Miscalenous

Question 1

Swan CO

Answer 1

4-8 L/min

Question 2

Swan CI

Answer 2

2.5-4L/min/m2

Question 3

Swan PA pressure

Answer 3

20-30/5-15 mmHg

Question 4

Swan wedge (PAWP)

Answer 4

8-12mmHg

Question 5

Swan SVR

Answer 5

900-1300

Question 6

TPN formula

Answer 6

1g/kg/day protein
25 kcal /kg/day (out of that 25% glucose, 3-4% aminoacids, 10% free fatty acids)
50% non protein calories as glucose and 50% fatty acids

Question 7

sensitivity

Answer 7

true positive / true positive + false negative

ability to SENCE the disease

Question 8

specificity

Answer 8

true negative / true negative + false positive

Question 9

positive predictive value

Answer 9

true positive / true positive + false positive

Question 10

negative predictive value

Answer 10

true negative / true negative + false negative

Question 11

Horner’s syndrome

Answer 11

miosis (constricted pupil)
ptosis
anhydrosis (if pre-ganglionic)
enophtalmus

due to injury of sympathetic chain

Question 12

post - sympathetcomy neuralgia

Answer 12

50% of patients

anteromedial thigh pain

Question 13

Marfan’s mutation

Answer 13

FBN1 mutation

Question 14

TGF-beta - 1 role

Answer 14

causes fibrotic reaction in skin in chronick venous insufficiency (inverted bottle neck)

Question 15

Hollenhorst plaque

Answer 15

cholesterol cristal embolization to retinal circulation, incidental, not associated with increased risk of stroke

Question 16

Hard signs of vascular injury

Answer 16

1) absent distal pulses
2. signs of distal ischemia
3. bruit / thrill
4. active, pulsatile bleeding
5. large, expanding hematoma
6. pulsatile hematoma

Question 17

soft signs of vascular injury

Answer 17

1. non expending hematoma
2. peripheral nerve deficit
3. h/o bleeding at the time of injury
4. hypotension
5. bony injury / penetrating wound

Question 18

nephrogenic systemic fibrosis

Answer 18

after giving gadolinium in patients with renal insufficiency for MRA
diagnosed by skin bx
no treatment

Question 19

what factors are expressed in macrophages of aortic aneurysms

Answer 19

MMP 2 and MMP 9

Question 20

where is MMP 2 mostly expressed

Answer 20

in small aneurysms

Question 21

where is MMP 9 mostly expressed

Answer 21

in large and ruptured aneurysms

Question 22

what inhibits MMP

Answer 22

doxycycline

Question 23

what excretes renin

Answer 23

juxtoglomerular aparatus

Question 24

what’s renin function

Answer 24

conversion of angiotensinogen to angiotensin I

Question 25

where is angiotensinogen produced

Answer 25

liver

Question 26

where is angiotensin converting enzyme produced

Answer 26

lung

Question 27

metabolic syndrome

Answer 27

3 or more of the following: 1. HTN >130 / >85 2. triglicerides >150mg/dl 3. HDL <50 mg/dl for women and <40mg/dl for male 4. fasting blood glucose >110 mg/dl 5. abdominal obesity

Question 28

whats the difference between hemangioma and AV malformation

Answer 28

hemangioma is proliferative and they will involute in puberty. Malformation is on bases of dysmorphogenesis

Question 29

What happens to arteries with age

Answer 29

Larger arteries stiffen with reduced compliance Systolic pressure increases Loss of recoil and ability to maintain the diastolic pressure within compartment Diastolic pressure decreases Plus pressure increases

Question 30

What is the anti inflammatory action of nitric oxide

Answer 30

Inhibits is xpression of pro inflammatory mediators (monocytes chemoattractant protein 1, interleukins, macrophage colony stimulating facto r) Inhibits activity of NF-kB v

Question 31

What is a primary vasoconstrictor

Answer 31

Endothelial. Also potent motive not

Question 32

What is tunica intima

Answer 32

Endothelium Innermost layer Monolayer of endothelium cells Matrix of elastic fibers and collagen

Question 33

Tunic media

Answer 33

Thick middle layer Varying amounts of collagen, elastic fibers and smooth muscles Amount of elastic decreases progressively from large to small vessels Provides structure Maintaining vessel tone Responding to signals from intimate endothelial cells

Question 34

Tunica adventitia

Answer 34

Outermost layer Appears fragile and thin but strong collagen and elastic structure One of the key components in overall strength of artery Collagen, autonomic nerves, vasa vasorum

Question 35

Trunks arterial malformations

Answer 35

``` Persistent sciatic artery Kommerells diverticulum Persistent right subclavian artery Aortic ring Mid aortic syndrome ```

Question 36

What is sciatic artery

Answer 36

Embryonic continuation of internal iliac artery 75% complete - hypoplastic or absent sfa 25% incomplete stops in the thigh

Question 37

Extratunkal arterial malformation definition

Answer 37

Embryologically developed inborn errors of vascular morphogenesis leading to true structural anomalies

Question 38

Types of vascular anomalies and division

Answer 38

1. Tumors - hemangiomas and others | 2. Malformations - high flow and low flow. Low flow - venous, lymphatic and combined

Question 39

Definition of hemangioma

Answer 39

True neoplasticism disorder and pathohistologically demonstrating increase endothelial cell turn over rate

Question 40

Definition of AVM

Answer 40

Arise by dysmorphogenesis without increased endothelial proliferation

Question 41

Infantile hemangioma

Answer 41

Most common vascular anomalies Proliphwrarive phase in first year of life Spontaneous involution Usually doesn’t need treatment Therapy is usually medical with corticosteroids and propranolol

Question 42

AVM on duplex

Answer 42

Demonstrates aretrialized venous waveform and spectral broadening

Question 43

Imaging modality of choice for hemodynamic diagnosis and treatment planning of AVM

Answer 43

DceMRI

Question 44

Bernoulli’s principle

Answer 44

When fluid flows it’s total energy remains constant provided there are no frictional losses When area increases velocity decrease

Question 45

Fluid energy possess

Answer 45

Viscous losses result from friction between adjacent layers of blood or between blood and the vessel wall Inertial losses relate to changes in the velocity or direction of blood flow

Question 46

Poiseuilles law

Answer 46

Pressure equals volume flow times resistance (8xlengthx viscosity over pi x radius to fourth)

Question 47

What does Poiseuille’s law describe

Answer 47

Describes the energy losses in an idealized fluid system | Estimates minimum pressure gradient expected for arterial flow

Question 48

Describe resistance in collaterals

Answer 48

It’s always higher than in normal vessels. | It’s fixed - does not change with exercise —> claudication

Question 49

Which way do you retract text is during spine exposure minimally invasive

Answer 49

Laterally

Question 50

When does retrograde ejaculation occur

Answer 50

Injury to sympathetic nerve plexus