Flashcards in Exam Questions Deck (54):
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
List causes of emboli in ALI.
Atheroembolism from aneurysm or proximal aortic disease
Most commonly femoral artery origin
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
Name 3 studies that support surgery for symptomatic stenosis
Name 2 studies that support surgery for asymptomatic stenosis
VA asympto trial
About carotid artery stenting. Name 4-5 studies on carotid stenosis and their results (inferior, superior, similar or results pending)
CREST (inferior or same)
SPACE (inferior or similar)
CAVATAS (similar, poor study)
What are side effects of scelrotherapy.
Anaphylaxis, allergic reaction
Thrombophlebitis (superficial and DVT)
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)
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
List anomalies of IVC and renal vein.
retroaortic renal vein
cirumaortic renal vein
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
List causes of IC other then atheromatous.
Cystic adventitial disease of popliteal artery
Remote trauma or radiation injury
Persistent sciatic artery
Iliac syndrome of the cyclist
Primary vascular tumors
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 Cosmesis (if AV fistula no longer needed, ie post renal transplant)
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%)
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)
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)
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
Name clinical differences b/w primary and secondary Raynauds
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
male or female
Single digit involved
Abnormal pulse examination
Vascular laboratory abnormalities
Renal artery aneurysm.
Most common presentation
Most common location
Most common morphological characteristic.
What is indication for intervention on RAA?
HTN (DBP >90 despite 3 antihtn
dissection if viability treatened
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
What is a type I error?
Incorrect rejection of a true null hypothesis
What is a type II error?
Failure to reject a false null hypothesis
What is alpha error?
type I error
What is beta error?
type II error
How do you calculate Odds ratio?
How do you calculate PPV?
# true positives/(#true positives + number of false positives)
How do you calculate NPV?
# of true negatives/(# of true negatives + # of false negatives)
How to calculate NNT?
How to calculate ARR?
control event rate-experimental event rate
What is the definition of primary assisted patency?
time from access placement to access thrombosis with intervention designed to maintain functionality of an access
What is functional patency?
indicate patent start date of first successful cannulation
List the seven roles of the CanMEDS framework.
What are symptoms of delirium tremens?
List large-vessel vasculitis.
Giant cell arteritis
List medium vessel vasculitis.
List small vessel vasculitis.
How is PAN divided?
secondary (hep B)
What vasculidities have circulating ANCA?
What are three clinical features of coogans?
sensorineural hearing loss
What are clinical features of Bechets?
recurrent mucocutaneous lesion
What is the most common cause of death in kawasaki?
what are clinical features of Giant cell?
modularity of temporal artery
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
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
What are components of metabolic syndrome?
Elevated fasting glucose
High serum cholesterol
What are the branches of the external iliac?
Deep circumflex iliac
What are the branches of the common femoral?
Superficial iliac circumflex
Superficial external pudendal
Deep external pudendal
What are the branches of the internal iliac?
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
What are clinical manifestations of cholesterol emboli?
What is medical therapy for cholesterol emboli syndrome?
What are the phases of growth of infantile hemangiomas?
What are findings on thoracic aorta on TEE that indicate high risk for atheroembolism?
Lack of plaque