PVD: Cerebrovasc, Renovasc, Mesenteric Flashcards Preview

Cardiology > PVD: Cerebrovasc, Renovasc, Mesenteric > Flashcards

Flashcards in PVD: Cerebrovasc, Renovasc, Mesenteric Deck (29):
0

4 things that make penumbra worse in stroke

Fever, hypoperfusion, Sz, hyperglycemia

1

Which gender has higher morbidity and mortality after stroke?

Female

2

Which race has higher incidence of stroke?

Black

3

When can you give TPA in stroke?

<4.5h from sxs onset

4

2 contraindications to TPA for stroke

If glucose < 50
If BP> 185/110

5

If pt is on warfarin and has stroke at what INR can you give TPA?

1.7

6

What is upper age limit to give TPA for stroke if within <3 hrs?

None

7

What is upper age limit to give TPA for stroke if within 3-4.5hr

<80

8

Name 4 contraindications for TPA in stroke within 3-4.5h

Age > 80
NIHSS> 25
DM w/ previous stroke
Taking warfarin

9

Can you give TPA for stroke if pt had seizure and is postictal?

No

10

Can you ever give TPA to a patient with even a remote history of ICH?

No

11

What is target BP in stroke pre and post TPA?

< 185/110
< 180/105

12

What do you combine with ASA to treat stroke?

Dipyridamole

13

What is a common side effect of dipyridamole (stroke lecture)

Headaches

14

Is there any benefit for heparin or lovenox in stroke?

No

15

Anatomical criteria (6) making a pt high risk for CEA

Lesion at C2 or higher, or below clavicle
Prior radical neck Sx or radiation
Contralateral carotid occlusion
Prior ipsilateral CEA
Contralateral laryngeal n. palsy
Tracheostoma

16

Medical comorbidities that make pt high risk for CEA

Age > 80
Class III/IV CHF
Class III/IV Angina, LM/2V CAD or recent MI
EF<30%
severe lung dz or renal dz.

17

What did CREST trial show for CEA vs CAS in terms of death, stroke and MI?

Death same
Stroke< CEA
MINote: COMPOSITE ENDPOINTS WERE SAME. CEA=CAS overall.

18

What was the difference in composite endpoints b/w CEA and CAS in CREST trial?

None

19

When can you do carotid bypass?

Never

20

4 reasons to look for RAS

Malignant/resistant HTN
Azotemia after ACEI/ARB
atrophic kidney or size discrepancy
Flash Pulm edema

21

What is a common way to test for renal artery stenosis besides duplex U/S?

Angiography or CTA

22

If a young girl comes with resistant HTN and you see "beads on a string" of renal arteries on MRA, what is next step?

Image carotid arteries

23

What two vessels does fibromuscular dysplasia effect?

Renal and carotid arteries

24

Out of the 5 classifications, what is the most common type of fibromuscular dysplasia?

Medial fibroplasia

25

What is intervention for renal arteries in fibromuscular dysplasia?

Angioplasty without stenting

26

If an elderly woman has abdominal pain out of oroportion to exam, what is diagnosis and imaging modality?

Acute mesenteric ischemia
Aortic angiography

27

If pt has chronic mesenteric ischemia, what is imaging modality?

MRA of abdomen

28

Two signs and sxs of chronic mesenteric ischemia

Weight loss
Post prandial pain