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RCE Guidelines Studying > Laflamme- Chapter 8 (Peripheral Vascular Disease) > Flashcards

Laflamme- Chapter 8 (Peripheral Vascular Disease) Flashcards

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1
Q

What is the definition of an aneurysm?

A
  • Diameter > 150% of normal for age/gender/BSA
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2
Q

What is the definition of a pseudo-aneurysm?

A

-Rupture of arterial wall contained by hematoma and adjacent tissues

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3
Q

What are 4 infectious causes of TAA?

A
  • Syphilis
  • HIV
  • Salmonella
  • Staphylococcus
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4
Q

Indication for TAA repair in degenerative dx?

A
  • 5.5 cm
  • more than 5mm/yr
  • Compressive symptoms
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5
Q

Repair for TAA if going for AVR?

A

-4.5 cm

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6
Q

3 indications for Aortic repair in BAV?

A
  • 5.5cm
  • > 5 cm if family history of dissection
  • > 5mm/ year
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7
Q

Aortic repair in patients with Marfans, Loeys Deitz and Turners?

A
  • 5 cm
  • 44mm or more
  • > 25mm/m2
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8
Q

Definition of large mediastinum on AP CXR?

A
  • > 8cm at the carina
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9
Q

Follow up by CTA for Dissection treated conservatively?

A

-1, 3, 6, 12, 18, 24 months

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10
Q

What are 3 indications to surgically repair type b dissection when initially managed conservatively?

A

> 55-60mm

> 4mm/year growth

Target organ ischemia or recurrent pain

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11
Q

Definition of AAA?

A

> 30 mm

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12
Q

6 RFs for AAA?

A
  • Age
  • Male
  • Smoking
  • COPD
  • HTN
  • Dyslipidemia
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13
Q

When to screen for AAA?

A

-Male aged 65-80 (updated)

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14
Q

Indications for AAA? (4)

A

> 55 mm

Symptoms

Progression > 10mm/yr

Infectious or inflammatory

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15
Q

Surveillance for AAA based on size?

A

30-39mm: q3 years

40-44mm: q2 years

> 45mm: q1 years

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16
Q

Name 4 genetic aortopathies and their genetic mutations

A

Marfan: FBN1 (AD)

LD: TGFBR1 (AD)

ED Type 4: COL3A1 (AD)

Turners 45XO

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17
Q

4 inflammatory causes of Aortopathy?

A
  • Takayasu’s
  • GCA
  • Bechets
  • Ank Spond
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18
Q

What is 5 year mortality for patients with PAD?

A

10-15%, equal risk to CAD

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19
Q

What is the Fontine classification for PAD?

A
  1. Asymptomatic
  2. Intermittent Claudication
  3. Rest pain
  4. Ulcer/Gangrene
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20
Q

Who should get an ABI? (4)

Study These Flashcards
A

Suspected claudication

Poor wound healing

> 50 years + DM/Smoking

> 65 with intermediate FRS

21
Q

What is subclavian steal syndrome?

Study These Flashcards
A

Claudication of the arm, reversal of flow of the vertebral artery or of a mammay bypass grafts to perfuse the arm

BP difference of 10 mmhg

22
Q

Why does Bilateral Renal Artery Stenosis result in flash pulmonary edema?

Study These Flashcards
A

-Increased BP with salt and water retention in the absence of compensatory sodium excretion -> flash pulmonary edema

23
Q

5 reasons to investigate for RAS?

Study These Flashcards
A

Onset of HTN < 30 or > 55

Severe or refractory HTN

Underlying atherosclerosis

Increase Cr > 30% with ACE/ARB

Recurrent flash pulmonary edema

24
Q

2 trials that support additional ECG monitoring beyond 24h for SCAF in TIA/Stroke?

Study These Flashcards
A
  • Embrace

- Crystal-AF

25
What is NNT for CEA in Symptomatic Carotid Artery Stenosis?
6
26
Two class 1 indications for CEA in Carotid artery Stenosis? 1 class II?
Symptomatic 70-99% (1a), 50-69% (Ib) Asymptomatic >70% (2a) Within 14 days
27
What is the pathology of HIT?
Antibodies directed against the neoantigens on proteins PF4 (Proteins released by activated platelets)
28
What should severity and timing of HIT be?
>50% of platelets or thrombosis beginning 5-10 days after the start of heparin
29
What are the 4 components of the 4T score?
Thrombocytopenia (> 50% decrease in plt and keep > 20) Timing (5-10 days post 1st exposure) Thrombosis Other causes (no other cause)
30
Definition of Type 1 PHT?
mPAP > 20 mmhg Wedge < 15 mmhg WU > 3
31
3 meds that cause PAH?
- Anorectics - Fenfluramine - Dexfenfluramine
32
5 systemic causes of PAH?
HIV Collagen Diseases Portal Htn Congenital heart disease/shunt Schistosomiasis
33
3 classes of etiologies for Group 5?
Hematological diseases, Systemic diseases, Systemic diseases
34
7 diagnostic work up for PHTn?
- CXR - PFTs - Immunologic testing - CPAP - Right and Left heart cath - VQ scan - High resolution CT
35
What is definition of positive vasoreactivity testing?
Absolute decrease of mPAP > 10mmhg (to mPAP < 40mmHg) in the absence of decreased CO
36
Three drugs that can be used in for vasoreactivity testing?
Inhaled NO Epoprostenol Adneosine
37
5 conservative managements for PH?
Rehabilitation Avoid high altitude Vaccination Smoking cessation Sodium restriction
38
Name 9 PAH therapies?
- Diuretics - CCBs - Prostanoids (Epoprostenol) - Selexipag - Endothelin Receptor Antagonist (Ambrisentan, Bosentan) - PDE5 inhibitor: Sildenafil, Tadalafil - Guanylase Cyclase stimulator: Riociguat
39
what are 3 histopathologic processes for aortic generation?
- Increase Metalloproteinases - Decreased elastic fibers - Increased proteoglycans
40
What % of Turner's syndrome have BAV? Aortic Coa?
BAV: 20% CoA: 10%
41
What are two criteria for critical limb ischemia?
-Ischemic pain at rest OR Ischemic lesion (ulcer, gangrene)
42
What is one year mortality for someone presenting with one year mortality?
25%
43
Name 5 mechanisms of stroke
- ICH - SAH - Large vessel disease - Lacunar/Small vessel - Cardioembolic
44
What is westermarks sign?
Segmental oligemia secondary to proximal artery occlusion
45
What is Hampton hump?
Triangular hyperdensity adherent to the pleura secondary to pulmonary infarction
46
When to go with Carotid Stenting instead of CEA?
-Focal lesion, Radiation therapy previous in area, high operative risk, obesity
47
What is the only PH therapy that has survival benefit?
-Epoprostenol
48
What are the main adverse effect of Endothelin antagonists?
-Liver injury

RCE Guidelines Studying (52 decks)

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