Hem/Imm (Final Exam) Flashcards
(234 cards)
1
Q
What is considered anemia in men? In women?
A
- Men: Hb <14
- Women: Hb <12
2
Q
What is the normal Hb:Hct ratio?
A
Hb:Hct = 1:3
3
Q
What are the three likely causes of anemia if there is decreased RBC production?
A
- Nutritional deficiencies (iron, B12/folate)
- Chronic disease
4
Q
What is the likely cause of anemia if there is increased RBC destruction?
A
Hemolysis
5
Q
What are the three likely causes of anemia if there is blood loss?
A
- Menstruation
- GI
- Trauma
6
Q
What are four signs of anemia?
A
- Pallor
- Heme in stool
- Orthostatic changes
- Tachycardia
7
Q
What are six symptoms of anemia?
A
- Fatigue
- Weakness
- Headache
- Dizziness
- Dyspnea
- Palpitations
8
Q
What are the three causes of microcytic anemia?
A
- Iron deficiency anemia
- Thalassemia anemia
- Sideroblastic anemia
9
Q
What are the three causes of normocytic anemia?
A
- Chronic disease
- Hypothyroidism
- Liver disease
10
Q
What are the two causes of macrocytic anemia?
A
- Folate deficiency
- Vitamin B12 deficiency
11
Q
What is the most common cause of anemia worldwide?
A
Iron Deficiency Anemia (IDA)
12
Q
What is the most common cause of Iron Deficiency Anemia (IDA) in adults?
A
Blood loss
13
Q
What type of anemia involves atrophic glossitis, angular cheilitis, koilonychia; pica?
A
Iron Deficiency Anemia (IDA)
14
Q
What type of anemia has labs that show:
- Low MCV (low RBCs, Hb, Hct)
- Low Serum Fe
- High TIBC
- Low Ferritin
- High RDW
A
Iron Deficiency Anemia (IDA)
15
Q
What type of anemia has a peripheral smear that shows Microcytic, hypochromic RBCs; anisocytosis, poikilocytosis?
A
Iron Deficiency Anemia (IDA)
16
Q
What is the recommended treatment for Iron Deficiency Anemia (IDA)?
A
Oral ferrous sulfate 325 mg TID daily
17
Q
What type anemia can lead to ineffective erythropoiesis and hemolysis (low RBC production and high RBC destruction) and then bone changes, impaired growth, iron overload?
A
Thalassemia Anemia
18
Q
What type of anemia shows:
- VERY low MCV
- Normal/high Serum Fe
- Normal/low TIBC
- Normal/high Ferritin
- Normal RDW
A
Thalassemia Anemia
19
Q
What type of anemia uses Hemoglobin Electrophoresis to help with diagnosis?
A
Thalassemia Anemia
20
Q
What type of anemia involves ONE beta-globin chain dysfunction; asymptomatic?
A
Beta Thalassemia Minor
21
Q
What type of anemia involves BOTH beta-globin chains dysfunction, but less severe?
A
Beta Thalassemia Intermedia
22
Q
What type of anemia involves BOTH beta-globin chains dysfunction but more severe?
A
Beta Thalassemia Major
23
Q
What type of anemia involves severe hemolytic anemia and is transfusion-dependent?
A
Beta Thalassemia Major
24
Q
What type of anemia is acquired more common in adults; often a variant of myelodysplastic syndrome (MDS)?
A
Sideroblastic Anemia
25
What type of anemia involves Bone Marrow Aspirate that shows ring sideroblasts?
Sideroblastic Anemia
26
What type of anemia involves systemic iron overload?
Sideroblastic Anemia
27
What is the second most common cause of anemia worldwide?
Anemia of Chronic Anemia (ACD)
28
What type of anemia involves hepcidin-induced alterations of iron metabolism?
Anemia of Chronic Anemia (ACD)
29
What type of anemia shows:
- Normal MCV
- Normal/low Serum Fe – low due to inflammation
- Normal/low TIBC – low due to inflammation
- Normal/high Ferritin
Anemia of Chronic Anemia (ACD)
30
If reticulocyte count is HIGH with macrocytic anemia, what two causes should be considered?
- Hemorrhage
| - Hemolysis
31
If reticulocyte count is LOW with macrocytic anemia, what two causes should be considered?
Megaloblastic:
- B12 deficiency
- Folate deficiency
32
What type of anemia involves anemia-related symptoms plus glossitis, vague GI (NO neuro issues)?
Folic Acid Deficiency Anemia
33
What type of anemia shows:
- High MCV
- Low serum folate level
- High homocysteine
- Normal serum MMA
Folic Acid Deficiency Anemia
34
What TWO types of anemia shows macro-ovalocytes, hypersegmented neutrophils on peripheral smear?
- Folic Acid Deficiency Anemia
| - Vitamin B12 Deficiency Anemia
35
What should ALWAYS be ruled out with Folic Acid Deficiency Anemia?
RULE OUT CO-EXISTING B12 DEFICIENCY
36
What is the most common cause of Vitamin B12 Deficiency Anemia?
Pernicious Anemia
37
Where is folate absorbed in the body? Where is B12 absorbed in the body?
- Folate: jejunum
| - Vitamin B12: ileum
38
What type of anemia can be caused by decreased intake (vegan), medications (Metformin), malabsorption (elderly)?
Vitamin B12 Deficiency Anemia
39
What type of anemia involves anemia-related symptoms plus glossitis, vague GI, atrophic glossitis; NEURO?
Vitamin B12 Deficiency Anemia
40
What type of anemia is associated with increased risk of gastric cancer?
Vitamin B12 Deficiency Anemia
41
What are the neuro symptoms in Vitamin B12 Deficiency Anemia caused by?
Defective myelin synthesis in CNS
42
What type of anemia shows:
- High MCV
- Low serum B12 level
- High homocysteine
- High MMA
Vitamin B12 Deficiency Anemia
43
Why can't you treat B12 deficiency with folic acid only?
If B12 is not ALSO replaced, patient can develop serious, possibly irreversible neuro damage
44
What group of anemias involve anemia-related plus jaundice, gallstones, dark urine?
Hemolytic Anemias
45
What type of anemias show:
- High reticulocyte count
- High unconjugated bilirubin
- High LDH
- Low haptoglobin
Hemolytic Anemias
46
What type of anemias shows immature RBCs (reticulocytes), nucleated RBCs, fragmented RBCs on peripheral smear?
Hemolytic Anemias
47
What is the difference between Extravascular Hemolysis and Intravascular Hemolysis (think location)?
What is another name of Intravascular Hemolysis?
- Extravascular Hemolysis: RBC destruction in reticuloendothelial system (spleen)
- Intravascular Hemolysis aka "Footstrike Hemolysis": destruction of RBCs within blood stream
48
What type of anemia involves pain crisis, acute chest syndrome?
Sickle Cell Anemia, (Hemolytic Anemia, EXTRA)
49
What type of anemia involves o aplastic crisis associated with Parvovirus 19 infections (Fifth Disease)?
Sickle Cell Anemia, (Hemolytic Anemia, EXTRA)
50
What type of anemia involves Howell-Jolly bodies?
Sickle Cell Anemia (Hemolytic Anemia, EXTRA)
51
What type of anemia involves IgM (“cold” agglutinins) vs. IgG (“warm” agglutinins)?
Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)
52
What type of anemia can be caused by SLE, CLL, Mycoplasma, EBV?
Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)
53
What type of anemia involves a Positive Coombs Test (DAT)?
Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)
54
How does treatment differ between "cold" and "warm" Autoimmune Hemolytic Anemia (AIHA), (Hemolytic Anemia, EXTRA)? What can both be treated with?
Both: Rituximab
- Cold: avoid cold
- Warm: STEROIDS
55
What symptom is most often associated with Hemolytic Transfusion Reaction (Hemolytic Anemia, INTRA)?
Fever
56
What type of anemia involves pallor, jaundice, splenomegaly, dark urine at night/early morning?
Paroxysmal Nocturnal Hemoglobinuria (Hemolytic Anemia, INTRA)
57
What two pharmacologic treatments can often help Hemolytic Anemia? What type of surgery is often advised with Hemolytic Anemia?
- Tx: steroids can help, Folic Acid supplements
| - Surgery: splenectomy
58
What type of anemia uses the Osmotic Fragility Test diagnostically?
Hereditary Spherocytosis (Hemolytic Anemia, EXTRA)
59
What type of anemia is often asymptomatic; may have mild jaundice/icterus, pigmented black gallstones, splenomegaly?
Hereditary Spherocytosis (Hemolytic Anemia, EXTRA)
60
What type of anemia often shows pancytopenia (anemia/reticulocytopenia + leukopenia + thrombocytopenia)?
Aplastic Anemias
61
What type of anemia involves bone marrow that lacks precursor platelets, RBCs and WBCs?
Aplastic Anemias
62
What is often the recommended treatment for Aplastic Anemias?
Bone marrow transplant
63
What condition involves Virchow’s Triad? What are the three components?
Venous Thromboembolism
- Stasis
- Hypercoagulability
- Vessel wall injury
64
What condition is associated with Factor V Leiden mutation; Prothrombin gene mutation?
Venous Thromboembolism
65
For a DVT, what should be ordered next if there is a high Wells score? Moderate/low Wells score?
- If high Wells: order compression ultrasound
| - If moderate/low Wells: order D-Dimer
66
For a DVT or PE, if D-Dimer was negative, what's next? What if D-Dimer was positive?
- If D-Dimer is negative, testing STOPS (<500 ng/mL)
| - If D-Dimer is positive, order US for DVT, or CPTA for PE
67
What is considered a POSITIVE D-Dimer test?
>500 ng/mL
68
What is one of the most common risk factors for a DVT?
Previous thrombotic event
69
What are the two most common symptoms associated with a PE?
- SOB
| - Pleuritic pain
70
For a PE, what should be ordered next if there is a high Wells score? Moderate/low Wells score?
- If high Wells: order CTPA
| - If moderate/low Wells: apply PERC
71
For a PE, what should be ordered next if there is a positive PERC score? Negative PERC score?
- If PERC positive, order D-Dimer
| - If PERC is negative, testing STOPS
72
What is the treatment for a patient with PE that has severe renal failure, a hemodynamically unstable PE, or has a massive iliofemoral DVT?
UFH (IV unfractionated heparin)
73
For a patient with PE that is pregnant or has active cancer, what is the DOC?
Lovenox (LMWH)
74
What is typically used for long-term anticoagulation therapy? What must be considered?
Warfarin
| - Must monitor PT and INR
75
To avoid the burden of PT/INR monitoring, what two groups of medications can be considered?
- Oral Factor Xa inhibitors
| - Oral thrombin inhibitors
76
What is the recommended course of treatment for a DVT?PE that was provoked? Unprovoked?
- Provoked (i.e. surgery): 3 months
| - Unprovoked: consider longer therapy (6-12 months)
77
What course of treatment would be considered for 1st or recurrent episode of unprovoked proximal PE/symptomatic PE, or if underlying thrombophilia or active malignancy?
Lifelong treatment
78
What is the one Anticoagulation Reversal Therapy we discussed in class?
aPCC
79
What are the "clot busters" for DVT/PE and when are they used?
Thrombolytics
| - Used for unstable PE patients
80
What two treatments are used for unstable PE patients?
- Thrombolytics
| - Thrombectomy/Embolectomy
81
Under what four conditions might a patient now be considered for discharge home after diagnosis or DVT/PE?
- Pain controlled
- Compliant/reliable
- Capable of administering injections if subQ tx
- Pay for injectable agents while transitioning to oral Warfarin
82
What type of immune system is the first line of defense, rapid response (minutes/hours), non-specific defense, no memory?
Innate Immune System
83
What type of immune system is the second line of defense, more sophisticated response, highly specific, long-lasting response, develops memory with each exposure?
Acquired Immune System
84
What are the five steps associated with the complement system? What immune system is the complement system associated with?
Innate Immune System
1. Activation via classical pathway
2. Formation of enzyme C3 Convertase
3. Opsonization and phagocytosis
4. Inflammation
5. Membrane Attack Complex (MAC) formation and lysis
85
What is the distribution of WBCs from most numerous → least (think of the mnemonic)?
Neutrophils → Lymphocytes → Monocytes → Eosinophils → Basophils
86
What type of WBC is the first responder, most active against bacteria?
Neutrophils
87
What type of WBC is associated with a "left shift", and what does this indicate?
Neutrophils
| - “Left shift” on CBC = sign of acute bacterial infection
88
What does Neutrophilia often indicate? Neutropenia?
- Neutrophilia: high neutrophils = bacterial infection
| - Neutropenia: low neutrophils = viral infection
89
What type of WBC is the largest?
Monocytes
90
What type of WBC become tissue resident macrophages or dendritic cells; found in blood and SPLEEN?
Monocytes
91
What type of WBC is most active against large parasites; found in mucous membranes?
Eosinophils
92
What two types of WBCs release histamines?
- Basophils
| - Mast cells
93
What two types of WBCs are involved in the allergy response?
- Eosinophils
| - Basophils
94
What type of WBCs are involves in anaphylaxis reactions?
Mast cells
95
What lymphatic organ hosts B cell maturation?
Bone marrow (primary)
96
What lymphatic organ hosts T cell maturation?
Thymus (primary)
97
What lymphatic organ is largest; removes old RBCs, stores RBCs and recycles iron; synthesizes antibodies?
Spleen (secondary)
98
What lymphatic organ has increased susceptibility to encapsulated bacteria (like Strep pneumoniae, H. influenzae and N. meningitidis)?
Spleen (secondary)
99
What lymphatic organ filters foreign molecules and cancer cells?
Lymph nodes (secondary)
100
What lymphatic organ is the 1st line of defense against ingested/inhaled pathogens; combats common cold?
Tonsils/Adenoids (secondary)
101
What lymphatic organ attacks antigens passing through mucosal epithelium?
MALT (secondary)
102
What are the two types of adaptive immunity?
- Humoral
| - Cell-Mediated
103
What type of adaptive immunity involves antibody-mediated, B-lymphocyte cells, extracellular pathogens?
Humoral (Adaptive Immunity)
104
What type of adaptive immunity involves direct cell-to-cell contact, T-lymphocyte cells, intracellular pathogens?
Cell-Mediated (Adaptive Immunity)
105
What type of Adaptive Immunity involves ONE step activation? Which involves TWO step activation?
- ONE: Humoral
| - TWO: Cell-Mediated
106
What type of antibody is the first responder, activates complement system, LARGE; NOT cross placenta?
IgM
107
What type of antibody is the second responder; most abundant and longest half-life; good at opsonization?
IgG
108
What type of antibody is found primarily in mucosal membranes?
IgA
109
What type of antibody binds to mast cells → release of histamine?
IgE
110
What type of immunity is obtained via breastfeeding or infusion?
Passive immunity
111
What type of immunity is obtained via exposure to antigen OR vaccine?
Active immunity
112
What is the growth pathway by which B cells and T cells progress (3 steps)?
1. Immature (bone marrow)
2. Mature naïve (bone marrow OR thymus)
3. Activated (secondary lymph organs)
113
Which type of cell is activated via TCR binds to MHC-antigen complex of antigen-presenting cell (APC), THEN TCR CD28 binds with B7, located on the APC?
T cells
114
What type of T cell has CD4+ surface receptors; binds to MHC II?
Helper T cells
115
What type of T cell has CD8+ surface receptors; binds to MHC I?
Cytotoxic T cells
116
What type of T cell distinguish self vs. non-self?
Suppressor T cells
117
What type of T cell recognizes antigens from previous exposures?
Memory T cells
118
What type of cell are Antigen-Presenting Cells (APCs)?
ANY nucleated cell in body
119
What is found on surface of ALL nucleated cells?
MHC I
120
What surface complex presents to cytotoxic T-cells (which contain CD8+ receptors)?
MHC I
121
What surface complex presents to helper T-cells (which contain CD4+ receptors)?
MHC II
122
What is found only on surface of B-cells, dendritic cells, macrophages?
MHC II
123
What are the three B symptoms?
- Weight loss
- Fever
- Night sweats
124
What is the most common acute leukemia in ADULTS (age 65 years)?
Acute Myeloid Leukemia (AML)
125
What is CA of bone marrow and lymphatic system?
Leukemia (4 types: AML, CML, ALL, CLL)
126
What type of CA is associated with chemical exposure/radiation or myelodysplastic syndrome (MDS)?
Acute Myeloid Leukemia (AML)
127
What type of CA involves pancytopenia (reduced production of RBCs, WBCs, platelets); elevated LDH?
Acute Myeloid Leukemia (AML)
128
What type of CA involves Auer rods; leukemic blasts (>20% on bone marrow aspiration and biopsy)?
Acute Myeloid Leukemia (AML)
129
What condition involves risk for progression to AML?
Myelodysplastic Syndrome (MDS)
130
What two conditions are often asymptomatic/found routinely on CBC?
- Myelodysplastic Syndrome (MDS)
| - Chronic Myeloid Leukemia (CML)
131
What condition involves a tx of donor bone marrow transplant = only possible cure?
Myelodysplastic Syndrome (MDS)
132
What condition is a oncologic emergency (high mortality)?
Tumor Lysis Syndrome
133
What condition is often caused by chemotherapy initiation (<1 day); can be spontaneous?
Tumor Lysis Syndrome
134
What type of CA is associated with BCR-ABL1/Philadelphia chromosome?
Chronic Myeloid Leukemia (CML)
135
What type of CA involves ionizing radiation as a risk factor?
Chronic Myeloid Leukemia (CML)
136
What is the most common phase of Chronic Myeloid Leukemia (CML)?
Chronic phase: most common
137
What type of CA involves a tx of donor stem cell transplant = only possible cure?
Chronic Myeloid Leukemia (CML)
138
What type of CA involves complications of tumor lysis syndrome; hyperviscosity syndrome; hyperleukocytosis = emergency?
Chronic Myeloid Leukemia (CML)
139
What is the most common cancer in children/teens (age 2-5 years)?
Acute Lymphoblastic Leukemia/Lymphoma (ALL)
140
What type of ALL is most cases of childhood ALL?
Precursor B-cell ALL
141
What type of ALL involves older age/mostly males; very high WBC count at dx?
T-cell ALL
142
What type of ALL is also called Burkitt cell; favorable prognosis?
Mature B-cell ALL
143
What type of CA involves LAD, hepatosplenomegaly, pallor, bone/MSK pain, fever?
Acute Lymphoblastic Leukemia/Lymphoma (ALL)
144
What type of CA shows lymphoblasts on peripheral smear and on bone marrow or tissue biopsy?
Acute Lymphoblastic Leukemia/Lymphoma (ALL)
145
What two conditions indicate a better diagnosis for Acute Lymphoblastic Leukemia/Lymphoma (ALL)?
- Child
| - B-cell ALL
146
What is the ONLY adult leukemia (age 70 years)?
Chronic Lymphocytic Leukemia (CLL)
147
What type of CA involves B-cell lymphocytosis?
Chronic Lymphocytic Leukemia (CLL)
148
How can you differentiate the two stages of Chronic Lymphocytic Leukemia (CLL)?
- Indolent stage: often asymptomatic
| - Advanced stage/Terminal phase: inclusion of B symptoms
149
What type of CA involves organomegaly (lymph, spleen, liver); skin involvement?
Chronic Lymphocytic Leukemia (CLL)
150
What is the only cancer that involves a tx of observation (that we discussed)? Under what conditions would this be considered?
Asymptomatic or early stage 1 Chronic Lymphocytic Leukemia (CLL)
151
What is the recommended treatment for symptomatic or advanced stage Chronic Lymphocytic Leukemia (CLL)?
Rituximab/other monoclonal antibodies
152
What type of CA begins in lymphocytes (lymph nodes, spleen, thymus, bone marrow, tonsils/adenoids)?
Lymphoma
153
What three symptoms present with both types of Lymphoma?
- Painless LAD
- Mediastinal mass
- B symptoms
154
What type of CA is associated with EBV as a risk factor?
Hodgkin Lymphoma (HL)
155
In what age group is Hodgkin Lymphoma (HL) more common/ What about for Non-Hodgkin Lymphoma (NHL)?
- Hodgkin Lymphoma (HL): 15-34 years
| - Non-Hodgkin Lymphoma (NHL): 66 years
156
What type of CA involves painless LAD, mediastinal mass, severe pain after alcohol, B symptoms, fatigue, pruritis/no rash?
Hodgkin Lymphoma (HL)
157
What type of CA shows Reed-Sternberg cells (“popcorn” cells) on peripheral smear?
Hodgkin Lymphoma (HL)
158
What type of CA can lead to other cancer or heart disease?
Hodgkin Lymphoma (HL)
159
What type of CA has a worse prognosis if bilateral LAD, bulky disease, distant spread?
Hodgkin Lymphoma (HL)
160
What type of CA involves extra lymph sites, painless LAD, mediastinal mass, B symptoms?
Non-Hodgkin Lymphoma (NHL)
161
What type of CA is diagnosed by biopsy (prefer 2+ cm lymph nodes); CT/PET scan; bone marrow aspiration and biopsy (specifically discussed)?
Non-Hodgkin Lymphoma (NHL)
162
What type of CA involves malignancy of plasma cells?
Multiple Myeloma (MM)
163
In what population is Multiple Myeloma (MM) more common?
African Americans
164
What type of CA involves back pain, neurologic changes, bone pain, fatigue?
Multiple Myeloma (MM)
165
What type of CA shows paraproteins on Protein Electrophoresis?
Multiple Myeloma (MM)
166
What type of CA involves an M spike? What does this indicate?
```
Multiple Myeloma (MM)
- Early indication of malignancy
```
167
What type of CA involves anemia (Rouleaux formation)?
Multiple Myeloma (MM)
168
What type of CA involves Bence-Jones proteins in urine?
Multiple Myeloma (MM)
169
What type of CA involves lytic lesions and generalized osteoporosis on axial skeleton x-ray?
Multiple Myeloma (MM)
170
What type of CA involves CRAB (diagnostically), and what does each letter stand for?
Multiple Myeloma (MM)
- Calcium
- Renal
- Anemia
- Bony lesions
171
What type of CA is associated with hyperviscosity syndrome?
Multiple Myeloma (MM)
172
What is the treatment for Multiple Myeloma (MM)?
IV bisphosphonates
173
What is the primary cause of Atherosclerosis?
Endothelial dysfunction
174
What are the steps in Atherosclerosis?
1. Fatty streak
2. Fibrous plaque
3. Atherosclerotic plaque (calcification)
4. Plaque rupture/fissure with thrombosis
175
What condition involves insufficient blood flow/O2 to meet metabolic demand due to thrombus or embolus?
Ischemia
176
What condition is underdiagnosed but highly prevalent?
Peripheral Artery Disease (PAD)
177
What condition is an independent mortality predictor?
Peripheral Artery Disease (PAD)
178
What is the most common etiology of Peripheral Artery Disease (PAD)?
Atherosclerosis of LE
179
What are the seven most common risk factors of Peripheral Artery Disease (PAD)?
- HTN
- DM
- Dyslipidemia
- Smoking
- Age
- Obesity
- FH
180
What condition involves a relationship between HBA1c and risk for amputation?
Peripheral Artery Disease (PAD)
181
What condition involves claudication in calf (worse with exercise, better with rest; pain worse with elevation?
Peripheral Artery Disease (PAD)
182
What condition involves Leriche syndrome? What are the three aspects of this syndrome?
Peripheral Artery Disease (PAD)
- Claudication
- Absent/diminished femoral pulses
- ED
183
What condition involves pallor with foot elevation, rubor when lowered; hairless skin; ulcers; diminished/absent pulses?
Peripheral Artery Disease (PAD)
184
What condition uses Ankle-Brachial Index/ABI diagnostically? What is an abnormal result?
Peripheral Artery Disease (PAD)
| - <0.90 with exertional symptoms
185
What is the gold standard diagnostic test for Peripheral Artery Disease (PAD)?
CTA or MRA (MRA is more expensive/longer but better)
186
What is the primary treatment for Peripheral Artery Disease (PAD)?
Lifestyle modifications and aggressive risk factor reduction
187
What is the recommended treatment for claudication?
WALK (creates collateral blood flow)
188
What condition involves possible treatment of endovascular (PTA +/- stents, atherectomy) or surgery (bypass graft)?
Peripheral Artery Disease (PAD)
189
What two conditions are an EMERGENCY due to threatened limb?
- Critical Limb Ischemia
| - Acute Arterial Occlusion
190
What condition involves ischemic rest pain: pain forefoot/toes aggravated by elevation (hang legs over side of bed); non-healing wounds/ulcers; gangrene?
Critical Limb Ischemia
191
What is the recommended tx for Critical Limb Ischemia?
Endovascular vs. surgery urgently
192
What is the most common cause of Acute Arterial Occlusion?
Thromboembolism
193
What condition involves the 6 P's, and what are they?
Acute Arterial Occlusion
- Paresthesia
- Pain (distal)
- Pallor
- Pulselessness
- Poikilothermia/coolness
- Paralysis
194
What condition is caused by valvular incompetence OR DVT with residual vein damage?
Chronic Venous Insufficiency
195
What condition involves late stage symptoms of significant edema, skin changes, ulcers?
Chronic Venous Insufficiency
196
What condition involves telangiectasias, prominent superficial veins; stasis dermatitis; ulcerations; edema?
Chronic Venous Disease (CVD)
197
What condition involves risk factors of older age, obesity, smoking, prior DVT, pregnancy, prior trauma, FH, standing occupation?
Chronic Venous Disease (CVD)
198
What condition involves venous HTN → dysfunction of venous valves, failure of “venous pump"?
Chronic Venous Disease (CVD)
199
What is pigmentation due to Hb byproduct? What condition is it associated with?
Hemosiderin staining
| - Chronic Venous Disease (CVD)
200
What condition involves lipodermatosclerosis and stasis dermatitis?
Chronic Venous Disease (CVD)
201
What is inflammation, scaling, pruritis (commonly medial ankle)?
Stasis dermatitis
202
For all peripheral vascular diseases, what diagnostic tool is often used in office, if available?
Doppler US
203
What is the gold standard diagnostic tool for Chronic Venous Disease (CVD)?
Venography
204
What condition involves recommended tx of elevate legs; compression therapy? What MUST be ruled out before beginning compression therapy (3)?
Chronic Venous Disease (CVD)
| - Only if arterial disease/DVT/cellulitis ruled out
205
What condition involves recommended tx of ablations; sclerotherapy; surgery (vein stripping/grafting)?
Chronic Venous Disease (CVD)
206
Is pain upon walking, resolves with rest associated with arterial PVD or venous PVD?
Arterial
207
Is cramping associated with arterial PVD or venous PVD?
Arterial
208
Is worsening pain when leg is elevated associated with arterial PVD or venous PVD?
Arterial
209
Is relief of pain in dependent position associated with arterial PVD or venous PVD?
Arterial
210
Is pain worse with standing associated with arterial PVD or venous PVD?
Venous
211
Is tired, heavy legs associated with arterial PVD or venous PVD?
Venous
212
Is relief of pain with leg elevation associated with arterial PVD or venous PVD?
Venous
213
Is increased discomfort with limb dependency associated with arterial PVD or venous PVD?
Venous
214
Are ulcers of the toe joints, malleoli, anterior shin, base of heel or pressure points associated with arterial PVD or venous PVD?
Arterial
215
Are ulcers with a dry, often pale/necrotic base associated with arterial PVD or venous PVD?
Arterial
216
Are ulcers WITHOUT a pulse associated with arterial PVD or venous PVD?
Arterial
217
Is skin with atrophy, shiny, taut, loss of hair associated with arterial PVD or venous PVD?
Arterial
218
Are ulcers of the malleoli above bony prominences, posterior calf, large/circumferential associated with arterial PVD or venous PVD?
Venous
219
Are ulcers with a pulse associated with arterial PVD or venous PVD?
Venous
220
Are ulcers with a pink/red, yellow, exudate base associated with arterial PVD or venous PVD?
Venous
221
Is skin with erythema, hyperpigmentation, edema, dry, varicosities associated with arterial PVD or venous PVD?
Venous
222
What is the most common cause of aortic disease?
Atherosclerosis
223
What type of aortic dissection has the worst prognosis?
Type A
224
What condition involves sudden onset severe/persistent chest pain, that radiates to back; syncope; CVA-like symptoms; Hypertensive → Hypotensive/Shock?
Aortic disease
225
What is the test of choice for Aortic disease?
CT chest/abdomen
226
What might a CXR for Aortic disease show?
Widened mediastinum
227
What type of Aortic disease is catastrophic (no time for emergent repair)?
Thoracic Aortic Aneurysm (TAA) that RUPTURES
228
What is the most common site for an Abdominal Aortic Aneurysm (AAA)?
Infrarenal abdominal aorta
229
What condition involves excruciating abdominal pain radiation to back just before rupture?
Abdominal Aortic Aneurysm (AAA)
230
What is the test of choice for Abdominal Aortic Aneurysm (AAA) SCREENING?
Abdominal US
231
What condition involves TIA; Amaurosis fugax (transient blindness)?
Cerebrovascular Disease: Carotid Artery Stenosis
232
What condition involves carotid bruit, absent pupillary light reflex?
Cerebrovascular Disease: Carotid Artery Stenosis
233
What diagnostic tool should be considered first with Cerebrovascular Disease: Carotid Artery Stenosis?
Carotid duplex
234
What is the gold standard diagnostic test for Cerebrovascular Disease: Carotid Artery Stenosis?
Cerebral angiography
