Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gastroenterology > Mesenteric Vascular Disease > Flashcards

Mesenteric Vascular Disease Flashcards

(48 cards)

Start Studying
1
Q

What part of the intestines is supplied by the celiac plexus?

A

Stomach and duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What part of the intestines is supplied by the SMA?

A

Small bowel from distal duodenum to mid-transverse colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What part of the intestines is supplied by the IMA?

A

Transverse colon to the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which arteries provide collateral circulation between the celiac axis and SMA?

A

Superior and inferior pancreatoduodenal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are two arterial structures that provides collaterals between SMA and IMA?

A

Marginal artery of Drummond

Arc of Riolan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which artery provides collateral flow between the aorta and celiac axis?

A

Phrenic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which arteries provide collateral flow to the rectum?

A

Internal iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are two watershed areas in the colonic blood supply that are common locations for ischemia?

A
  1. Griffith point in splenic flexure

2. Sudeck point in rectosigmoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What percentage of cardiac blood flow goes to the splanchnic circulation under basal conditions?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage of cardiac output goes to the splanchnic circulation post-prandially?

A

At least 35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the classic patient to present with acute mesenteric ischemia?

A
  • Age > 50
  • Hx cardiovascular diseas
  • Sudden onset of abdominal pain that is out of proportion to physical exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the diagnostic procedure of choice for acute mesenteric ischemia?

A

Angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 4 main causes of acute mesenteric ischemia?

A
  1. SMA embolism (50%)
  2. SMA thrombosis (15-20%)
  3. Nonocclussive mesenteric ischemia (NOMA) 20-25%
  4. Mesenteric venous thrombosis (5-10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What percentage of patients with acute mesenteric artery thrombosis have chronic intestinal ischemia?

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the role of plain abdominal x-rays in acute mesenteric ischemia?

A

To rule out other acute abdominal processes such as perforation or obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Although angiography is the gold standard for diagnosing acute mesenteric ischemia, what other imaging modality has an 80% sensitivity?

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment of choice for patients with acute mesenteric ischemia without peritoneal signs?

A

Angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment of choice for patients with acute mesenteric ischemia and peritoneal signs?

A

Emergent laparotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are 3 signs of intestinal ischemia on CT?

A
  1. Small bowel thickening
  2. Small intestinal pneumatosis
  3. Portal venous gas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 3 main causes of mesenteric vein thrombosis?

Study These Flashcards
A
  1. Hypercoagulable state
  2. Inflammatory disorders (eg pancreatitis, intra-abdominal sepsis)
  3. Cirrhosis and portal hypertension
21
Q

The 3 main causes of mesenteric vein thrombosis (hypercoagulable state, inflammatory disorders, cirrhosis/portal HTN) account for what percentage of cases?

22
Q

What is the gold standard for diagnosis of mesenteric vein thrombosis?

Study These Flashcards
A

CT with IV contrast

23
Q

What is the classic finding on CT with IV contrast of mesenteric vein thrombosis, with 90% sensitivity?

Study These Flashcards
A

Dilated SMV with clot or filling defect in lumen

24
Q

What is the treatment of mesenteric vein thrombosis with peritoneal signs?

25
What is conservative treatment of mesenteric vein thrombosis in the absence of peritoneal signs and good mesenteric blood flow demonstrated by angiography?
Anticoagulation for 6 months
26
Which patients typically develop no occlusive mesenteric ischemia?
Elderly with diffuse vascular disease
27
What is the gold standard for diagnosis and management?
Angiography
28
Which medication, delivered intra-arterially, can reverse vasoconstriction and restore mesenteric blood flow?
Papaverine
29
What are the three main arteries that supply the intestines?
1. Celiac artery 2. Superior mesenteric artery (SMA) 3. Inferior mesenteric artery (IMA)
30
Which intestinal artery is most likely to be embolized from dislodged clot from the left atrium, left ventricle or cardiac valves?
Superior mesenteric artery (SMA)
31
Acute thrombosis of the SMA usually occurs at the __1__ of the vessel, which is often severely narrowed due to __2__
1. origin | 2. atherosclerosis
32
Chronic mesenteric ischemia results from reduced blood flow from luminal narrowing due to ____ of at least two of three major arteries (i.e. celiac axis, SMA, IMA)
atherosclerosis
33
What is the classic triad for chronic mesenteric ischemia (CMI)?
1. postprandial abdominal pain 2. weight loss 3. abdominal (epigastric) bruit
34
What percentage of patients have an abdominal (epigastric) bruit in chronic mesenteric ischemia?
50%
35
Although angiography is the diagnostic test of choice, what other (3) tests may be useful for measuring mesenteric blood flow?
1. CT angiography 2. Magnetic resonance angiography (MRA) 3. Doppler ultrasound
36
It is important to correlate angiographic findings with symptoms as patients may have complete occlusion of all three major mesenteric arteries but still remain asymptomatic. Why?
Collateral blood flow
37
What is the most common form of mesenteric ischemia?
Colonic ischemia, i.e. ischemic colitis
38
Colonic ischemia may be initially misdiagnosed as either __1__ or __2__
1. IBD | 2. Infectious colitis
39
Patients who recently have had ____ surgery are at highest risk for colonic ischemia
cardiovascular
40
What percentage of cases of colonic ischemia spontaneously resolve within 2 weeks?
85%
41
What are the two watershed areas of the colon?
1. Splenic flexure | 2. Left colon
42
Why are gangrenous colitis and colonic strictures rare in ischemic colitis/colonic ischemia?
Colonic ischemia is usually mucosal and rarely transmural
43
More than 90% of patients with colonic ischemia are over the age of ____?
60
44
What is the typical presentation of colonic ischemia?
Cramps left lower quadrant pain with mild to moderate real bleeding or bloody diarrhea within 24 hours
45
What triad is associated with colonic ischemia in young women?
1. Smoking 2. Oral contraceptives 3. Factor V leiden
46
PCN-derived drugs given to patients with Klebsiella oxytoca may precipitate ____ ____
hemorrhagic colitis
47
What diagnostic procedure makes a definitive diagnosis in patients with colonic ischemia/ischemic colitis?
Colonoscopy with biopsy
48
What stool studies should be ordered to evaluate ischemic colitis to rule out infection causing hemorrhagic colitis?
1. Escherichia coli O157:H7 2. Campylobacter enteritis 3. Klebsiella oxytoca 4. Shigella 5. Clostridium difficile

Gastroenterology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions