Unit 3 Lecture 3 Flashcards

(47 cards)

1
Q

Def. of aneurysm

A

abnl vessel dilation 1.5-2 times normal size/ greater than 50% enlargement

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2
Q

def of dissection

A

tear in vessel wall creating a true and false lumen

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3
Q

risk factors for atherosclerotic aneurysms

A

tobacco and hypertension

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4
Q

sxs of thoracic aortic aneurysm

A

compression, pain, hoarseness, valve regurg

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5
Q

repair of thoracic AA

A
  • ascending/arch=sternotomy and surgical repair

- descending=left thoracotomy and surgical repair or endovascular repair/graft

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6
Q

debakey classification

A

type1-entire aorta
type2-only ascending
type3-only descending

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7
Q

signs/sxs of aortic dissection

A

chest pain, back pain (b/t shoulder blades), HYPERtension, transient or permanent neuro changes, distal ischemia, acute cardiac failure, widened mediastinum, pleural capping/effusion; rupture=HYPOtension and shock

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8
Q

triad of aortic dissection

A

abrupt onset of thoracic/abd pain, mediastinal +/- aortic widening on CXR, HYPERtension +/- discrepant BP

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9
Q

gold standard imaging for aortic dissection

A

spiral CT

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10
Q

tx of aortic dissection

A

beta blockers (esmolol) then add vasodilators (Nipride), decrease systolic BP to 100-120, decrease LVP, pain control

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11
Q

tx of type A (proximal) aortic dissection

A

emergent surgery

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12
Q

complications of type A (proximal) aortic dissection

A

aortic rupture, cardiac tamponade, acute aortic regurg, acute coronary ischemia

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13
Q

tx of type B (descending aorta) aortic dissection

A

uncomplicated-medical therapy

complicated-surgery or endovascular tx

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14
Q

AAA rupture sxs/signs

A

abdominal pain, pulsatile abd mass, tenderness, and HYPOtension

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15
Q

constellation of ruptured/symptomatic AAA

A

flank/back pain, HD instablity, pulsatile abdominal mass

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16
Q

tx of ruptured/symptomatic AAA

A

ABC, T&C for 10U of PRBCs, U/S, pain control, EKG, go to OR!

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17
Q

cause of thoracic aortic transection

A

rapid deceleration from MVA

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18
Q

clinical clue of thoracic aortic transection

A

respond to fluid->hypotension->respond to fluids->hypotension

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19
Q

dx of thoracic aortic transection

A

CXR then CT

  • “funny-looking mediastinum”
  • blurred aortic knob
  • widened mediastinum
  • 2nd rib fracture
  • pleural effusion
  • apical cappin
20
Q

pts with thoracic aortic transection are at a high risk for what

A

paraplegia (artery of adamkiewicz)

21
Q

causes of myocardial contusion

A

MVA, falls, car vs peds, direct chest trauma

22
Q

sxs of myocardial contusion

A

similar to MI, chest pain, N/V, SOB

23
Q

most common compartments of heart involved in myocardial contusion

24
Q

dx of myocardial contusion

A

serial EKG, tele monitoring, serial enzymes (troponin), echo

25
acute VSD seen on what day
post-MI day 2-5
26
most common location of MI a/w acute VSD
transmural anterolateral MI
27
murmur heard with acute VSD
harsh holosystolic murmur +/- thrill
28
dx of acute VSD
Echo wtih color flow
29
tx of acute VSD
urgent surgical repair
30
timeframe for acute mitral regurg
13 hours up to 5-7 days post MI
31
most common involvement of acute mitral regurg.
posteromedial papillary muscle rupture
32
murmur heard with acute mitral regurg
pansystolic
33
tx of acute mitral regurg
afterload reduction and surgery
34
vessels commonly used in CABG
LIMA and saphenous vein
35
most common arrhythmia to develop following CABG
a fib
36
causes of acute mesenteric ischemia
arterial embolism, arterial thrombus, venous thrombus, non-occlusive etiologies
37
triad of SMA embolism
GI empyting, abdominal pain, underlying cardiac disease
38
non specific labs that are helpful in dx acute mesenteric ischemia
leukocytosis, increased D-dimer, increased lactate
39
dx of acute mesenteric ischemia
CT scan +/- angio
40
tx of acute mesenteric ischemia
ABC, cardiac monitor, O2, IV access, abx, pain control; papaverine infusion, surgical embolecctomy, intraarterial thrombolysis
41
presentation of mesenteric venous thrombosis (MVT)
acute, subacute, or chronic; acute presents with abd pain that is severe in the mid abdomen and out of proportion to physical signs
42
presentation of aorto-iliac occlusive disease
neuro deficit including paralysis, absent femoral pulses
43
tx of aorto-iliac occlusive ds
aorto-bifemoral bypass
44
what is blue toe syndrome
cool, painful, cyanotic toe with preserved pulses; result of embolic occlusion; Bil. involvement indicates an embolic source that is located above the aortic bifurcation
45
most common cause of acute limb ischemia
embolism
46
6 P's of acute obstruction | same as compartment syndrome
pain, pallor, paresthesia, paralysis, pokilothermia, pulselessness
47
tx of acute obstruction
heparin, endovascular thrombolytics, percutaneous removal, etc -watch for reperfusion phenomenon and for compartment syndrome