Exam Questions Flashcards Preview

Vascular Surgery > Exam Questions > Flashcards

Flashcards in Exam Questions Deck (54):
1

Name histological findings of scalene muscle in TOS?

a. Predominance of Type I fibres
b. Increase in connective tissue
c. Endomysial fibrosis
d. Mitochondrial changes

2

List causes of emboli in ALI.

Cardiac (80-90%)
Atrial fibrillation
Post MI
Valvular prosthesis
Intracardiac tumour
Septic embolus
Non-cardiac (10%)
Atheroembolism from aneurysm or proximal aortic disease
Non-cardiac tumour
Paradoxical embolism
Foreign body
Microemboli
Most commonly femoral artery origin

3

8. Name 3 groups that should be screened for AAA according to the vascular society

All men 65-75 years of age
Women over 65 years with high risk (smoking, family history, CVD)
Men below 65 years with family history

4

Name 3 studies that support surgery for symptomatic stenosis

NASCET
ECST
VAST

5

Name 2 studies that support surgery for asymptomatic stenosis

ACAS
VA asympto trial

6

About carotid artery stenting. Name 4-5 studies on carotid stenosis and their results (inferior, superior, similar or results pending)

ICSS (inferior)
CREST (inferior or same)
EVA-3S (inferior)
SPACE (inferior or similar)
SAPPHIRE (superior)
CAVATAS (similar, poor study)

7

What are side effects of scelrotherapy.

Anaphylaxis, allergic reaction
Thrombophlebitis (superficial and DVT)
Cutaneous necrosis
Pigmentation
Neoangiogenesis

8

List ways to avoid hyper pigmentation after sclerotherapy.

Use weaker concentration of sclerosing solution
Minimize intravascular pressure during injection
Remove postsclerotherapy coagula (use No 21 or 18 needle to allow expulsion of entrapped blood under pressure)

9

List technique to salvage stent deployment if balloon ruptures after 50% deployment.

a. Maintain wire access, replace balloon and deploy stent at original target
b. Maintain wire access, replace smaller balloon, “capture” stent and deploy in safe location (external iliac artery)
c. Snare stent and remove percutaneously or from surgically accessible location

10

List anomalies of IVC and renal vein.

retroaortic renal vein
cirumaortic renal vein
duplicated IVC
absent infrarenal IVC
Double IVC with Retroaortic Right Renal Vein and Hemiazygos Continuation of the IVC
Double IVC with Retroaortic Left Renal Vein and Azygos Continuation of the IVC
Azygos Continuation of the IVC

11

List causes of IC other then atheromatous.

Popliteal entrapment
Popliteal aneurysm
Cystic adventitial disease of popliteal artery
Pseudoxanthoma elasticum
Thromboangiitis obliterans
Peripheral emboli
Aortic coarctation
Takayasu's disease
Remote trauma or radiation injury
Arterial fibrodysplasia
Persistent sciatic artery
Iliac syndrome of the cyclist
Primary vascular tumors

12

Pseudoaneurysm with AVF (hemodialysis) List 4-5 reasons to repair

o Increase in size
o Distal ischemia
o Overlying skin changes (may predispose pseudoaneurysm rupture)
o Persistent bleeding from puncture site
o Rupture
o Cosmesis (if AV fistula no longer needed, ie post renal transplant)

13

List 5 pathogens involved in infected aneurysm

o Salmonella spp (30%)
o Staphylococcus spp (19%)
o Streptococcus spp (9%)
o E Coli (9%)
o Bacteroides spp (5%)
o Enterococcus group (3%)
o Clostridium spp (3%)
candida
mycobacterium
treponema pallidum

14

Name different types of infected aneurysm.

o Mycotic aneurysm (gr + cocci: Strep viridans and faecalis, Staph aureus and epidermidis, )
o Microbial arteritis (Salmonella, Staph spp, E Coli and Bacteroides fragilis)
o Infection of existing aneurysm (Staph spp)
o Post-traumatic infected false aneurysm (Staph aureus, polymicrobial – Staph aureus, e Coli, Strep fecalis, Pseudomonas, various Enterobacter)

15

List 6 ways to predict success of a profundaplasty

a. Significant profunda stenosis or occlusion
b. Rest pain or minimal tissue loss
c. Good inflow
d. Occluded SFA
e. Healthy distal profunda
f. Good collaterals to tibial vessels (preferably 2 out of 3)

16

List facts that favour AKA over BKA.

i. Physical exam (ie. lack of femoral pulse)
ii. Skin temperature < 90°F
iii. Absolute ankle pressure < 60 mmHg
iv. Skin perfusion pressure < 20 mmHg at BKA level
v. Trans-cutaneous O2 below 30 mmHg at BKA level

17

Name clinical differences b/w primary and secondary Raynauds

Primary
female
teens-20s
family history
live in colder climates
Attacks triggered by exposure to cold and/or stress
Symmetric bilateral involvement
Absence of necrosis
Absence of a detectable underlying cause
Normal capillaroscopy findings
Normal laboratory findings for inflammation
Absence of antinuclear factors


Secondary
male or female
40s
Single digit involved
Abnormal pulse examination
Vascular laboratory abnormalities
Positive autoantibodies

18

Renal artery aneurysm.
Most common presentation
Most common location
Most common morphological characteristic.

incidental
90% extraparynchymal
75% saccular

19

What is indication for intervention on RAA?

>2-3cm
pregnancy
rupture
HTN (DBP >90 despite 3 antihtn
dissection if viability treatened

20

What is the difference between first and second generation fibrinolytics?
List 2nd generation.

2nd are fibrin selective
avoid systemic depletion of circulating fibrinogen and plasminogen

tPA (alteplase)
pro-urokinase

21

What is a type I error?

Incorrect rejection of a true null hypothesis

22

What is a type II error?

Failure to reject a false null hypothesis

23

What is alpha error?

type I error

24

What is beta error?

type II error

25

How do you calculate Odds ratio?

AD/BC

26

How do you calculate PPV?

# true positives/(#true positives + number of false positives)

27

How do you calculate NPV?

# of true negatives/(# of true negatives + # of false negatives)

28

How to calculate NNT?

1/ARR

29

How to calculate ARR?

control event rate-experimental event rate

30

What is the definition of primary assisted patency?

time from access placement to access thrombosis with intervention designed to maintain functionality of an access

31

What is functional patency?

indicate patent start date of first successful cannulation

32

List the seven roles of the CanMEDS framework.

medical expert
scholar
professional
health advocate
manager
communicator
collaborator

33

What are symptoms of delirium tremens?

hallucinations
fever
HTN
sweating
tachycardia
tremors
anxiey
confusion
seizure

34

List large-vessel vasculitis.

Giant cell arteritis
takayasu
PMR

35

List medium vessel vasculitis.

Polyarteritis nodosa
Burgers
kawasaki

36

List small vessel vasculitis.

bechets
churg strauss
henoch-scholein

37

How is PAN divided?

idopathic
secondary (hep B)

38

What vasculidities have circulating ANCA?

wegners
microscopic polyangitis

39

What are three clinical features of coogans?

interstitial keratitis
vestibular dysfunction
sensorineural hearing loss

40

What are clinical features of Bechets?

recurrent mucocutaneous lesion
genital ulcers
opthalmic complications

41

What is the most common cause of death in kawasaki?

MI

42

what are clinical features of Giant cell?

H/A
modularity of temporal artery
constitutional symptoms
TIA

42

What are criteria to reopen a CEA on intra-op duplex?

Wall irregularity or small flap <3mm
Stenosis PSV >150cm/s and turbulent flow spectra
Lumen thrombosis

43

What are duplex criteria of carotid occlusion?

No flow distal ICA on low PRF settings
CCA low velocity high resistance pattern, possible reverse flow in diastole
Low flow resistance in ECA internalization of ECA(collaterals)
Flow thump recorded at prox ICA
Increased contralateral velocities in ICA CCA

44

What are components of metabolic syndrome?

Central obesity
Elevated BP
Elevated fasting glucose
High serum cholesterol
Low HDL

45

What are the branches of the external iliac?

Inferior epigastric
Deep circumflex iliac

46

What are the branches of the common femoral?

Superficial epigastric
Superficial iliac circumflex
Superficial external pudendal
Deep external pudendal

47

What are the branches of the internal iliac?

Obturator
Superior vesical
Inferior vesical
Middle rectal
Internal pudendal
Inferior gluteal
Superior gluteal
Lateral sacral

48

What are key elements for cholesterol embolization syndrome?

Plaque in large arteries
Spontaneous, traumatic plaque rupture
Embolization of material
Lodging of emboli in small artery
Foreign body inflammatory response
End organ damage

49

What are clinical manifestations of cholesterol emboli?

Purple toes
Gangrenous digits
Ulcerations
Renal failure
Htn
Tia
Stroke
Hollenhorst plaque
Mi
GI bleeding
Ischemic bowel

50

What is medical therapy for cholesterol emboli syndrome?

Corticosteroids
Statins
Iloprost
Anti PLT

51

What are the phases of growth of infantile hemangiomas?

Growth <8
Resting 8-14
Involution 1-5

52

What are findings on thoracic aorta on TEE that indicate high risk for atheroembolism?

Thickness >4mm
Lack of plaque
Mobile plaque

53

What is the blood supply to the spinal cord?

Vertebrals-one anterior spinal artery
PICA-paired posterior spinal artery
Spinal arteries supplied by radicular artery