertension due to calcification of arteries

Question 6

What spinal structural abnormality can mimick peripheral arterial disease?

Answer 6

Neurogenic claudication from spinal stenosis

Question 7

How do you diagnose arterial occlusions?

Answer 7

MRA

Question 8

What is a potential complication of creating a venous bypass in the lower extremities?

Answer 8

The distal vessels cannot handle the new higher pressure and they rupture

Question 9

In atrial fibrillation, where do 50% of cardiac emboli go?

Answer 9

The legs

Question 10

What medication should be administered before revascularization of an embolized extremity?

Answer 10

NaHCO₃

Question 11

What are the 6 P’s of acute arterial occlusion?

Answer 11

Pain

Pallor

Paralysis

Paresthesias

Pulselessness

Poikilothermia (irregular temp)

Question 12

What are the D’s of vertebro-basilar TIA?

Answer 12

Dizziness

Diplopia

Dysphagia

Dysarthria

Dysmetria

Ataxia

Question 13

What is amaurosis fugax? What is it indicative of?

Answer 13

Sudden loss of vision in one eye

Indicative of a carotid territory TIA

Question 14

What is a red clot?

Answer 14

Clot in the venous systems

Red because red cells get caught in fibrin meshwork

Question 15

What is a white clot?

Answer 15

Clot in the arterial system

White because platelets are caught in fibrin meshwork, but not RBCs

Question 16

What cardiac complications occur in pts with Marfan syndrome?

Answer 16

Valvular issues

Dilation of vessels

Dilation of chambers

Question 17

What layer of the artery do aortic dissections dissect into?

Answer 17

The tunica media

Question 18

What kind of pain is associated with dissecting aortic aneurysm?

Answer 18

Tearing chest pain that radiates to the back

Question 19

What type of MI is associated with a dissecting aortic aneurysm?

Answer 19

Inferior wall MI because dissection can enter RCA

Question 20

What type of murmur will a dissecting aortic aneruysm create?

Answer 20

A diastolic murmur because it will affect the aortic valve

Question 21

What symptoms does Darrow associate with dissecting aortic aneurysm?

Answer 21

Hypertension

Paraplegia

Question 22

What is Virchow’s Triad?

Answer 22

Hypercoagulability

Stasis

Trauma

Question 23

Where do venous ulcers tend to occur?

Answer 23

Over the medial malleolus

Question 24

What are the characteristics of venous ulcers?

Answer 24

History of trauma

Irregular margins

Beefy appearing tissue

Edema

Induration/sclerosis

Hyperpigmentation from hemosiderin deposition

Exudative

Question 25

What are the characteristics of arterial ulcers?

Answer 25

Claudication

Occur at a site of pressure

Sharp borders

Pale grey or yellow in color

Hair loss around site

Cold feet

Absent pulses

Question 26

What are the characteristics of neuropathic ulcers?

Answer 26

Hx of numbness

Common in pts with diabetes mellitus

Occur at sites of pressure

Area of hardening surrounding ulcer (called a callus)

Question 27

What is phlegmasia cerulean dolens?

Answer 27

Condition where there is so much venous insufficiency that the leg swells up and blocks off the arterial supply.

Results in an inflamed, edematous, purple extremity that can become ischemic

Associated with cancer

Question 28

What is the most common cause of vena cava syndrome?

Answer 28

NSCLC