TruLearn Question Pearls

Question 1

Describe the scoring system for the Well’s criteria (clinical risk assessment for PE)

Answer 1

• Clinical symptoms of DVT (leg swelling, pain on palpation) - 3.0 points
• Other diagnosis less likely than PE - 3.0 points
• Heart rate > 100 - 1.5 points
• Immobilization for > 3 days or surgery within 4 weeks - 1.5 points
• Previous DVT/PE - 1.5
• Hemoptysis - 1.0 points
• Malignancy - 1.0 points

High probability of PE > 6.0 points
Moderate probability of PE 2.0 - 6.0 points
Low probability of PE < 2.0 points

Modified Well’s criteria
PE likely >4.0 points
PE unlikely < /= 4.0 points

Question 2

What velocities on mesenteric duplex are consistent with >70% stenosis of Celiac or SMA?

Answer 2

Celiac: >200 cm/s
SMA: >275 cm/s

Question 3

Treatment for Type B aortic dissection

Answer 3

• Strict blood pressure control with a beta-blocker
• Indications for Emergent Surgery
• – renal failure
• – signs of mesenteric ischemia
• – acute lower extremity ischemia

Question 4

In Carotid Endarterectomy, what muscle may require division for distal control?

Answer 4

The posterior digastric muscle is divided for high lesions.

Question 5

What is the MOST common location of peripheral aneurysms?

Answer 5

Popliteal artery = most common

Common femoral artery = 2nd most common

Question 6

What artery supplies the posterior flap in BKA, and with good flow, decreases the risk for stump breakdown?

Answer 6

Sural Artery (branch of above-knee popliteal, supplies the gastrocnemius and soleus muscles)

Question 7

What is the most likely cause of late access complications in AV fistula/graft?

Answer 7

Intimal hyperplasia of the graft-venous anastomosis

Question 8

What causes Amaurosis fugax?

Answer 8

An isolated embolism to the retinal or ophthalmic artery, which is the first branch of the internal carotid artery. Chances of embolization to the ophthalmic artery are increased with ulcerative plaques.

Question 9

What vascular injury is associated with posterior knee dislocation?

Answer 9

popliteal artery injury

Question 10

What vascular injury is associated with Anterior hip dislocation?

Answer 10

femoral artery injury

Question 11

What vascular injury is associated with Posterior shoulder dislocation?

Answer 11

axillary artery

Question 12

What vascular work-up is required for posterior knee dislocation?

Answer 12

ABI >0.9 and Observation for 12-24 hours.

If patient alert and able to give a reliable exam, CTA no longer routinely recommended

Question 13

What vessel is the MOST likely site of fibromuscular dysplasia?

Answer 13

Fibromuscular dysplasia (FMD) typically occurs in the renal artery of females between the ages of 40-50.